Raised serum homocysteine levels in patients of coronary artery disease and the effect of vitamin B12 and folate on its concentration

Springer Science and Business Media LLC - Tập 21 - Trang 95-100 - 2006
R Abraham1, M Joseph John2, R Calton3, J Dhanoa2
1Dept of Biochemistry, Christian Medical College, Ludhiana
2Dept of Medicine, Christian Medical College, Ludhiana
3Dept of Cardiology, Christian Medical College, Ludhiana

Tóm tắt

Homocysteine(Hcy) has been implicated as a novel risk factor of Coronary Artery Disease (CAD) among Asian Indians, but many studies done in India failed to reveal any direct correlation. It has also been reported that Folic acid and Vitamin B12 levels inversely affect serum levels of homocysteine. In this study, we looked at the levels of homocysteine among patients with CAD. The effect of Vitamin B12, Folate and other risk factors on homocysteine levels were also evaluated. Mean homocysteine levels in cases (22.81±13.9, n=70) were significantly higher (p=<0.001) than the controls (7.77±7.3, n=70). However no statistically significant correlation could be deduced between homocysteine Vitamin B12, and Folate. Cumulative analysis have indicated an increase in homocysteine levels among patients with CAD with every additional risk factor.

Tài liệu tham khảo

Setti, K.K. and Mantri, R.R. (1999). Homocysteine —Emerging evidences as an independent risk factor for CAD. Cardiology Today. 3, 122–129. Scott, J.M. and Weir, D.G. (1998). Folic Acid, Homocysteine and one carbon metabolism: A review of the essential Biochemistry. J Cardiovascular Risk. 5, 223–227. Stampfer, M.J., Malinow, M.R., Wilet, W.C.et al. (1992). A prospective study of plasma homocysteine and risk of myocardial infarction in United States physicians. JAMA. 268, 877–881. Wayne, H.G., Janet, B., Greenlund, K.et al. (2000). Association between total homocysteine and the likelihood for a history of acute myocardial infarction by race and ethnicity. Am. Heart. J. 139, 446–453. Sehlub, J., Jacques, P.F., Bosten, A.G.et al. (1995). Association between plasma homocysteine concentration and extracranial carotiod artery stenosis. N. Engl. J. Med. 332, 286–291. Perry, J., Refsum, H., Morris, R.W., Ebrahim, S.B.,et al. (1995). Prospective study of serum total homocysteine concentration and risk of stroke in middle aged British men. Lancet 346, 1395–1398. Den, M., Henk, T.K., Bos, G.M.et al. (1996). Hyperhomocysteinaemia as a risk factor for deep vein thrombosis. N. Engl. J. Med. 334, 759–762. Harker, L.A., Sherril, J., Ronald, C. and Ross, R. (1974). Homocysteinaemia, Vascular injury and arterial thrombosis. N. Engl. J. Med. 291, 537–543. Brattstrom, E., Lindgren, A., Israilsson, B., Andersson, A. and Hultberg, B. (1994). Homocysteine ans cysteine: determinants of plasma levels in middle aged and elderly subjects. J. Intern. Med. 236, 633–641. Malinow, A. (1994). Homocysteine and arterial occulusive diseases. J. Internal. Med. 236, 603–617. Nygard, O., Volloset, S.E., Refsum, H., Stenvoald, I., Tverdal, A., Nordrehaug, J.E.et al. (1997). Plasma homocysteine levels and mortality in patients with coronary artery diseases. N. Eng. J. Med. 337, 230–236. Chambers, J.C., Obeid, O.A., Refsum, H., Ueland, P., Hacket, D., Hooper, J., Turner, R.M., Thompson, S.G. and Kooner, J.S. (2000). Plasma Homocysteine concentrations and risk of coronary heart disease in UK India Asian and European men. Lancet 160, 422–434. Chacko, K.A. (1998). Plasma homocysteine levels in patients with coronary artery disease. Indian Heart J. 50, 295–299. Gheye, S., Lakshmi, Krishna T.P.et al. (1999). Fibrinogen and Homocysteine levels in coronary artery diseases. Indian Heart J. 51, 499–502. Gersh, B.J., Braunwald, E. and Rutherford, J.D. (1977). Chronic Coronary Artery Disease: In Heart Disease—Textbook of Cardiovascular Medicine. 5th ed. Ed. Braunwald, E. and Saunder, W.B., Philadelphia. 1331–1340. Homocysteine by Enzyme Immunoassay. BIORAD-(Company Manual) 1997. Mc Cully, K.S. (1969). Vascular pathology of homocysteine: Implications for the pathogenesis of arteriosclerosis. Am. J. Pathol. 56, 111–128. Wilken, D.E.L. and Wilken, B. (1976). Pathogenesis of coronary artery disease. A possible role for methionine metabolism. J. Clin. Invest. 57, 1079–1082. Deepa, R., Velmurugan, K., Sarvanan, G., Karkuzhah, Diwakanath V. and Mohan, V. (2001). Absence of association between serum homocysteine levels and coronary artery disease in South Indian males. Indian Heart J. 53, 44–47. Misra, A., Vikram, N.K., Pandey, R.M., Dwivedi, M., Ahmad, F.U., Luthra, K., Jain, K., Khanna, N., Devi, J.R., Sharna, R. and Guleria, R. (2002). Hyperhomocysteinaemia, and low intakes of folic acid and vitamin B12 in urban North India. Eur. J. Nutr. 41 (2), 68–77. Hermann, W., Schorr, H., Purschwitz, K., Rassoul, F. and Richter, V. (2001). Total Homocysteine, Vitamin B12 and total anti oxidants status in vegetarians. Clinical Chem. 47 (6), 1094–1101. Ortega, R.M., Jemenez, A., Andres, P., Faci, M., Lollo, J.M., Lozano, M.C., Bermejo, L.M., Lopez-Sobaler, A.M. and Requejo, A.M. (2002). Homocysteine levels in elderly Spanish people: Influence of pyridoxine, Vitamin B12 and folic acid intakes. J. Nutr. Health Ageing. 6 (1), 69–71. Pancharunti, L., Lewis, C.A., Sauberlich, H.E., Perkins, L.L., Go, P.C.P. and Alwarez, J.O. (1994). Plasma homocysteine, folate and Vitamin B12 concentrations and risk of early onset coronary artery disease. Am. J. Clin. Nutr. 59, 940–948. Krishnaswamy, K. and Lakshmi, A.V. (2002). Role of Nutritional supplementation in reducing the levels of homocysteine. J. Assoc. Physicians India. 50 (Suppl), 36–42. Mathews, J.H. and Wood, J.K. (1984). Megaloblastic anemia in vegetarian Asians. Clin. Lab. Haematol. 6, 1–7. Dawson, D.W. and Waters, H.M. (1994). Malnutrition, folate and cobalamine deficiency. Br. J. Biomed. 51, 221–227. Yeolkar, M.E. and Shete, M.M. (2002). Homocysteine and hypertension. J. Assoc. Physicians India. 50 (Suppl), 29–35. Wall, R.T., Harlan, J.M., Haeber, L.A. and Striker, G.E. (1980). Homocysteine induced endothelial cel injury in vivo: A model for the study of vascular injury. Thrombo Res. 18, 113–121. Munshi, M.N., Stone, A., Fink, L. and Fonseca, V. (1996). Hyperhomocysteinaemia following a methionine load in patients with non-insulin dependent diabetes mellitus and macrovascular disease. Metabolism. 45, 133–135. Hoffman, M.A., Kohl, B., Zumbach, M.S., Borcea, V.J., Bierhaus, A., Henkels, M.,et al. (1997). Hyperhomocysteinaemia and endothelial dysfunction in IDDM. Diabetes Care. 20, 1880–1886.