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