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Yong Y, Dong H, Zhu Y, Gu M, Li W, Jiang W, Lv J. The association between hyperhomocysteinemia and the prevalence of bilateral carotid atherosclerotic plaques in a middle-aged population. Clin Neurol Neurosurg 2024; 243:108361. [PMID: 38851120 DOI: 10.1016/j.clineuro.2024.108361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE We conducted a cross-sectional study to investigate the impact of hyperhomocysteinemia (HHcy) on the prevalence of CASP among middle-aged individuals, aiming to provide insights for CASP prevention. METHODS 1105 subjects were categorized into HHcy group or normal tHcy group based on their plasma total homocysteine (tHcy). All participants underwent carotid artery ultrasonography to assess the presence of unilateral and bilateral CASP. Comparative analyses of demographic and clinical data were conducted between the two groups. Logistic regression and prespecified subgroup analyses were performed to determine whether HHcy independently contributed to bilateral CASP. RESULTS 132 individuals exhibited bilateral CASP. The prevalence of bilateral CASP was significantly higher in the HHcy group compared to the normal tHcy group (21.55 % vs. 10.82 %, p = 0.003). Univariate logistic analysis showed a significant association between HHcy and the prevalence of bilateral CASP (OR = 2.056, 95 %CI 1.089-3.881, p = 0.026). In all four models of multivariate logistic analysis, HHcy consistently emerged as an independent risk factor for bilateral CASP, with odd ratios of 1.958, 2.047, 2.023, and 2.186. This association remained significant across all five subgroups stratified by age, sex, hypertension, diabetes, and BMI. CONCLUSION Our studies demonstrated HHcy was an independent risk factor for the prevalence of bilateral CASP in the middle-aged population. Theses results emphasized the importance of addressing HHcy in preventive strategies aimed at mitigating the burden of CASP among middle-aged individuals.
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Affiliation(s)
- Yufei Yong
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| | - Hui Dong
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| | - Yan Zhu
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| | - Meiling Gu
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| | - Wenxiao Li
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| | - Wenbin Jiang
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| | - Jinglei Lv
- Department of Health Management Center, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
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Momin M, Fan F, Yang Y, Li J, Jia J, Zhang Y. Additive effect between homocysteine and low-density-lipoprotein cholesterol upon incidence of novel carotid plaque formation: data from a Chinese community-based cohort. BMC Cardiovasc Disord 2023; 23:332. [PMID: 37386358 PMCID: PMC10311758 DOI: 10.1186/s12872-023-03282-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 05/07/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE Homocysteine (HCY) has been associated with carotid plaque in cross-sectional studies, but the prospective relationship between HCY and incident carotid plaque has not been well established. The purpose of this study was to investigate the association between HCY and incidence of novel carotid plaque in a Chinese community-based population without pre-existing carotid atherosclerosis and to assess the additive effect of HCY and low-density lipoprotein cholesterol (LDL-C) on the incidence of novel plaque. METHODS At baseline, we measured HCY and other risk factors in subjects aged ≥ 40 years. All participants underwent carotid ultrasound examinations at baseline and after an average of 6.8 years of follow-up. Incidence of plaque was identified if plaque was absent at baseline, but plaque was detected at the end of follow-up. A total of 474 subjects were included in the analysis. RESULTS The incidence of novel carotid plaque was 24.47%. Multivariate regression analyses showed that HCY was independently associated with a 1.05-fold-higher likelihood for incident novel plaque (adjusted odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01-1.09, P = 0.008). Using tertile 1 and tertile 2 for reference, the top HCY tertile (T3) showed a 2.28-fold-higher likelihood for incident plaque (adjusted OR = 2.28, 95%CI: 1.33-3.93, P = 0.002). The combination of HCY T3 and LDL-C ≥ 3.4 mmol/L had the highest risk for novel plaque formation (adjusted OR = 3.63, 95%CI: 1.67-7.85, P = 0.001) compared to those without either condition. In the LDL-C ≥ 3.4 mmol/L subgroup, HCY was significantly associated with incidence of plaque (adjusted OR = 1.16, 95%CI: 1.04-1.28, P = 0.005, P-interaction = 0.023). CONCLUSION In the Chinese community-based population, HCY was independently associated with the incidence of novel carotid plaque. There were additive effect between HCY and LDL-C on the incidence of plaque, the highest risk was observed in individuals with both high HCY levels and LDL-C ≥ 3.4 mmol/L. Our findings suggest that HCY may be a potential target for preventing the incidence of carotid plaque, particularly in individuals with elevated LDL-C levels.
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Affiliation(s)
- Mohetaboer Momin
- Department of Cardiology, Peking University First Hospital, 8thXishiku Road, Beijing, 10003 China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, 8thXishiku Road, Beijing, 10003 China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Ying Yang
- Department of Cardiology, Peking University First Hospital, 8thXishiku Road, Beijing, 10003 China
- Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, 8thXishiku Road, Beijing, 10003 China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, 8thXishiku Road, Beijing, 10003 China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, 8thXishiku Road, Beijing, 10003 China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
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Gospodarczyk A, Marczewski K, Gospodarczyk N, Widuch M, Tkocz M, Zalejska-Fiolka J. HOMOCYSTEINE AND CARDIOVASCULAR DISEASE - A CURRENT REVIEW. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2862-2866. [PMID: 36591781 DOI: 10.36740/wlek202211224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cardiovascular diseases remain the leading cause of death worldwide for the past 20 years. Of these, ischemic heart disease has the highest mortality rate. In over 98% of cases it is caused by atherosclerosis of the coronary arteries. Homocysteine is an amino acid, containing a sulfhydryl group, which is formed as a result of the metabolism of the amino acids methionine and cysteine, which is supplied with protein-containing foods. A small amount of it is necessary for the proper functioning of the body, however, an increased concentration in blood plasma, which hyperhomocysteinemia, negatively affects blood vessels leading to the development of atherosclerosis and thrombotic com¬plications. The adverse effect on blood vessels results from various mechanisms, such as: excessive activation of Toll-like 4 receptor, activation N-methyl-d-aspartate receptors, increased production of reactive oxygen species, and impairment of nitric oxide synthesis. Elevated levels of reactive oxygen species are associated with increased expression of proinflammatory cytokines such as IL-1β, IL-6, TNF-α (tumor necrosis tumor necrosis factor), MCP-1 and intracellular adhesion molecule-1. Another factor contributing to hyperhomocysteinemia is mutation of the MTHFR gene, which in normal conditions is responsible for maintaining homocysteine levels within the normal range. People with MTHFR mutation are more prone to develop atherosclerosis and the following complications: myocardial infarction, stroke, thrombotic episodes and coronary artery disease. The aim of this paper is to present evidence supporting the role of homocysteine in the development of many cardiovascular diseases.
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Affiliation(s)
| | - Kamil Marczewski
- DEPARTMENT OF EMERGENCY MEDICINE, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
| | - Natalia Gospodarczyk
- DEPARTMENT OF EMERGENCY MEDICINE, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
| | - Michał Widuch
- DEPARTMENT OF BIOCHEMISTRY, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
| | - Michał Tkocz
- UROLOGICAL DEPARTMENT OF MUNICIPAL HOSPITAL, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
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Qiu Z, Guo T, Sheng X, Tang Y, Du H. Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients with Chronic Internal Carotid Artery Occlusion Complicated by Cerebral Infarction. Neuropsychiatr Dis Treat 2022; 18:2265-2271. [PMID: 36268267 PMCID: PMC9578499 DOI: 10.2147/ndt.s384512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/08/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This study aims to investigate the prognostic value of the peripheral neutrophil-to-lymphocyte ratio (NLR) in patients with chronic internal carotid artery occlusion (CICAO) complicated by cerebral infarction. PATIENTS AND METHODS The clinical data of 99 CICAO patients complicated by cerebral infarction were retrospectively analyzed. The modified Rankin Scale (mRS) was used to assess their 3-month prognosis, and a multivariate logistic regression model was established to explore risk factors for poor prognosis. RESULTS Multivariate logistic regression analysis demonstrated that NLR (OR=2.114; 95% CI: 1.129-3.959) and baseline National Institute of Health Stroke Scale (NIHSS; OR=1.288, 95% CI: 1.053-1.574) score were risk factors of poor prognosis. The area under the receiver operator characteristic (ROC) curve of NLR in predicting the 3-month outcome after onset was 0.717 (95% CI: 0.606-0.828, P<0.000). The optimal cut-off value was 3.22, with a sensitivity of 0.743 and a specificity of 0.791. CONCLUSION NLR is an independent risk factor for the poor prognosis of CICAO patients complicated by cerebral infarction and can serve as an indicator for clinical prognosis.
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Affiliation(s)
- Zhuoyin Qiu
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Tingting Guo
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Xihua Sheng
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Ying Tang
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Huaping Du
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
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Wong LM, Phoon LQ, Wei LK. Epigenetics Modifications in Large-Artery Atherosclerosis: A Systematic Review. J Stroke Cerebrovasc Dis 2021; 30:106033. [PMID: 34598837 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/15/2021] [Accepted: 08/01/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES In recent years, the evidence of the relationship between epigenetics and acute ischemic stroke (AIS) were accumulating, however, the epigenetic characteristics that directs specifically towards the aetiology of large-artery atherosclerosis (LAA) remain ambiguous. The aim of this study was to highlight the overall evidence concerning the epigenetic mechanisms associated with the occurrence of LAA. MATERIALS AND METHODS Studies that involve investigations related to epigenetic markers (DNA methylation and RNA modifications) and LAA were retrieved from eleven scientific publication databases. The studies were screened through the pre-set inclusion and exclusion criteria prior to the NOS evaluation. RESULTS Eligible studies (n=25) were evaluated. Of which, six reported on DNA methylation and 19 studies assessed RNA modifications (16 on miRNAs, two on lncRNAs, and one study on circRNA). Hypomethylation of MTRNR2L8 and ERα promoters; microRNAs (miR-7-2-3p, miR-16, miR-34a-5p, miR-126, miR-143, miR-200b, miR-223, miR-503, miR-1908, miR-146a rs2910164 C/G, miR-149 rs2292832 T/C, miR-200b rs7549819 T/C, miR-34a rs2666433); lncRNA of ZFAS1; and circRNA of hsa_circRNA_102488 were associated with LAA significantly. CONCLUSION Current systematic review highlighted hypomethylation of miRNAs and lncRNA might be the potential biomarkers for LAA.
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Affiliation(s)
- Li Min Wong
- Department of Biological Science, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar, Perak 31900, Malaysia
| | - Lee Quen Phoon
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar, Perak 31900, Malaysia
| | - Loo Keat Wei
- Department of Biological Science, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar, Perak 31900, Malaysia.
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Holmen M, Hvas AM, Arendt JFH. Hyperhomocysteinemia and Ischemic Stroke: A Potential Dose-Response Association-A Systematic Review and Meta-analysis. TH OPEN 2021; 5:e420-e437. [PMID: 34595387 PMCID: PMC8463136 DOI: 10.1055/s-0041-1735978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/19/2021] [Indexed: 12/17/2022] Open
Abstract
Background and Purpose Previous studies suggest an association between increased homocysteine (Hcy) and risk of ischemic stroke. Yet, it remains unknown whether a dose-response association exists between Hcy levels and risk of ischemic stroke. Methods Systematic literature searches were performed in PubMed, Embase, Scopus, and Web of Science. Inclusion criteria were studies investigating ischemic stroke risk in an adult population with measured Hcy levels. We computed odds ratios (ORs) for a 5 µmol/L increase in Hcy levels using a random effects meta-analysis. Results In total, 108 studies met the inclusion criteria of which 22 were rated as high-quality studies, and 20 studies included a dose-response analysis. Hcy levels were analyzed either as a continuous or categorical variable. The majority of the studies found an increased risk of ischemic stroke when comparing the highest-to-lowest Hcy strata. A graded association was observed over the Hcy strata, indicating a dose-response association, with the most apparent effect when Hcy levels exceeded approximately 15 µmol/L. No studies explored a potential nonlinear association between Hcy levels and ischemic stroke. Six studies were included in a meta-analysis, showing an OR of 1.43 (95% confidence interval [CI]: 1.28-1.61) per 5 µmol/L increase in Hcy levels. Conclusion This review and meta-analysis indicate a dose-response association between Hcy levels and ischemic stroke. An evident increase in effect measures was observed when Hcy levels exceeded 15 µmol/L, indicating a nonlinear association between ischemic stroke and Hcy levels. This nonlinear association warrants further study. This study is registered with clinical trial ( https://www.crd.york.ac.uk/prospero/ ; unique identifier: CRD42019130371).
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Affiliation(s)
- Marte Holmen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Mette Hvas
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Johan F. H. Arendt
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
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Azzini E, Ruggeri S, Polito A. Homocysteine: Its Possible Emerging Role in At-Risk Population Groups. Int J Mol Sci 2020; 21:ijms21041421. [PMID: 32093165 PMCID: PMC7073042 DOI: 10.3390/ijms21041421] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/30/2020] [Accepted: 02/14/2020] [Indexed: 12/13/2022] Open
Abstract
Increased plasma homocysteine is a risk factor for several pathological disorders. The present review focused on the role of homocysteine (Hcy) in different population groups, especially in risk conditions (pregnancy, infancy, old age), and on its relevance as a marker or etiological factor of the diseases in these age groups, focusing on the nutritional treatment of elevated Hcy levels. In pregnancy, Hcy levels were investigated in relation to the increased risk of adverse pregnancy outcomes such as small size for gestational age at birth, preeclampsia, recurrent abortions, low birth weight, or intrauterine growth restriction. In pediatric populations, Hcy levels are important not only for cardiovascular disease, obesity, and renal disease, but the most interesting evidence concerns study of elevated levels of Hcy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Finally, a focus on the principal pathologies of the elderly (cardiovascular and neurodegenerative disease, osteoporosis and physical function) is presented. The metabolism of Hcy is influenced by B vitamins, and Hcy-lowering vitamin treatments have been proposed. However, clinical trials have not reached a consensus about the effectiveness of vitamin supplementation on the reduction of Hcy levels and improvement of pathological condition, especially in elderly patients with overt pathologies, suggesting that other dietary and non-dietary factors are involved in high Hcy levels. The importance of novel experimental designs focusing on intra-individual variability as a complement to the typical case-control experimental designs and the study of interactions between different factors it should be emphasized.
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Singh S, Mohan B. Triple-Vessel Coronary Artery Disease Associated with Familial Hyperhomocysteinemia. Res Cardiovasc Med 2020. [DOI: 10.4103/rcm.rcm_34_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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