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[Homocysteinemia as a risk factor in early cerebrovascular disease]
R P Reis1, J Azinheira, H P Reis
1Serviço de Medicina, Hospital S. Francisco Xavier, Lisboa.
Insights
High homocysteine levels are a risk factor for early thrombotic cerebrovascular disease in individuals under 55. Methionine loading tests are more effective than basal tests for identifying this risk.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Cerebrovascular disease poses a significant health burden, particularly in younger populations.
- Identifying novel risk factors for early-onset thrombotic events is crucial for preventative strategies.
Purpose of the Study:
- To investigate whether hyperhomocysteinemia is a risk factor for thrombotic cerebrovascular disease in patients under 55 years of age.
- To compare the diagnostic utility of basal versus methionine-loaded homocysteinemia measurements.
Main Methods:
- A case-control study involving 33 patients (under 55) with confirmed ischemic stroke and matched healthy controls.
- Exclusion criteria included alcoholism, renal/hepatic insufficiency, and recent B vitamin intake.
- Plasma homocysteine levels were measured basally and after a methionine load.
Main Results:
- Patients with early thrombotic cerebrovascular disease exhibited significantly higher basal (p < 0.05) and methionine-loaded (p < 0.01) homocysteine levels compared to controls.
- The methionine loading test demonstrated greater discriminative power than basal homocysteine measurement.
Conclusions:
- Hyperhomocysteinemia is identified as a risk factor for thrombotic cerebrovascular disease in individuals under 55.
- Methionine loading enhances the detection of hyperhomocysteinemia as a risk factor.
- Further research with larger cohorts is needed to ascertain the relative importance of homocysteine among other vascular risk factors.
Purpose:
To determine whether hyperhomocysteinemia represents a risk factor of early thrombotic cerebrovascular disease.
Method:
In a group of patients under 55 years of age (n = 33, 19 males) which had suffered a stroke from 3 months to 1 year before the study, defined by clinical criteria and presence of cerebral infarction confirmed by tomography, without history or predisposition to embolic disease. The patients were matched with a group of normal controls of checkup program, in terms of age, and sex. Patients and controls with a history of alcoholism, clinical or laboratory signs of renal or hepatic insufficiency or with a history of recent ingestion of Group B vitamins were excluded since these conditions would influence homocysteinemia levels. We measured the plasmatic basal homocysteinemia of patients and controls (HC) and 6 hours later a methionine overload of 0.1 g/Kg body weight (LOAD HC).
Results:
Patients; Controls; Signific.; Age 46.0 +/- 7.7; 45.9 +/- 7.8; NS; Basal HC. 10.1 +/- 3.4; 8.5 +/- 1.7; p < 0.05; Load HC 28.0 +/- 7.6; 22.7 +/- 5.5; p < 0.01.
Conclusion:
In this study hyperhomocysteinemia appears as a risk factor for thrombotic cerebrovascular disease before the age of 55;-The measurement of homocysteinemia after the methionine loading test was more discriminative than the basal measurement;-A larger number of patients and controls will be necessary to establish the relative importance of homocysteinemia among other vascular risk factors in cerebrovascular disease.