Serum Homocysteine Levels Correlate With Carotid Intima-Media Thickness in Adults With Subclinical Atherosclerosis: A...

Early atherosclerosis may remain clinically silent until significant vascular disease develops. Carotid intima-media thickness is a useful non-invasive measure for detecting subclinical vascular wall changes. Serum homocysteine has been linked to endothelial dysfunction, oxidative stress, and vascular inflammation. The present study was conducted with the following objectives: (1) to compare serum homocysteine levels between adults with subclinical atherosclerosis and controls; (2) to assess the correlation between serum homocysteine levels and carotid intima-media thickness; and (3) to evaluate the diagnostic performance of serum homocysteine in identifying subclinical atherosclerosis.

A cross-sectional analytical study was conducted among 120 adults aged 30-60 years. Participants were divided into two groups: individuals with subclinical atherosclerosis (n=60), identified by increased carotid intima-media thickness (CIMT >0.8 mm), and age- and sex-matched controls (n=60). Fasting serum homocysteine levels were measured using an immunoassay. CIMT was assessed by high-resolution ultrasonography. Statistical analysis included independent t-test, Pearson correlation, and receiver operating characteristic (ROC) analysis.

Mean serum homocysteine levels were significantly higher in the subclinical atherosclerosis group compared to controls (18.6 ± 5.2 µmol/L vs 10.9 ± 3.7 µmol/L, p<0.001). CIMT values were also elevated in cases (0.92 ± 0.08 mm) compared to controls (0.64 ± 0.07 mm, p<0.001). A moderate positive correlation was observed between homocysteine levels and CIMT (r=0.62, p<0.001). ROC analysis showed an area under the curve (AUC) of 0.84 for homocysteine, with a cut-off value of 14.5 µmol/L yielding 78% sensitivity and 82% specificity for detecting early atherosclerosis.

Elevated serum homocysteine is strongly associated with early vascular changes and correlates with CIMT. It may serve as a useful, accessible biomarker for early detection of atherosclerosis in clinical settings.