Julat Rujukan Bagi Jumlah Homosisteina Dalam Plasma Di Kalangan Kanak-Kanak Di Malaysia (Reference range for plasma total homocysteine among Malaysian’s children) / Jurnal Sains Kesihatan Malaysia

@#Homocystineimia is an Inborn Errors of Metabolism (IEM) which can occur due to accumulation of homocysteine. Homocysteine is one of the sulfur-containing amino acid with thiol group that is formed by demethylation of methionine. Deficiency of enzymes involves in homocysteine metabolism can give rise to seven types of homocystinemia subject to total homocysteine level. Therefore reference ranges are needed to differentiate between normal and abnormal population as well as the type of homocystineimia depending on the enzymes defect in the pathway. Hence, homocysteine reference ranges in children for the Malaysian population were postulated. 3 mL of blood was collected from 86 normal individuals (52 boys and 34 girls) and then subsequently processed and analysed using High Performance Liquid Chromatogrphy – Ion Exchange Chromatography (HPLC-IEC). The calculated mean total homocysteine for the population was 8.1 ± 3.89 µM (95% confidence interval, l 7.3-8.9 µM). Reference range was 2.5 – 16.2 µM with lower and upper cut-off were 1.0 µM dan 21.0 µM, respectively. The newly developed reference range of total homocysteine for Malaysian children is able to reduce false negative cases in the laboratory.

Effect of B-Vitamin Therapy on Neurological Dysfunction of Brain Infarction in Patients with Hyperhomocysteinemia / 天津医药

Objective To investigate whether vitamin B complex supplements would reduce stroke-related disabili-ty in hyperhomocysteinemia (Hhcy) patients with recent ischemic stroke. Methods One thousand patients with brain infarc-tion and Hhcy were assigned to receive either a daily dose of vitamin B complex (treatment group, n=500) or not (control group, n=500) on the base of conventional secondary prevention medications for a period of 2 years. The neurological dys-function was assessed by National Institutes of Health Stroke Scale (NIHSS) and stroke disability was evaluated by Barthel Index (BI) score. High performance liquid chromatographic method with fluorescence detection was used for the determina-tion of total plasma homocysteine levels. After 2 years of follow-up, the patients in the treatment group, whose tHcy level was reduced by 3-μmol/L or more, was defined as the treatment subgroup. Results The homocysteine levels were significantly reduced after 3, 12 and 24-month treatment than those of control group (P＜0.05). A lower NIHSS scale was found at 12, 18 and 24-month in treatment group compared with that in control group (P＜0.05), no significant differences at other time points between two groups (P>0.05). For the BI score, there were no significant differences at any time points between two groups (P>0.05). After 2 years of vitamin B complex supplementation, there were lower NIHSS scale and higher BI scale in treatment subgroup than those of control group (P＜0.05). Conclusion The lower level of tHcy induced by vitamin B inter-vention may be beneficial to the improvement of neurological deficit in patients with ischemic stroke.