ABSTRACT
Homocysteine [Hcy] is a sulfur containing amino acid that is formed as an intermediate in methionine metabolism. Extensive evidence shows that hyperhomocysteinemia is considered an independent risk factor for atherothrombotic vascular disease. Methionine metabolism occurs mostly in the liver. Altered methionine metabolism, in advanced liver disease, may play a pathogenic role. The aim of this work was to evaluate the clinical significance of plasma Hcy concentration in chronic hepatitis C patients with liver cirrhosis. Twenty male patients [mean age 43.13 +/- 7.02 year] with chronic hepatitis C with liver cirrhosis [Group I] and 10 healthy age-matched control subjects [Group II] were included into the study. Ten patients with liver cirrhosis were diagnosed with hepatorenal syndrome [HRS] [Group Ia] and 10 did not have FIRS, Liver function, renal function tests, urinalysis, HCV Ab, HCV-PCR, plasma folate, B12 and Hcy concentration, abdominal ultrasound were performed for all studied subjects. Plasma Hcy concentration was significantly elevated in cirrhotic patients compared to healthy controls [P<0.05]. Hcy was positively correlated with the severity of liver disease as expressed by the Child score [P<0.05]. Plasma Hcy concentration was significantly higher in patients with HRS than in patients without HRS [P<0.05], and inversely correlated with the creatinine clearance rate [P<0.05]. There was no significant difference in folate and B12 levels between patients and controls. Plasma Hcy is elevated in patients with chronic hepatitis C and liver cirrhosis, and correlated with the progression of liver disease, Patients with cirrhosis complicated with HRS have higher Hcy concentration compared to patients with normal renal functions, and Hcy level increases with the deterioration of renal function