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Homocysteine in sickle cell disease: relationship to stroke
P E Houston1, S Rana, S Sekhsaria
1Department of Pediatrics, Howard University College of Medicine, Washington, D.C., USA.
The American Journal of Medicine
|October 8, 1997
Summary
High homocysteine levels are a significant risk factor for stroke in sickle cell disease (SCD) patients. Further research is needed to understand homocysteine
Area of Science:
- Hematology
- Neurology
- Vascular Biology
Background:
- Sickle cell disease (SCD) complications, including stroke, have poorly defined risk factors and pathophysiology.
- Hyperhomocysteinemia is a known vascular disease risk factor in the general population but uninvestigated in SCD.
Purpose of the Study:
- To investigate the role of hyperhomocysteinemia as a potential risk factor for stroke in patients with sickle cell disease.
Main Methods:
- Serum homocysteine and red cell folate levels were measured in 100 SCD patients (16 with stroke).
- Disease severity was assessed, categorizing patients without stroke into mild (44) or severe (40) groups.
Main Results:
- Stroke patients exhibited significantly higher homocysteine levels (median 13.3 mumol/L) compared to non-stroke patients (median 9.7 mumol/L).
- Homocysteine levels were independently correlated with stroke (P < 0.026) and inversely correlated with folate levels (r = -0.41).
- Patients with homocysteine levels above the median had a 3.5-fold increased odds ratio for stroke.
Conclusions:
- Elevated homocysteine levels may represent a risk factor for stroke development in SCD.
- Prospective studies are warranted to elucidate the role of homocysteine in SCD stroke pathogenesis.
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