Yıl: 2019 Cilt: 8 Sayı: 1 Sayfa Aralığı: 11 - 15 Metin Dili: İngilizce DOI: 10.5455/medscience.2018.07.8932 İndeks Tarihi: 26-09-2019

Correlation between homocysteine levels and stroke in patients with acute ischemic stroke

Öz:
Ischemic strokes are mostly caused by atherosclerosis, and increased homocysteine levels are considered to play a role in atherosclerosis. The aim of this study was to investigate serum total homocysteine (tHcy) levels in the first 24 h of ischemic stroke patients and to analyze the correlation between tHcy levels and the clinical severity of ischemic stroke. The study included a total of 151 participants including a patient group of 83 patients diagnosed with acute ischemic stroke and a control group of 68 age- and gender-matched subjects with no history of ischemic vascular diseases between June 2006 and December 2007. Demographic characteristics of were recorded for each participant and stroke severity was assessed using the modified Rankin Scale (mRS) in each patient. Serum tHcy, vitamin B12, folic acid, and fibrinogen levels as well as platelet count and lipid profiles were measured for each participant. Serum tHcy levels were significantly higher and the folic acid levels were significantly lower in the patient group compared to the control group (p<0.001, p=0.009, respectively). A negative correlation was found between folic acid and serum tHcy levels and a moderately positive correlation was found between tHcy and age and total cholesterol and LDL cholesterol levels. The covariate analysis of the risk factors adjusted for tHcy indicated that the tHcy levels were significantly higher in the patient group compared to the control group. Additionally, no significant correlation was found between the homocysteine levels and the stroke severity. Serum tHcy level was increased in acute ischemic stroke. Moreover, although the increased tHcy level did not indicate stroke severity, it can be considered as a major risk factor for ischemic stroke.
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  • Stroke http://www.clevelandclinicmeded.com/medicalpubs/ diseasemanagement/neurology/ischemic-stroke/#definition acces date 19.10.2018.
  • Sidney S, Sorel ME, Quesenberry CP. Comparative Trends in Heart Disease, Stroke, and All-Cause Mortality in the United States and a Large Integrated Healthcare Delivery System. Am J Med. 2018;131:829-36.
  • Meschia JF, Bushnell C, Boden-Albala B. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:3754-832.
  • Auriel E, Gur AY, Uralev O. Characteristics of first ever ischemic stroke in the very elderly: profile of vascular risk factors and clinical outcome. Clin Neurol Neurosurg. 2011;113:654-7.
  • Foody JM, Milberg JA, Robinson K. Homocysteine and lipoprotein (a) interact to increase CAD risk in young men and women. Arterioscler Thromb Vasc Biol. 2000;20:493-9.
  • Poddar R, Sivasubramanian N, DiBello PM. Homocysteine induces expression and secretion of monocyte chemoattractant protein-1 and interleukin-8 in human aortic endothelial cells: implications for vascular disease. Circulation. 2001;103:2717-23.
  • Clarke R, Armitage J, Lewington S. Homocysteine-lowering trials for prevention of vascular disease: protocol for a collaborative meta-analysis. Clin Chem Lab Med. 2007;45:1575-81.
  • Virtanen JK, Voutilainen S, Happonen P. Serum homocysteine, folate and risk of stroke: Kuopio ischaemic heart disease risk factor (KIHD) study. Eur J Prev Cardiol. 2005;12:369-75.
  • Lonn E, Yusuf S, Arnold M. Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med. 2006;354:1567-77.
  • Newman GC, Bang H, Hussain SI. Association of diabetes, homocysteine, and HDL with cognition and disability after stroke. Neurology. 2007;69:2054–62.
  • Hankey GJ, Eikelboom JW. Homocysteine levels in patients with stroke. CNS drugs. 2001;15:437-43.
  • Perry I, Morris R, Ebrahim S. Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. The Lancet. 1995;346:1395-8.
  • Overview of homocysteine https://www.uptodate.com/contents/overview-ofhomocysteine acces date 12.11.2018.
  • Hoffer LJ. Homocysteine remethylation and trans-sulfuration. Metabolism. 2004;53:1480-3.
  • Badner NH, Spence JD. Homocyst (e) ine, nitrous oxide and atherosclerosis. Best Pract Res Clin Anaesthesiol. 2001;15:185-93.
  • Sönmezler A, Ulaş T, Dal MS. Plasma Homocysteine Levels in Patients with Acute Ischemic Stroke: A Cross-Sectional Study. Turkiye Klinikleri J Med Sci. 2013;33:384-8.
  • Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials: a literature review and synthesis. Stroke. 2007;38:1091-6.
  • Pezzini A, Del Zotto E, Padovani A. Homocysteine and cerebral ischemia: pathogenic and therapeutical implications. Curr Med Chem. 2007;14:249-63.
  • Bostom AG, Rosenberg IH, Silbershatz H. Nonfasting plasma total homocysteine levels and stroke incidence in elderly persons: the Framingham Study. Ann Intern Med. 1999;131:352-5.
  • Evers S, Koch H-G, Grotemeyer K-H. Features, symptoms, and neurophysiological findings in stroke associated with hyperhomocysteinemia. Arch Neurol. 1997;54:1276-82.
  • Howard VJ, Sides EG, Newman GC. Changes in plasma homocyst (e) ine in the acute phase after stroke. Stroke. 2002;33:473-8.
  • Hankey GJ, Eikelboom JW. Homocysteine and stroke. Curr Opin Neurol. 2001;14:95-102.
  • Bushnell CD, Goldstein LB. Homocysteine testing in patients with acute ischemic stroke. Neurology. 2002;59:1541-6.
  • Tanne D, Haim M, Boyko V. Prospective study of Chlamydia pneumoniae IgG and IgA seropositivity and risk of incident ischemic stroke. Cerebrovasc Dis. 2003;16:166-70.
  • Kuo YS, Chang JY, Wang YP. Significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in patients with Behcet’s disease. J Formos Med Assoc. 2018;117:932-8.
  • Wang X, Qin X, Demirtas H. Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. The Lancet. 2007;369:1876-82.
  • Toole JF. Vitamin intervention for stroke prevention. J Neurol Sci. 2002;203:121-4.
  • Iso H, Moriyama Y, Sato S. Serum total homocysteine concentrations and risk of stroke and its subtypes in Japanese. Circulation. 2004;109:2766-72.
  • Dhamija RK, Gaba P, Arora S. Homocysteine and lipoprotein (a) correlation in ischemic stroke patients. J Neurol Sci. 2009;281:64-8.
  • Mizrahi EH, Fleissig Y, Arad M. Plasma homocysteine level and functional outcome of patients with ischemic stroke. Arch Phys Med Rehabil. 2005;86:60-3. .
APA KİRMİT A, AKAGÜNDÜZ EGE A, GÜÇTEKİN A, BAŞARILI M, ERCAN KARADAĞ M (2019). Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. , 11 - 15. 10.5455/medscience.2018.07.8932
Chicago KİRMİT ADNAN,AKAGÜNDÜZ EGE Ayşegül,GÜÇTEKİN Ali,BAŞARILI Mustafa Kemal,ERCAN KARADAĞ MÜJGAN Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. (2019): 11 - 15. 10.5455/medscience.2018.07.8932
MLA KİRMİT ADNAN,AKAGÜNDÜZ EGE Ayşegül,GÜÇTEKİN Ali,BAŞARILI Mustafa Kemal,ERCAN KARADAĞ MÜJGAN Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. , 2019, ss.11 - 15. 10.5455/medscience.2018.07.8932
AMA KİRMİT A,AKAGÜNDÜZ EGE A,GÜÇTEKİN A,BAŞARILI M,ERCAN KARADAĞ M Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. . 2019; 11 - 15. 10.5455/medscience.2018.07.8932
Vancouver KİRMİT A,AKAGÜNDÜZ EGE A,GÜÇTEKİN A,BAŞARILI M,ERCAN KARADAĞ M Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. . 2019; 11 - 15. 10.5455/medscience.2018.07.8932
IEEE KİRMİT A,AKAGÜNDÜZ EGE A,GÜÇTEKİN A,BAŞARILI M,ERCAN KARADAĞ M "Correlation between homocysteine levels and stroke in patients with acute ischemic stroke." , ss.11 - 15, 2019. 10.5455/medscience.2018.07.8932
ISNAD KİRMİT, ADNAN vd. "Correlation between homocysteine levels and stroke in patients with acute ischemic stroke". (2019), 11-15. https://doi.org/10.5455/medscience.2018.07.8932
APA KİRMİT A, AKAGÜNDÜZ EGE A, GÜÇTEKİN A, BAŞARILI M, ERCAN KARADAĞ M (2019). Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. Medicine Science, 8(1), 11 - 15. 10.5455/medscience.2018.07.8932
Chicago KİRMİT ADNAN,AKAGÜNDÜZ EGE Ayşegül,GÜÇTEKİN Ali,BAŞARILI Mustafa Kemal,ERCAN KARADAĞ MÜJGAN Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. Medicine Science 8, no.1 (2019): 11 - 15. 10.5455/medscience.2018.07.8932
MLA KİRMİT ADNAN,AKAGÜNDÜZ EGE Ayşegül,GÜÇTEKİN Ali,BAŞARILI Mustafa Kemal,ERCAN KARADAĞ MÜJGAN Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. Medicine Science, vol.8, no.1, 2019, ss.11 - 15. 10.5455/medscience.2018.07.8932
AMA KİRMİT A,AKAGÜNDÜZ EGE A,GÜÇTEKİN A,BAŞARILI M,ERCAN KARADAĞ M Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. Medicine Science. 2019; 8(1): 11 - 15. 10.5455/medscience.2018.07.8932
Vancouver KİRMİT A,AKAGÜNDÜZ EGE A,GÜÇTEKİN A,BAŞARILI M,ERCAN KARADAĞ M Correlation between homocysteine levels and stroke in patients with acute ischemic stroke. Medicine Science. 2019; 8(1): 11 - 15. 10.5455/medscience.2018.07.8932
IEEE KİRMİT A,AKAGÜNDÜZ EGE A,GÜÇTEKİN A,BAŞARILI M,ERCAN KARADAĞ M "Correlation between homocysteine levels and stroke in patients with acute ischemic stroke." Medicine Science, 8, ss.11 - 15, 2019. 10.5455/medscience.2018.07.8932
ISNAD KİRMİT, ADNAN vd. "Correlation between homocysteine levels and stroke in patients with acute ischemic stroke". Medicine Science 8/1 (2019), 11-15. https://doi.org/10.5455/medscience.2018.07.8932