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Hyperhomocyst(e)inemia Is Associated with Carotid Atherosclerosis

Stefano Rufini

Emanuela H. Locati

Rita Lombardini

Giovanni Ciuffetti

Donatella Siepi

Elmo Mannarino

Graziana Lupattelli, MD

Internal Medicine, Angiology, and Atherosclerosis Unit Policlinico Monteluce via Brunamonti, 2 06122 Perugia Italy

The atherogenicity of homocyst(e)ine—H(e) —emerged from many studies showing an association between moderately elevated levels and vascular occlusive disease. The aim of this study was to evaluate whether high homocyst(e)ine levels were associated with carotid atherosclerosis. Carotid atherosclerosis was defined as an intimal media thickness of internal and carotid bifurcation of at least 2 mm on the near and far walls as deter mined by B-mode ultrasonography. The study population included 91 patients: group 1 (61% males, mean age 64 ± 10 years, 57% with history of hypertension) with ultrasound evidence of carotid atherosclerosis and 100 with normal carotid walls—group 2 (36% males, mean age 52 ± 15 years, 27% with history of hypertension). Homocyst(e)ine levels (µmol/L) were determined by high-performance liquid chromatography with a fluorescent detector. Body mass index, dyslipidemia, smoking, diabetes, serum creatinine, plasma folic acid and vitamin B₁₂ were not significantly different in the two groups. Homocyst(e)ine levels (µmol/L) were significantly higher in patients with carotid ather- osclerosis than in those with normal arteries (11.7 ± 6.5 µmol/L, 95% CI 10.4-13.1 vs 8.07 ±4.4 µmol/L, 95% CI 7.2-8.9, p < 0.0001). By multiple regression analysis H(e) levels were positively correlated with male gender (p < 0.02), age (p < 0.001), and nega tively with folic acid (p < 0.0001). By logistic regression the independent predictors of carotid atherosclerosis were male gender (OR 2.65), hypertension (OR 2.55), age (x 10 years, OR 2.15) and H(e) levels (x 1 µmol/L, OR 1.11).

This study confirmed homocyst(e)ine is associated with carotid atherosclerosis. Consequently the authors recommend H(e) levels be screened in all patients at risk for atherosclerosis.

Angiology, Vol. 50, No. 10, 823-830 (1999)
DOI: 10.1177/000331979905001006


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