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Diagnostic Value of Homocysteine Metabolic Pathway in Coronary Atherosclerosis: A Study on Reference Intervals and
Shen Li1, Furong Zhao2, Mo Hong3,4
1Central Laboratory, Central Hospital of Dalian University of Technology, Dalian, People's Republic of China.
Insights
Establishing reference intervals for homocysteine (Hcy), cysteine (Cys), and methionine (Met) aids in coronary atherosclerosis (CA) risk assessment. These metabolites are independent risk factors, improving CA diagnosis and prediction accuracy.
Area of Science:
- Biochemistry
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Coronary atherosclerosis (CA) risk assessment requires accurate diagnostic tools.
- The homocysteine (Hcy) metabolic pathway, including cysteine (Cys) and methionine (Met), is implicated in cardiovascular health.
- Establishing reliable reference intervals for these metabolites is crucial for clinical application.
Purpose of the Study:
- To determine reference intervals for the homocysteine (Hcy) metabolic pathway in healthy adults.
- To explore the correlations between Hcy, Cys, and Met levels and coronary atherosclerosis (CA).
- To enhance the risk assessment and diagnostic accuracy of CA using Hcy metabolic pathway markers.
Main Methods:
- Direct continuous sampling was used to recruit 426 healthy adults for reference interval determination.
- Serum levels of Hcy, Cys, and Met were analyzed using LC-MS/MS.
- 75 patients diagnosed with CA were included to assess correlations with metabolite levels.
Main Results:
- Reference intervals were established: Hcy 7-25 μmol/L, Cys 227-410 μmol/L, and Met 21-39 μmol/L.
- Significant differences in Met and Hcy levels were observed between sexes but did not meet criteria for separate reference intervals.
- Hcy, Cys, and Met were identified as independent risk factors for CA, with a combined AUC of 0.86, sensitivity of 78%, and specificity of 83%.
Conclusions:
- The Hcy metabolic pathway provides valuable reference values for CA diagnosis and risk prediction.
- Utilizing Hcy, Cys, and Met levels significantly enhances the capability for CA risk assessment.
- This pathway offers a promising approach to improve diagnostic accuracy for coronary atherosclerosis.
Purpose:
To determine the reference intervals of homocysteine (Hcy) metabolic pathway in healthy adults using direct continuous sampling, and to explore their correlations with coronary atherosclerosis (CA) for improving the risk assessment and diagnostic accuracy of CA.
Patients And Methods:
A total of 426 reference individuals were selected via direct continuous sampling of the two centers from healthy adults based on questionnaires and laboratory indicators. Additionally, 75 patients were diagnosed with CA by cardiologists. Standardized analysis of Hcy, cysteine (Cys) and methionine (Met) levels in serum were conducted using commercial assay kits compatible with LC-MS/MS.
Results:
Although Met and Hcy showed significant differences between the sexes, they could not meet the criteria for setting reference intervals. After outlier removal and normality conversion, 95% reference intervals of Hcy, Cys and Met were calculated as 7-25 μmol/L, 227-410 μmol/L, and 21-39 μmol/L, respectively. In addition, the correlations among Hcy, Cys, and Met were influenced by CA, and each served as an independent risk factor. The area under the curve (AUC) for the combined three indicators increased to 0.86 (95% CI: 0.81-0.91). The specificity increased to 83%, while the sensitivity reached 78%.
Conclusion:
The Hcy metabolic pathway significantly enhances risk assessment capability and may be helpful in providing reference values for the diagnosis and risk prediction of CA.
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