Fermo I, D'Angelo SD, Paroni R, Mazzola G, Calori G, D'Angelo
A
Prevalence of moderate hyperhomocysteinemia in patients with
early-onset venous and arterial occlusive disease
Ann Int Med
(Nov) 123:747-753 1995
Homocystinuria is associated with severe vascular disease at an early age and
an increased incidence of thromboembolism. Recent data suggest that patients
in whom plasma levels of homocysteine are increased to a much lesser extent
also suffer from accelerated atherosclerosis. In the present study, 107
patients with venous thromboembolism (mean age 33) and 50 patients with early
onset arterial occlusive disease (mean age 32) and without other known
diseases underwent measurement of fasting plasma homocysteine (H) levels and
a number of clotting tests. In 87 patients plasma homocysteine was also
measured after an oral methionine load.
Baseline or methionine-challenged H levels were elevated in 13% of patients
with thromboembolism and 18% of patients with vascular occlusive disease.
Typically baseline H levels in such patients were 30 and 20 in men and women,
respectively. The prevalence of hyperhomocysteinemia in the affected
patients may have been an underestimate, as only 55% of patients underwent
methionine-loading. The incidence of recurrent thrombosis also was high in
patients with moderate hyperhomocysteinemia.
Comment: This study is important in its own right, and also bears on
dialysis patients, in whom plasma homocysteine levels are known to be
elevated.
(Daugirdas)
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H: Pathophysiology :
Hormonal aberrations
H: Pathophysiology :
Genetics