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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
PubMed

Insights

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.
Abstract

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