Structural changes of fibrinogen molecule mediated by the N-homocysteinylation reaction.

Homocysteine and its cyclic ester homocysteine thiolactone (HTL) have been involved in the detrimental consequences associated to hyperhomocysteinemia, an independent risk factor for vascular diseases. HTL reacts with protein lysine residues in a process named N-homocysteinylation. The aim of our study was to evaluate the in vitro effects of HTL on the fibrinogen through electrophoretic methods. Fibrinogen was incubated with HTL at different molar ratios and structural changes of the protein were assessed by polyacrylamide gel electrophoresis (PAGE), capillary zone electrophoresis (CZE) and capillary isoelectric focusing (CIEF). Ellman´s reaction, CZE and proton nuclear magnetic resonance (1H NMR) were used to evaluate HTL hydrolyisis. On denaturing PAGE numerous bands were observed, being the three lower bands identical to those obtained by treatment with 2-mercaptoethanol. This effect was also detected by CZE. The results show a reducing action of HTL on the fibrinogen molecule, probably attributed to the sulfhydryl groups generated by N-homocysteinylation and/or by the ones present in the homocysteine molecule yielded by HTL hydrolysis. In order to distinguish between these two options, HTL stability was evaluated at different pH and incubation times. The results showed minimum HTL hydrolysis in our experimental conditions. We postulate that the reducing effect observed would be mainly associated to the new sulfhydryl groups generated by the N-homocysteinylation process. Moreover, a displacement of the HTL-treated fibrinogen isoforms towards more acidic pH values was detected. The structural changes of N-homocysteinylated fibrinogen could be involved in the pathological consequences of hyperhomocysteinemia.

Reacciones de N-homocisteinilación asociadas a hiperhomocisteinemia / N-homocysteinylation reactions related to hyperhomocysteinemia / Reações de N-homocisteinilação associadas a hiper-homocisteinemia

Numerosas evidencias clínicas avalan la asociación entre concentración plasmática elevada de homocisteína (hiperhomocisteinemia) y las enfermedades vasculares oclusivas, tales como la aterosclerosis y la trombosis. La homocisteína reducida (Hcy) y su éster cíclico homocisteína-tiolactona (HTL) serían los principales responsables de los efectos nocivos asociados a la hiperhomocisteinemia. Tanto la Hcy como la HTL pueden interactuar espontáneamente con proteínas, a través de reacciones de S y N-homocisteinilación, respectivamente. Ambos procesos provocan alteraciones proteicas post-traduccionales, e inducen cambios estructurales y funcionales a nivel molecular. En los últimos años ha cobrado interés el conocimiento acerca de la HTL y las consecuencias de concentraciones elevadas de este metabolito sobre la salud humana. En las reacciones de N-homocisteinilación, el grupo carbonilo de la HTL se une al grupo ε-amino de los residuos lisina de las proteínas, con lo que se generan grupos sulfhidrilo libres, susceptibles de participar en reacciones redox. Las proteínas N-homocisteiniladas pueden sufrir plegamiento incorrecto de la molécula y daño oxidativo, y en consecuencia se inducen efectos citotóxicos e inmunogénicos. Se ha establecido que la conversión metabólica de la Hcy en HTL y la N-homocisteinilación de proteínas es uno de los mecanismos involucrados en el desarrollo de patologías asociadas con la hiperhomocisteinemia, tales como las enfermedades cardiovasculares y neurodegenerativas.

Increased plasma homocysteine levels (hyperhomocysteinemia) are associated with occlusive vascular diseases, such as atherosclerosis and thrombosis. Reduced homocysteine (Hcy) and its cyclic ester, homocysteine thiolactone (HTL) would be involved in the detrimental effects associated to hyperhomocysteinemia. These two species, Hcy and HTL can spontaneously react with proteins, through S and N-homocysteinylation process, respectively. Both reactions produce post-translational protein changes, impairing structural and functional features. In recent years, interest has been developed in HTL and its effects on human health. N-homocysteinylation is the reaction between the carboxyl group of HTL and ε-amino group of lysine residues, rendering free sulfhydryl groups able to participate in redox reactions. N-homocysteinylated proteins are prone to misfolding and oxidative damage, inducing cytotoxic and immunogenic effects. Metabolic conversion of Hcy to HTL as well as protein N-homocysteinylation is one of the mechanisms underlying the development of pathologies associated to hyperhomocysteinemia, such as cardiovascular and neurodegenerative diseases.

Numerosas evidências clínicas garantem a associação entre concentração plasmática elevada de homocisteína (hiper-homocisteinemia) e as doenças vasculares oclusivas, tais como a aterosclerose e a trombose. A homocisteína reduzida (Hcy) e seu éster cíclico homocisteína tiolactona (HTL) seriam os principais responsáveis pelos efeitos nocivos associados à hiper-homocisteinemia. Tanto a Hcy quanto a HTL podem interagir espontaneamente com proteínas, através de reações de S e N-homocisteinilação, respectivamente. Ambos os processos provocam alterações proteicas pós-traducionais, induzindo alterações estruturais e funcionais em nível molecular. Nos últimos anos, cobrou interesse o conhecimento acerca da HTL e as consequências de concentrações elevadas deste metabólito sobre a saúde humana. Nas reações de N-homocisteinilação, o grupo carbonila da HTL se une ao grupo ε-amino dos resíduos lisina das proteínas, gerando grupos sulfidrila livres, suscetíveis de participar em reações redox. As proteínas N-homocisteiniladas podem sofrer dobramento incorreto da molécula e dano oxidativo, induzindo efeitos citotóxicos e imunogênicos. Estabeleceu-se que a conversão metabólica da Hcy em HTL e a N-homocisteinilação de proteínas é um dos mecanismos envolvidos no desenvolvimento de patologias associadas com a hiper-homocisteinemia, tais como as doenças cardiovasculares e neurodegenerativas.

Novel sulfated xylogalactoarabinans from green seaweed Cladophora falklandica: Chemical structure and action on the fibrin network.

The water-soluble sulfated xylogalactoarabinans from green seaweed Cladophora falklandica are constituted by a backbone of 4-linked ß-l-arabinopyranose units partially sulfated mainly on C3 and also on C2. Besides, partial glycosylation mostly on C2 with single stubs of ß-d-xylopyranose, or single stubs of ß-d-galactofuranose or short chains comprising (1→5)- and/or (1→6)-linkages, was also found. These compounds showed anticoagulant activity, although much lower than that of heparin. The effect of a purified fraction (F1) on the fibrin network was studied in detail. It modifies the kinetics of fibrin formation, suggesting an impaired polymerization process. Scanning electron microscopy showed a laxer conformation, with larger interstitial pores than the control. Accordingly, this network was lysed more easily. These fibrin properties would reduce the time of permanence of the clot in the blood vessel, inducing a lesser thrombogenic state. One of the possible mechanisms of its anticoagulant effect is direct thrombin inhibition.

Chemical structure and anticoagulant activity of highly pyruvylated sulfated galactans from tropical green seaweeds of the order Bryopsidales.

Sulfated and pyruvylated galactans were isolated from three tropical species of the Bryopsidales, Penicillus capitatus, Udotea flabellum, and Halimeda opuntia. They represent the only important sulfated polysaccharides present in the cell walls of these highly calcified seaweeds of the suborder Halimedineae. Their structural features were studied by chemical analyses and NMR spectroscopy. Their backbone comprises 3-, 6-, and 3,6-linkages, constituted by major amounts of 3-linked 4,6-O-(1'-carboxy)ethylidene-d-galactopyranose units in part sulfated on C-2. Sulfation on C-2 was not found in galactans from other seaweeds of this order. In addition, a complex sulfation pattern, comprising also 4-, 6-, and 4,6-disulfated galactose units was found. A fraction from P. capitatus, F1, showed a moderate anticoagulant activity, evaluated by general coagulation tests and also kinetics of fibrin formation was assayed. Besides, preliminary results suggest that one of the possible mechanisms involved is direct thrombin inhibition.

Impact of homocysteine-thiolactone on plasma fibrin networks.

Epidemiologic studies have shown that hyperhomocysteinemia is an independent risk factor for vascular disease. Homocysteine (Hcy) circulates as different species, mostly protein bound, and approximately 1% as its reduced form and the cyclic thioester homocysteine-thiolactone (HTL). Despite the level of plasma thiolactone being markedly low, detrimental effects are related to its high reactivity. HTL reacts with proteins by acylation of free basic amino groups; in particular, the epsilon-amino group of lysine residues forms adducts and induces structural and functional changes in plasma proteins. In order to assess the effects of HTL on plasma fibrin networks, a pool of normal plasma incubated with HTL (100, 500 and 1,000 µmol/L, respectively) was evaluated by global coagulation tests and fibrin formation kinetic assays, and the resulting fibrin was observed by scanning electron microscopy. HTL significantly prolonged global coagulation tests in a concentration-dependent manner with respect to control, and increases were up to 14.5%. Fibrin formation kinetic parameters displayed statistically significant differences between HTL-treated plasma and control in a concentration-dependent way, showing higher lag phase and lower maximum reaction velocity and final network optical density. Electron microscopy analysis of HTL plasma networks revealed a compact architecture, with more branches and shorter fibers than control. We can conclude that HTL induced a slower coagulation process, rendering more tightly packed fibrin clots. Since these features of the networks have been related to impaired fibrinolysis, the N-homocysteinylation reactions would be involved in the prothrombotic effects associated to hyperhomocysteinemia.

Characterization of N-homocysteinylated albumin adducts.

Increased plasma homocysteine levels are considered an important risk factor for vascular disease. Homocysteine, an intermediate compound in methionine metabolism, is an amino acid that includes a thiol group, and circulates as different species. One of them, Homocysteine thiolactone (HTL) forms adducts through irreversible reactions with epsilon-NH2 groups of lysine residues. These processes can alter the structure and biological function of diverse proteins that may be involved in the detrimental effects of homocysteine. Particularly, in this work we evaluated HTL-mediated molecular changes in human serum albumin (HSA) through electrophoretic techniques. Albumin and HTL were incubated (37 °C, 6 h) at HSA:HTL molar ratios of 1:25, 1:50 and 1:100. Polyacrylamid gel electrophoresis showed that electrophoretic mobility was increased in the treated HSA respect to control, in an HTL-concentration-dependent manner. That anodic shift of the treated samples was also observed in crossed immunoelectrophoresis profiles. As expected, a decrease in the isoelectric point of the homocysteinylated albumin (pI 4.7) in comparison to that of control (pI 4.8) was shown by the isoelectric focusing technique. Moreover, the electropherogram acquired by capillary zone electrophoresis indicated that migration times and full width at half height were enhanced with the rise of HTL concentration. We propose that the in vitro structural changes of albumin described in the present work would be involved in the harmful effects of the N-homocysteinylation process.

Inhibition of ATP-induced calcium influx by homocysteine in human umbilical vein endothelial cells.

Mechanisms involved in the association between hyperhomocysteinemia and vascular occlusive diseases remain unclear. Homocysteine (Hcy) may disturb calcium (Ca(2+) ) cytosolic regulation in endothelial cells, a process that can directly affect the synthesis of vasoactive substances, such as nitric oxide (NO). We have investigated the effect of acute and chronic incubation with high concentrations of Hcy (100 and 500 µmol/L) on the changes in the intracellular Ca(2+) concentration ([Ca(2+) ]i ) induced by ATP, using primary cultures of human umbilical vein endothelial cells (HUVEC). The changes in [Ca(2+) ]i , expressed as ΔFt /Fb , were measured using the microspectrofluorimetric technique with Fluo-3 as Ca(2+) indicator. HUVEC acutely exposed to Hcy did not produce significant effects on any of the parameters studied. However, chronic exposition (24 h) caused a significant decrease in the speed of store-mediated Ca(2+) entry, expressed as (ΔFt /Fb )/t (s(-1) ). Exposure of HUVEC to 100 and 500 µmol/L Hcy gave significantly lower values (0.019 ± 0.002 s(-1) , n = 5 and 0.021 ± 0.004 s(-1) , n = 6, respectively) compared to the controls (0.046 ± 0.004 s(-1) , n = 8, P < 0.003). This was detected only when the sustained phase of the ATP-induced [Ca(+2) ]i increase was isolated. These results demonstrate that high concentrations of Hcy can affect the mechanisms involved in [Ca(2+) ]i regulation of HUVEC, and that alteration occurs specifically in the sustained phase, which has been directly associated with NO synthesis.

Alterations of fibrin network structure mediated by dermatan sulfate.

Dermatan sulfate (DS) is well-known for its anticoagulant activity through binding to heparin cofactor II (HCII) to enhance thrombin inhibition. It has also been reported that DS has a profibrinolytic effect. We have evaluated the effects of DS solutions (4-20 µg/mL) on the formation (by kinetic studies), structure (by electron microscopy and compaction assays) and lysis (with urokinase-type plasminogen activator) of plasma fibrin networks. The results showed that DS significantly prolonged the lag phase and decreased the fibrin formation rate and the optical density of the final networks versus control, in a concentration dependent way. DS-associated networks presented a minor network percentage compared with control, composed of lower number of fibers per field, which resulted significantly thinner and longer. Moreover, DS rendered gels more sensible to rupture by centrifugal force and more susceptible to lysis. When fibrin formation kinetic assays were performed with purified fibrinogen instead of plasma, in the absence of HCII, the optical density of final DS-associated networks was statistically lower than control. Therefore, a direct effect of DS on the thickness of fibers was observed. Since in all in vitro assays low DS concentrations were used, it could be postulated that the fibrin features described above are plausible to be found in in vivo thrombi and therefore, DS would contribute to the formation of less thrombogenic clots.

Anticoagulant activity of a unique sulfated pyranosic (1->3)-ß-L-arabinan through direct interaction with thrombin.

A highly sulfated 3-linked ß-arabinan (Ab1) with arabinose in the pyranose form was obtained from green seaweed Codium vermilara (Bryopsidales). It comprised major amounts of units sulfated on C-2 and C-4 and constitutes the first polysaccharide of this type isolated in the pure form and fully characterized. Ab1 showed anticoagulant activity by global coagulation tests. Less sulfated arabinans obtained from the same seaweed have less or no activity. Ab1 exerts its activity through direct and indirect (antithrombin- and heparin cofactor II-mediated) inhibition of thrombin. Direct thrombin inhibition was studied in detail. By native PAGE, it was possible to detect formation of a complex between Ab1 and human thrombin (HT). Ab1 binding to HT was measured by fluorescence spectroscopy. CD spectra of the Ab1 complex suggested that ligand binding induced a small conformational change on HT. Ab1-thrombin interactions were studied by molecular dynamic simulations using the persulfated octasaccharide as model compound. Most carbohydrate-protein contacts would occur by interaction of sulfate groups with basic amino acid residues on the surface of the enzyme, more than 60% of them being performed by the exosite 2-composing residues. In these interactions, the sulfate groups on C-2 were shown to interact more intensely with the thrombin structure. In contrast, the disulfated oligosaccharide does not promote major conformational modifications at the catalytic site when complexed to exosite 1. These results show that this novel pyranosic sulfated arabinan Ab1 exerts its anticoagulant activity by a mechanism different from those found previously for other sulfated polysaccharides and glycosaminoglycans.

Impaired fibrin gel permeability by high homocysteine levels.

Mechanisms involved in the relationship between hyperhomocysteinemia and thrombosis are still unclear. In previous reports we have shown that high homocysteine concentrations led to more compact and branched fibrin networks than controls. These clots showed an impaired lysis associated to their architecture. The aim of this study was to evaluate the effects of homocysteine on permeation of clots obtained from plasma and purified systems. Fibrin gels were prepared with normal plasma incubated with homocysteine and, in the purified systems, with fibrinogen and factor XIII treated with the amino acid. Permeability constants (K(s)) were determined through flow measurements. Linear regression curve between K(s) values and homocysteine levels in the plasmatic assays showed a negative correlation coefficient, r = -0.997 (p = 0.003). K(s) of fibrin gels obtained from purified systems with fibrinogen incubated with homocysteine was (7.07 ± 0.27) × 10(-9) cm(2), control was (11.40 ± 0.37) × 10(-9) cm(2) (n = 3; p < 0.01). K(s) of fibrin gels obtained with factor XIII treated with homocysteine was (1.47 ± 0.17) × 10(-9) cm (2), and control was (3.31 ± 0.31) × 10(-9) cm(2) (n = 3; p<0.01). Plasma incubated with high homocysteine concentrations produced fibrin clots significantly less permeable than controls in a dose dependent manner, and the results showed that fibrinogen and factor XIII were involved in that detrimental effect. These findings might explain the impaired fibrinolysis related to increased homocysteine levels and contribute to understanding the association between the amino acid and thrombosis.

Polysaccharides from the green seaweeds Codium fragile and C. vermilara with controversial effects on hemostasis.

Codium fragile and Codium vermilara biosynthesize water-soluble sulfated arabinans and galactans (and/or sulfated arabinogalactans), alpha(1-->4)-D-glucans and beta(1-->4)-D-mannans. The former polysaccharides are composed by 3-linked beta-D-galactopyranose and beta-L-arabinopyranose residues, they are highly sulfated and substituted with pyruvic acid ketals. For both seaweeds, they have the same main structural units, but in different percentages. All the room-temperature water extracts from both seaweeds showed a dual haemostatic effect: they prevented coagulation, but they induced platelet aggregation. Anticoagulant activity and platelet aggregation were higher in the samples with polysaccharides richer in sulfate, mainly in those from C. vermilara, which have a higher degree of sulfation and arabinose content.

[Teamwork in teaching mental health in medical training]. / Trabajo en equipo para la enseñanza de la materia Salud Mental en la formación médica.

In this paper we describe the methodology of teaching learning process that permits integration of theory and practice for the transmission of the three fundamental pillars of Mental Health Programme: learning doctor patient relationship, situational diagnosis and team work. The number and diversity of students in each course is a challenge for the teacher, who sustains the idea that the doctor patient relationship is learned starting from the teacher student relationship. Like patients, each student is unique. We describe the method used: to divide students into groups, that throughout the year become working-teams with the intention of practicing Medicine with an interpersonal relationship concept (with the patient, his or her family, his social circle, with colleagues, nursery, assistants and institutions). Each unit is coordinated by a group teacher. They have periodic meetings with the students (in the Balint Junior groups' method). The students have to create the contents and participate in the dynamics of the classes. This methodology changes the traditional vision and the teacher has the function of an organizer and facilitator of learning. It includes: a. Group division, b. Preparation of a file, c. Workshop, d. Teaching and e. Evaluation Teaching learning is conducive to a facilitating atmosphere through different resources like story telling, diagrams, drawings, movies, literature, use of plastic, role playing, elaborating scenes, characters and the file, evidence of all the activities.

Plasma homocysteine cutoff values for venous thrombosis.

BACKGROUND: Hyperhomocysteinemia is considered an independent risk factor for vascular occlusive diseases. To date, there is no general agreement on hyperhomocysteinemia cutoff values. METHODS: To establish a homocysteine cutoff value, we performed a case-control study in 118 patients suffering from venous thrombosis and in 115 healthy subjects. We calculated odds ratios at different cutoff points and considered hyperhomocysteinemia as homocysteine levels above which the risk of venous thrombosis was increased. RESULTS: Initially we used the 97.5th percentiles for fasting homocysteine levels in the control group to calculate odds ratios (95% CI) of 9.5 (2.6-35.3), 3.7 (0.8-17.9) and 4.5 (1.7-123.8) for the total population, women and men, respectively. When individuals with well-known thrombotic risk factors were excluded (selected population), odds ratios were 10.5 (2.7- 41.1), 6.5 (1.3-32.1) and 11.2 (1.2-103.1), respectively, confirming hyperhomocysteinemia as an independent risk factor for venous thrombosis. We did not find any association of venous thrombosis with the homozygous methylenetetrahydrofolate reductase C677T mutation. When the hyperhomocysteinemia cutoff was set at other arbitrary points, odds ratios for the selected population were statistically significant only at >12 micromol/L. CONCLUSIONS: Based on our results, we propose 12 micromol/L as the hyperhomocysteinemia cutoff value.

Influence of homocysteine on fibrin network lysis.

To elucidate some of the links between homocysteine and vascular disease, we have evaluated the effect of the amino acid on the formation (by kinetics studies), structure (by electron microscopy) and lysis of the fibrin network, using tissue-type plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA). We have studied whether homocysteine could alter the activity of the components involved in fibrinolysis (by amidolytic and thrombolytic methods). The results showed that homocysteine-associated networks were more compact and branched than controls (52 +/- 6 vs 44 +/- 5 fibers/field, P = 0.008), and were formed by shorter and thicker fibers. This clot proved to be more resistant to fibrinolysis with u-PA than control [lysis time 50%: 257 +/- 16 (homocysteine) vs 187 +/- 6 min (control); P < 0.004], but there were no differences with t-PA. Homocysteine did not affect the biological activities of plasmin, or plasminogen activation by t-PA and u-PA. Defective fibrinolysis with u-PA was therefore associated with homocysteine-fibrin structural alterations rather than the homocysteine effect on the biological activities of the fibrinolytic components evaluated. Results suggest that hyperhomocysteinemic patients could produce tight clots, were more resistant to lysis, and generated a procoagulant environment in situ. We believe that our findings may contribute to understanding the mechanisms involved in the homocysteine harmful effect.

Algunas consideraciones acerca de la carrera de obstetricia / Some considerations on the obstetrics career

El propósito de este trabajo es analizar distintos observables en la Carrera de Obstetricia; deconstruir una serie de procesos de producción-reproducción de subjetividad, para que lo invisible de dichos procesos pase a ser visto y hablado, cada vez menos desconocido y, por ende, menos padecido, no más fatalmente reproducido

Effects of homocysteine thiol group on fibrin networks: another possible mechanism of harm.

On the basis of growing clinical evidence, it is well known that elevated plasma homocysteine (Hcy) levels are associated with higher risk of venous and arterial thrombosis. Several experimental studies have been carried out in order to elucidate the mechanisms involved that still remain unclear. The aim of our study was to evaluate the homocysteine effects on formation and structure of plasmatic fibrin network. We also assayed homocystine and cysteine to determinate possible participation of thiol group in the tested activity. Aliquots of a pool of plasma incubated separately with sulfur compounds were clotting with thrombin. Fibringeneration and fibrin networks were evaluated by kinetic studies and scanning electronic microscopy, respectively. No significant differences were observed on fibrin generation of the substances assayed in comparison to control. The scanning electronic microscopy showed that Hcy-associated networks were different from control, with shorter, thicker and more branched fibers, resulting in a more compact structure and probably more resistant to fibrinolysis. The thiol group would be involved in this effect. Our findings would be a new contribution to elucidate the mechanisms involved in harmful effects associated to hyperhomocysteinemia.

Prevalence of hyperhomocysteinemia in an elderly population.

BACKGROUND: Currently, total hyperhomocysteinemia (tHHcy) is a well-known condition linked to a higher risk of vascular disease. Prevalence of HHcy increases in elderly persons as the risk associated with it persists. Because factors can be potentially reduced in the elderly, it is important to carry out epidemiologic studies of HHcy. PROCEDURE: Previously we described the prevalence of hypertension control in an elder population; now, in an observational cross-sectional simple blind study, total homocysteine (tHcy) concentration was determined in 196 of 400 patients from the original cohort. RESULTS: Mean Hcy concentration was 13.2 ,amol/L (95% confidence interval 12.4-14.0; range, 5.0 to 48.9); 15.0 ,imol/L for men and 12.3 pAmol/L for women. Mean serum folic acid levels were 4.9 + 3.1 ng/mL (range, 2.0 to 20.0 ng/mL), and vitamin B12 levels were 384.8 314.1 pg/mL (range, 48.0 to 1500.0 pg/mL). Taking into account the reference values established by the Third National Health and Nutrition Examination Survey III study, HHcy was detected in 69.8% of all the subjects evaluated. The study showed that 76.2% of the men and 66.4% of the women had high Hcy levels. CONCLUSIONS: The very high prevalence of tHHcy in the elderly population, and the consequent risks associated with it suggest that although there are no trials that effectively prove the benefit of tHcy decrease, nutritional intervention is still justified.

Homocisteinemia de la población de Buenos Aires: una realidad alejada de la idealidad / Homocysteinemia in Buenos Aires: the reallity outweigh the ideal refernce value

Numerosas evidencias científicas indican que una concentración elevada de homocisteína plasmática (hiperhomocisteinemia) sería un factor de riesgo independiente para las enfermedades vasculares oclusivas, tanto o más importante que el colesterol, el tabaquismo o la hipertensión. Surge entonces la necesidad de conocer y determinar los niveles normales de homocisteinemia. En nuestro estudio se analizaron las muestras de 151 individuos (3 a 59 años) aparentemente sanos, obteniéndose un valor de homocisteina total = 12.1 +- 3.6 umol/l (media +- DE). Además se evaluaron los datos registrados para dos grupos etáreos extremos, obteniéndose 6.4 +- 2.6 umol (neonatos) y 13.6 +- 5.9 umol/l (> 60 años). Se encontró que la homocisteinemia se incrementa con la edad, aún en el grupo de 3 a 59 años, y el valor medio es significativamente mayor en los hombres que en las mu

Homocisteinemia de la población de Buenos Aires: una realidad alejada de la idealidad / Homocysteinemia in Buenos Aires: the reallity outweigh the ideal refernce value

Numerosas evidencias científicas indican que una concentración elevada de homocisteína plasmática (hiperhomocisteinemia) sería un factor de riesgo independiente para las enfermedades vasculares oclusivas, tanto o más importante que el colesterol, el tabaquismo o la hipertensión. Surge entonces la necesidad de conocer y determinar los niveles normales de homocisteinemia. En nuestro estudio se analizaron las muestras de 151 individuos (3 a 59 años) aparentemente sanos, obteniéndose un valor de homocisteina total = 12.1 +- 3.6 umol/l (media +- DE). Además se evaluaron los datos registrados para dos grupos etáreos extremos, obteniéndose 6.4 +- 2.6 umol (neonatos) y 13.6 +- 5.9 umol/l (> 60 años). Se encontró que la homocisteinemia se incrementa con la edad, aún en el grupo de 3 a 59 años, y el valor medio es significativamente mayor en los hombres que en las mu