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La cisteína total en plasma como factor de riesgo de enfermedades vasculares: El proyecto europeo de acción
L El-Khairy1, P M Ueland, H Refsum
1LOCUS for Homocysteine and Related Vitamins, University of Bergen, Bergen, Norway. lina.el-khairy@smis.uib.no
Circulation
|May 31, 2001
Resumen
La cisteína total plasmática (tCys) muestra un vínculo en forma de U con el riesgo de enfermedad vascular, con niveles bajos y altos que aumentan el riesgo. Esto contrasta con la homocisteína total (tHcy), un conocido factor de riesgo cardiovascular.
Área de la Ciencia:
- La bioquímica es la bioquímica.
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Epidemiología La epidemiología.
Sus antecedentes:
- El aumento de la homocisteína total en plasma (tHcy) es un factor de riesgo reconocido de enfermedad cardiovascular (ECV).
- La asociación entre la cisteína total en plasma (tCys) y el riesgo de ECV sigue siendo poco investigada a pesar de los vínculos metabólicos con tHcy.
Objetivo del estudio:
- Investigar la relación entre los niveles plasmáticos de cisteína total (tCys) y el riesgo de enfermedad vascular a través de los vasos coronarios, cerebrales y periféricos.
Principales métodos:
- Un estudio de caso-control en el que participaron 750 pacientes con enfermedades vasculares y 800 controles en 9 países europeos.
- Se midieron los niveles plasmáticos de tCys, tHcy, ácido fólico, B6, B12 y creatinina.
- Ajustado por los factores de riesgo convencionales de enfermedad cardiovascular.
Principales resultados:
- Se observó una relación significativa en forma de U entre los niveles de tCys y el riesgo general de enfermedad vascular.
- Los niveles bajos de tCys (<=225 micromol/L) mostraron un riesgo ajustado de 2,1 (IC del 95% 1,2 a 3,6).
- Los niveles altos de tCys (>300 micromol/L) mostraron un riesgo ajustado de 1,6 (IC del 95% 1.1 a 2.3) en comparación con los niveles de referencia (250-275 micromol/L).
- Las relaciones dosis-respuesta variaron según el lecho vascular: en forma de U para la enfermedad periférica y cerebrovascular, débil positivo para la enfermedad coronaria.
Conclusiones:
- La cisteína total plasmática (tCys) exhibe una asociación significativa en forma de U con el riesgo de enfermedad cardiovascular.
- Esta relación persiste después de ajustar por tHcy, creatinina y otros factores de riesgo de ECV.
- Los hallazgos destacan tCys como un marcador potencial e independiente para el riesgo de enfermedad vascular.
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