Physiopathologic role of plasma homocysteine concentration, folic acid and vitamin B[12] levels in patients with thrombotic stroke: relation to helicobacter pylori infection

ABSTRACT

To establish the link between serum homocysteine [Hcyst], folic acid and vitamin B[12] levels and Helicobacter pylori [H pylori] infection in the pathogenesis of thrombotic cerebrovascular stroke [CVS]. Subjects and Fourty patients with thrombotic CVS were selected at the Main Alexandria Hospital compared with 10 healthy subjects of matched age as a control group. Serum folate, vitamin B[12] and total Hcyst levels were determined. Also, serum anti-H pylori IgG was estimated in all included subjects. in thrombotic stroke patients; both serum folic acid and B[12] levels were significantly decreased while serum Hcyst level was significantly elevated compared to controls. Patients with hyper homocysteinemia [> 15 micro mol/l] had significantly lower levels of serum folate and vitamin B[12] and significantly higher levels of H pylori IgG than patients with normal serum Hcyst level. Serum Hcyst in stroke patients was significantly positively correlated to H pylori IgG levels and inversely correlated to serum folate and vitamin B[12]. Also, H pylori IgG level was significantly inversely correlated to serum folate and vitamin B[12]. H pylori infection may decrease serum folate and vitamin B[12] levels possibly through impairment of their absorption. This could lead to hyperhomocysteinemia due to abnormal Hcyst metabolism. Hcyst is toxic to endothelial cells and results in atherothrombosis and its sequelae