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Association between Homocysteine and Cerebral Small Vessel Disease: A Meta-Analysis

Xiangyu Piao1, Guangyao Wu2, Pei Yang2

  • 1Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|May 27, 2018
PubMed

Insights

Elevated homocysteine levels are linked to a higher risk of cerebral small vessel disease (CSVD) and its subtypes. This meta-analysis confirms a significant association between higher homocysteine and CSVD prevalence.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Biochemistry

Background:

  • Cerebral small vessel disease (CSVD) encompasses various cerebrovascular conditions affecting small arteries, arterioles, capillaries, and venules.
  • Elevated homocysteine levels have been implicated as a potential risk factor in cardiovascular and neurological diseases.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the association between elevated homocysteine levels and the risk of different subtypes of cerebral small vessel disease (CSVD).

Main Methods:

  • Systematic literature search of electronic databases up to April 2018 for studies reporting homocysteine levels in CSVD patients and controls.
  • Inclusion and exclusion criteria were applied, followed by data extraction.
  • Meta-analysis was performed using Stata v.12.0, employing standardized mean difference (SMD) and 95% confidence intervals (CI) for comparisons.

Main Results:

  • Eighteen studies with 5088 participants (1987 CSVD patients, 3101 controls) were included.
  • Overall, CSVD patients exhibited significantly higher homocysteine levels compared to controls (SMD = 0.50, 95% CI: 0.36-0.64).
  • Subgroup analyses indicated significantly higher homocysteine levels in white matter lesions (SMD = 0.56, 95% CI: 0.39-0.73), silent brain infarction (SMD = 0.33, 95% CI: 0.24-0.42), and lacunar infarction (SMD = 0.17, 95% CI: -0.06 to 0.40).

Conclusions:

  • This meta-analysis demonstrates a significant association between elevated homocysteine levels and the presence of CSVD and its subtypes.
  • Further prospective, population-based studies are warranted to investigate the longitudinal relationship between homocysteine levels and the progression of various CSVD subtypes.
Abstract

Keywords:
Cerebral small vessel diseasehomocysteinemeta-analysisstroke

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