Correlation between Serum Levels of Hcy,Cys C and Cognitive Impairmentin Patients with Chronic Kidney Disease / 现代检验医学杂志

Objective To investigate the correlation between serum levels of homocystein (Hcy),Cystatin C (Cys C)and cognitive impairment in patients with chronic kidney disease (CKD).Methods 78 patients with CKD from January 2016 to May 2017 in Hanzhong People's Hospital in Shaanxi were enrolled for the study and divided into stage 3 groups (n 27),stage 4 group (n=28) and stage 5 group (n =23) according to stage of CKD.Montreal cognitive assessment scale (MoCA) was performed to evaluate the cognitive level of patients,and they were divided into cognitive impairment group and normal group.Serum levels of Hcy,Cys C,creatinine (SCr) and urea nitrogen (BUN) were compared among groups,and the correlation between them and cognitive level was analyzed.Results ①Serum levels of Hcy,Cys C,SCr and BUN in stage 3 group were significantly lower than that in stage 4 and 5 group,and these indexes in stage 4 group were significantly lower than that in stage 5 group (F=19.221～66.539,all P＜0.05).The score of MoCA in stage 3 group was significantly lower than that in stage 5 group,and the incidence of cognitive impairment was significantly higher than that in stage 5 group (F/x2 =3.993～6.358,all P＜0.05).②The serum levels of Hcy,Cys C,SCr and BUN in cognitive impairment group were significantly higher than in normal group (t =2.198 ～ 3.835,all P＜ 0.05).③ Pearson analysis result showed that MoCA score was negatively correlated with serum Hcy,Cys C and SCr (r=-0.370,-0.392,-0.253,P＜0.05),but there was no sig nificant correlation between score and BUN (r=-0.211,P＞0.05).④For prediction of cognitive impairment,area under the receiver operating curve of serum levels of Hcy,Cys C,SCr and BUN were 0.818,0853,0.751 and 0.709 (P＜0.05).Conclusion Serum levels of Hcy,Cys C were significantly negatively correlated with cognitive function in patients with CKD,whose predictive value were higher than that ot traditional renal function indexes such as SCr and BUN.

An analysis on the level of homocysteine and related factors among healthy examination population / 预防医学

Objective To investigate the level of homocysteine among healthy examination people and the possible related factors.Methods Retrospective analysis was performed to collect 1 259 results of healthy examination people from July to September in 2015,and 564 patients were confirmed to be hyperhomocysteinemia.The serum level of lipoids,glucose,uric acid and blood routine results were also collected.Results The incidence of hyperhomocysteinemia was 45.52％,and man has a higher rate than woman.The results of logistic regression showed positive results of UA (OR =1.006,95％ CI =1.005-1.008),HBG(OR =1.035,95％CI=1.026-1.045),and PLT (OR =0.996,95％ CI =0.993-0.998) in high hyperhomocysteinemia patients.Condusion High UA、HBG and low PLT levels are risk factors in hyperhomocysteinemia,and could be the important way for the early diagnoses of hyperhomocysteinemia.

Polimorfismo do gene timidilato sintase e nível plasmático total de homocisteína em um grupo de pacientes turcos com artrite reumatoide: relação com a atividade da doença e toxicidade ao metotrexato / Thymidylate synthase genetic polymorphism and plasma total homocysteine level in a group of Turkish patients with rheumatoid arthritis: relationship with disease activity and methotrexate toxicity

Resumo Introdução: Relata-se que o polimorfismo do gene timidilato sintase (TS) e a homocisteína têm relação com o metabolismo do metotrexato (MTX), com achados conflitantes. O objetivo deste estudo foi determinar os níveis de homocisteína e a frequência de polimorfismos de repetição tripla (TS3R) e dupla (TS2R) do gene TS em um grupo de pacientes turcos com AR e avaliar sua associação com a toxicidade ao MTX e a atividade da doença. Métodos: Foram incluídos no estudo 64 pacientes com AR e 31 indivíduos no grupo controle, com média de 48,7 ± 12,5 e 46,2 ± 13,4 anos. Foram obtidas as características demográficas e foi registrado o número de pacientes que relataram efeitos adversos ao MTX no grupo AR. Foram analisados os níveis de homocisteína e os polimorfismos TS2R/TS3R. Foi determinada a distribuição de genótipos de acordo com a toxicidade ao MTX e a atividade da doença. Resultados: Os dados demográficos foram semelhantes entre os pacientes e controles. Todos faziam suplementação de ácido fólico a uma dose média de 5 mg/semana. Dos 64 pacientes, 36 apresentaram efeitos adversos ao tratamento com MTX. Encontrou-se uma frequência de polimorfismos TS2R e TS3R semelhante nos grupos AR e controle. Encontrou-se que os polimorfismos TS2R e TS3R eram semelhantes em pacientes com e sem eventos adversos relacionados com o MTX. O nível médio de homocisteína também foi similar em pacientes com e sem polimorfismo do gene TS, mas era mais elevado (12,45 μmol/L vs. 10,7 μmol/L) em pacientes com do que sem efeitos adversos relacionados com o MTX. O nível médio de homocisteína se correlacionou com o VHS no grupo AR. Conclusões: Os níveis de homocisteína podem afetar a atividade da doença e a toxicidade ao MTX, mas os polimorfismos 2 R e 3 R no gene TS não se correlacionaram com a toxicidade ao MTX em pacientes com AR que recebem suplementação de ácido fólico. São necessários mais estudos para esclarecer os polimorfismos em outras enzimas que podem ser responsáveis pela toxicidade ao MTX em pacientes com AR.

Abstract Background: The polymorphism of thymidylate synthase (TS) gene and homocysteine are reported to have a relationship to methotrexate (MTX) metabolism, with conflicting results. The aim of this study was to determine homocysteine levels and the frequency of TS gene triple repeat (TS3R) and double repeat (TS2R) polymorphisms in a group of Turkish RA patients and evaluate its association with MTX toxicity and disease activity. Methods: Sixty-four patients with RA and 31 control subjects with a mean age of 48.7 ± 12.5 and 46.2 ± 13.4 years were enrolled for the study. Demographic characteristics were obtained and a number of patients with MTX-related adverse affects were recorded in the patient group. The homocysteine levels and TS2R/TS3R polymorphisms of the TS gene were analyzed and the distribution of genotypes according to MTX toxicity and disease activity was determined. Results: The demographic properties were similar between the patient and control subjects. Folic acid supplementation with a mean dose of 5 mg folic acid/week was present in all patients. Thirty-six of the 64 patients showed adverse effects to MTX treatment. The respective frequency of TS2R and TS3R polymorphisms was found to be similar in the patient and control groups. TS2R and TS3R gene polymorphisms were found to be similar in patients with and without MTX-related adverse events. The mean homocysteine level was also similar in patients with and without TS gene polymorphism, but was found to be higher (12.45 μmol/L vs 10.7 μmol/L) in patients with MTX-related side effects than in patients without side effects. The mean level of homocysteine was correlated with levels of ESR in the patient group. Conclusions: In conclusion, homocysteine levels might affect the disease activity and toxicity of MTX but 2R and 3R polymorphisms in the TS gene were not related with MTX-related toxicity in RA patients receiving folate supplementation. Further studies are needed to illuminate the polymorphisms in other enzymes that might be responsible for the MTX toxicity in patients suffering from RA.

Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus / Relação entre a homocisteína e a condição não dipper em pacientes com diabetes melito tipo 2

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patien­ts (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

OBJETIVO: A taxa de redução da pressão arterial noturna (PAN) é menor em pacientes com diabetes melito tipo 2 (DM tipo 2). A hiper-homocisteinemia (HHC) perturba a estrutura e a função vascular, independentemente das causas subjacentes. O risco de desenvolvimento de doenças vasculares é maior em pacientes diabéticos com hiper-homocisteinemia do que em pacientes com níveis normais de homocisteína. O objetivo deste estudo foi investigar se há diferenças entre os níveis de homocisteína em pacientes com DM2 em condição dipper ou não dipper. SUJEITOS E MÉTODOS: Comparamos 50 pacientes (33 mulheres, 17 homens) com DM tipo 2 e 35 indivíduos saudáveis (18 mulheres, 17 homens), usados como grupo controle. A monitorização ambulatorial da pressão arterial (MAPA) e os níveis de hemocisteína foram medidos em todos os pacientes. RESULTADOS: Observamos que a porcentagem de não dipper foi de 72% em pacientes com DM tipo 2 e 57% no grupo controle. Em indivíduos diabéticos e controle, os níveis de homocisteína foram mais altos em indivíduos não dipper (respectivamente 13,4 ± 8,1 µmol/L e 11,8 ± 5 µmol/L) do que em indivíduos dipper (respectivamente, 11,8 ± 5,8 µmol/L e 10,1 ± 4,2 µmol/L), mas não houve diferença significativa entre os dois grupos (respectivamente, p = 0,545, p = 0,294). CONCLUSÃO: Em ambos os grupos, os níveis de homocisteína foram mais altos nos indivíduos não dipper do que nos indivíduos dipper, mas não houve diferença significativa entre os grupos. Altos níveis de homocisteína e a condição não dipper aumentam o risco cardiovascular. Portanto, a relação entre as alterações da pressão arterial noturna e os níveis de homocisteína deve ser investigada em um estudo mais amplo.

Concentration of Blood Homocystein in TYP 2 Diabetics

Introduction: Diabetes is a serious metabolic disease with chronic and acute complications, especially atherosclerosis. The increase of blood homocystein level is obviously related to blood injuries\u2019 in a number of diseases including diabetes. In Vietnam, blood Homocystein in Diabetics has not been comprehensively studied. \r\n', u'Objectives: The study was conducted with two surveyed groups. Determination of blood homocystein concentration in type 2 diabetics in comparison with a group of normal people. \r\n', u'Subjects and method: The study was conducted on a sample of 57 type 2 diabetics according to WHO-2001 standards and a group of 46 normal people. Concentration of blood homocystein was assayed by a competition fluorescence immunoassay, and by other experiments according to normal biochemical methods.\r\n', u'Results: The tHcy concentration in diabetics is 12.19 \xb1 3.47 mmo/L and in the normal group is 7.87 \xb1 2.26 IJmo/L. \r\n', u'Conclusion: The tHcy concentration in the 57 type 2 diabetics group has a statistically increasing mean in comparison with the normal group for both men and women. However, there is no comparative difference in the tHcy concentration of diabetics in gender and age categories. \r\n', u'

The research on blood homocystein level as a new risk factor for stroke

The research was carried out on 108 stroke patients, 108 healthy control subjects matched in age and gender at the Hue Central Hospital in 2004. Results: Increasing the mean level of homocystein in blood is new risk factor of stroke. It’s maybe an independent risk factor or combining with other risk factors of stroke (especially hypertension). The rate of hyperhomocysteinemia is higher in patient group than in control group. There were statistically significant association between the mean blood homocystein level with amount risk factors of stroke (age, smoking, blood pressure, uremia, creatininemia, HCT, platelet). Especially, the mean homocystein level in blood had a negative correlation with Glasgow scores. Quantifying the homocystein level in blood of stroke patients can predict the severity of conscious impairment

Preliminary survey on blood homocystein level in cerebrovascular stroke

The concentration of blood homocystein (Hcy) in 26 patients with cerebrovascular accident (CVA) was determined preliminarily in Central Hospital in Hue city. 57.69% was the incidence of CVA in male and 42.31% in female patients (in male it was 1.36 fold higher than in female). Hcy concentration increased in 80.77% CVA patient. The rate of increase of blood level of Hcy was 66.67% in brain hemorrhage, 92.86% in brain infarctus. The incidence of CVA enhanced with the age, especially after the age of 55. High blood pressure accounted for 76.92% in CVA. 17/26 (65.38%) was the ratio of tobacco smoler.

Plasma homocystein in type 2 diabetes patients

At the University Medical Center, from August, 2001 to August, 2002, total plasma Homocystein of 31 controls and 50 type 2 diabetes was measured. The mean value of homocystein concentrations in type 2 diabetes is 11.77  4.45 M/l (mean  SD). This is significantly higher than the value of controls (9.93  2.93 M/l (mean  SD)

Homocyst(e)ine and atherosclerosis in patients on chronic hemodialysis

Hyperhomocyst(e)inemia is an established risk factor for atherosclerosis. We performed this study to identify the correlating variables and risk factors for atherosclerosis, as measured by the atherosclerotic score (AS), and to determine the relative risk for cardiovascular disease in relation to plasma homocyst(e)ine levels in patients on chronic hemodialysis. We evaluated and measured 61 patients on chronic hemodialysis for clinical and biochemical parameters including atherosclerotic score (AS) and plasma homocyst(e)ine. We divided patients into high and low groups, first, by the mean AS, and second, by the median value of plasma total homocyst(e)ine levels. Then we compared the variables between the two groups. Out of the 61 patients, the median plasma total homocyst(e)ine level was 24.4 micromol/L (mean+/-SD, 27.7+/-17.4; range, 9.8-127.4 micromol/L), and the median AS was 5 (mean+/-SD, 6.2+/-2.8; range, 3-13) out of a possible 20 points. AS was significantly correlated with plasma total homocyst(e)ine levels (r=0.37) and age (r=0.67). Through multivariate analysis, plasma total homocyst(e)ine level and age were determined as significant risk factors for the high-AS group (p0.05). Eighteen of the 61 patients, presented with cardiovascular disease until the present study, had an AS>6. Cardiovascular disease was found more often in the high-homocyst(e)ine group (>24.4 micromol/L) than in the low-homocyst(e)ine group (odds ratio, 9.3; 95% confidence interval, 2.3-37.4). Regardless of age, hyperhomocyst(e)inemia (especially homocyst(e)ine levels >24.4 micromol/L) is a risk factor that can be modified for the development of cardiovascular disease in patients on chronic hemodialysis.

Relationship between genetic polymorphism of homocysteine metabolism enzyme and unexplained repeated spontaneous abortion / 中华围产医学杂志

Objective To explore the significance of gene mutations of cystathionine ? synthase (CBS) 844ins68,methione synthase (MS) A2756G and methylene tetrahydrofolate reductase (MTHFR) C677T in patients with unexplained repeated spontaneous abortion(URSA). Methods The genotypes of CBS,MS and MTHFR in 50 patients and 56 healthy controls were determined by PCR-based assay and their restricted enzyme digested maps were analyzed. Results Allelic frequency of MTHFR 677C→T mutations in URSA patients was obviously higher than those in controls (24.0% vs 7.1%). The frequency of allelic mutations was elevated in the URSA group comparing with the control (26.0% vs 17.9%). No significant difference was shown in the frequency of CBS and MS mutations between the two groups. Conclusions The MTHFR 677 C→T mutation is associated with URSA. CBS and MS mutations might not be an independent risk factor for URSA.

Study of plasma homocystein level and methylene-tetrahydrofolate reductase (MTHFR) gene polymorphism in the patients with hyper-and hypothyroidism / 中华内分泌代谢杂志

Plasma homocystein (Hcy) level and 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism were investigated in 50 normal subjects, 32 cases of hypothyroidism and 48 cases of hyperthyroidism. As compared with normal group, plasma Hcy level was increased in hypothyroidism group (P