The total homocysteine concentration in the patients with ischemic stroke or carotid atherosclerosis disease, and intervention study / 中华神经科杂志

ABSTRACT

Objective To investigate total serum homocysteine (tHcy) concentration in ischemic stroke patients and in carotid atherosclerosis patients in comparison with normal con trol elders and to evaluate whether providing folate and vitamin B 12 coul d decrease serum homocysteine concentration. Methods The sampl e in this study was obtained from the inpatients and outpatients of geriatric d epartment, Huashan Hospital. 160 patients were recruited and were divided int o two groups with smoking controlled. Thyroid gland abnormality and renal f a i lure were excluded. One group consisted of 71 male and 9 female ischemic strok e patients aged 73 years on average;There were 71 male, 9 female carotid ather osclerosis disease patients, aged 7 years on average in the second group. H y pertension and mellitus diabetes were controlled to avoid the influence of the f actors in these patients; the third group consisted of 72 male and 8 female norm al control elders, aged 71 years on average. Besides fast serum total homocyst e ine, every patient took laboratory and physical examinations,including plasma fo liate, vitamin B 12, free plasma glucose, creatinine, cholesterol, triglyce ride, blood pressure and blood mass index. Then each group was randomly subdivided in t o two groups in which one group was provided with folate 1.25 mg qod, and vitam in B 12 8?g qd w hile the other was not provited with folate and vitaminB 12. These patient s were reexamined after 10 months. Results The serum tHcy concentration was (16.1 ?5.3) ?mol/L in ischemic stroke group and (14.2?4.72) ?mol/L in caroti d athero sclerosis group compared with (12.5?3.0) ?mol/L in normal control elders ( P=0.000 1). The plasma foliate was low in ischemic stroke and carotid athe rosclerosis patients, and there were no significantly statistics dif ferences in the other examinations.Correlation analysis showed that tHcy was ne gatively correlated with foliate and vitamin B 12, r=-0.392,-0.36 r e spectively i n ischemic stroke group, r=-0.287,-0.339 respectively in carotid ath eroscleros is group, and r=-0.338,-0.227 in normal control group. The tHcy concent ration was lower in the groups provided with foliate and vitamin B 12 than that in the g roups without foliate and vitamin B 12 (P=0.000 1), even in the normal elders. Conclusions The tHcy concentration was higher in the patients with ischemic st roke and with carotid atherosclerosis. Folate supplement could moderately lowe r tHcy.