1
|
Mizuno T, Hoshino T, Ishizuka K, Toi S, Takahashi S, Wako S, Arai S, Kitagawa K. Hyperhomocysteinemia Increases Vascular Risk in Stroke Patients with Chronic Kidney Disease. J Atheroscler Thromb 2023; 30:1198-1209. [PMID: 36436876 PMCID: PMC10499453 DOI: 10.5551/jat.63849] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/31/2022] [Indexed: 09/05/2023] Open
Abstract
AIMS We aimed to assess the prognostic impact of hyperhomocysteinemia (HHcy) on the recurrent vascular event risk in stroke patients with or without chronic kidney disease (CKD). METHODS In this prospective observational study, 621 patients (mean age, 69.5 years; male, 62.2%) with ischemic stroke or transient ischemic attack were consecutively enrolled within 1 week of onset and followed-up for 1 year. HHcy was defined as elevated levels of fasting total homocysteine >15 µmol/L. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 or a history of renal replacement therapy. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including nonfatal stroke, nonfatal acute coronary syndrome, major peripheral artery disease, and vascular death. RESULTS The prevalence of HHcy was 18.5%. Patients with HHcy were more likely to have intracranial (37.4% versus 24.8%; p=0.008) and extracranial (20.9% versus 13.0%; p=0.037) artery stenosis than were those without HHcy. At 1 year, patients with HHcy were at a greater risk of MACE than were those without HHcy (annual rate, 17.8% versus 10.4%; log-rank p=0.033). In the Cox proportional hazard regression models, HHcy was independently associated with an increased risk of MACE in patients with CKD (adjusted hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.02-4.20), whereas HHcy was not predictive of MACE in those without CKD (adjusted HR, 1.00; 95% CI, 0.30-3.32). CONCLUSIONS Elevated levels of serum homocysteine can be an important modifiable risk factor in stroke patients with CKD, but not in those without CKD.
Collapse
Affiliation(s)
- Takafumi Mizuno
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Takao Hoshino
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Kentaro Ishizuka
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Sono Toi
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Shuntaro Takahashi
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Sho Wako
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Satoko Arai
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| |
Collapse
|
2
|
Kruglova MP, Ivanov AV, Fedoseev AN, Virus ED, Stupin VA, Parfenov VA, Titova SA, Lazareva PI, Kubatiev AA, Silina EV. The Diagnostic and Prognostic Roles Played by Homocysteine and Other Aminothiols in Patients with Chronic Kidney Disease. J Clin Med 2023; 12:5653. [PMID: 37685718 PMCID: PMC10488590 DOI: 10.3390/jcm12175653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
We examined standard clinical and laboratory biochemical parameters, as well as the levels of aminothiols in the blood and urine (homocysteine (Hcy), cysteine (Cys), S-adenosylmethionine (SAM), and S-adenosylhomocysteine (SAH)) via capillary electrophoresis in patients with CKD at stages II-V. Patient outcomes were assessed after five years. To complete forecasting, correlation and ROC analysis were performed. It was found that the levels of Cys and Hcy in blood plasma were earlier markers of CKD starting from stage II, while the levels of SAM and SAM/SAH in urine made it possible to differentiate between CKD at stages II and III. Blood plasma Hcy and urinary SAM and SAM/SAH correlated with mortality, but plasma Hcy concentrations were more significant. Thus, plasma Hcy, urine SAM, and SAM/SAH can be considered to be potential diagnostic and prognostic markers in patients with CKD.
Collapse
Affiliation(s)
- Maria Petrovna Kruglova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia; (M.P.K.); (V.A.P.); (S.A.T.); (P.I.L.)
| | - Alexander Vladimirovich Ivanov
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.V.I.); (E.D.V.); (A.A.K.)
| | | | - Edward Danielevich Virus
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.V.I.); (E.D.V.); (A.A.K.)
| | | | - Vladimir Anatolyevich Parfenov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia; (M.P.K.); (V.A.P.); (S.A.T.); (P.I.L.)
| | - Svetlana Andreevna Titova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia; (M.P.K.); (V.A.P.); (S.A.T.); (P.I.L.)
| | - Polina Igorevna Lazareva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia; (M.P.K.); (V.A.P.); (S.A.T.); (P.I.L.)
| | - Aslan Amirkhanovich Kubatiev
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.V.I.); (E.D.V.); (A.A.K.)
| | - Ekaterina Vladimirovna Silina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia; (M.P.K.); (V.A.P.); (S.A.T.); (P.I.L.)
| |
Collapse
|
3
|
Garibotto G, Picciotto D, Verzola D, Valli A, Sofia A, Costigliolo F, Saio M, Viazzi F, Esposito P. Homocysteine exchange across skeletal muscle in patients with chronic kidney disease. Physiol Rep 2023; 11:e15573. [PMID: 36945836 PMCID: PMC10031238 DOI: 10.14814/phy2.15573] [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: 11/14/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 03/23/2023] Open
Abstract
Sites and mechanisms regulating the supply of homocysteine (Hcy) to the circulation are unexplored in humans. We studied the exchange of Hcy across the forearm in CKD patients (n = 17, eGFR 20 ± 2 ml/min), in hemodialysis (HD)-treated patients (n = 14) and controls (n = 9). Arterial Hcy was ~ 2.5 folds increased in CKD and HD patients (p < 0.05-0.03 vs. controls). Both in controls and in patients Hcy levels in the deep forearm vein were consistently greater (+~7%, p < 0.05-0.01) than the corresponding arterial levels, indicating the occurrence of Hcy release from muscle. The release of Hcy from the forearm was similar among groups. In all groups arterial Hcy varied with its release from muscle (p < 0.03-0.02), suggesting that muscle plays an important role on plasma Hcy levels. Forearm Hcy release was inversely related to folate plasma level in all study groups but neither to vitamin B12 and IL-6 levels nor to muscle protein net balance. These data indicate that the release of Hcy from peripheral tissue metabolism plays a major role in influencing its Hcy plasma levels in humans and patients with CKD, and that folate is a major determinant of Hcy release.
Collapse
Affiliation(s)
| | - Daniela Picciotto
- Division of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San MartinoGenoaItaly
| | - Daniela Verzola
- Department of Internal MedicineUniversity of GenovaGenovaItaly
| | - Alessando Valli
- Department of Internal MedicineUniversity of GenovaGenovaItaly
| | - Antonella Sofia
- Division of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San MartinoGenoaItaly
| | - Francesca Costigliolo
- Division of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San MartinoGenoaItaly
| | - Michela Saio
- Division of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San MartinoGenoaItaly
| | - Francesca Viazzi
- Department of Internal MedicineUniversity of GenovaGenovaItaly
- Division of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San MartinoGenoaItaly
| | - Pasquale Esposito
- Department of Internal MedicineUniversity of GenovaGenovaItaly
- Division of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San MartinoGenoaItaly
| |
Collapse
|
4
|
Kruglova MP, Ivanov AV, Virus ED, Bulgakova PO, Samokhin AS, Fedoseev AN, Grachev SV, Kubatiev AA. Urine S-Adenosylmethionine are Related to Degree of Renal Insufficiency in Patients with Chronic Kidney Disease. Lab Med 2021; 52:47-56. [PMID: 32702115 DOI: 10.1093/labmed/lmaa034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To determine whether urine S-adenosylmethionine (SAM) might be an indicator of chronic kidney disease (CKD). METHODS We investigated urine levels of SAM and related metabolites (S-adenosylhomocysteine and homocysteine cysteine) in 62 patients (average age, 65.9 years) with CKD (stages II-V). RESULTS Patients with stages III-V CKD stages have significantly decreased urine levels and SAM/S-adenosylhomocysteine ratio and also cysteine/homocysteine ratio in blood plasma (P <.05), compared with patients with stage II CKD. Urine SAM levels allowed us to distinguish patients with mildly decreased kidney function from those with moderate to severe renal impairment (AUC, 0.791; sensitivity, 85%; specificity, 78.6%). CONCLUSIONS Our study results demonstrate that urine SAM is a potent biomarker for monitoring renal function decline at early CKD stages. Urine SAM testing confers an additional advantage to healthcare professionals in that it is noninvasive.
Collapse
Affiliation(s)
| | | | - Edward Danielevich Virus
- Department of Molecular and Cell Pathophysiology, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Polina Olegovna Bulgakova
- Department of Molecular and Cell Pathophysiology, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Andrey Segeevich Samokhin
- Department of Molecular and Cell Pathophysiology, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | | | | | - Aslan Amirkhanovich Kubatiev
- Department of Molecular and Cell Pathophysiology, Institute of General Pathology and Pathophysiology, Moscow, Russia.,Russian Medical Academy of Postdoctoral Education, Moscow, Russia
| |
Collapse
|
5
|
Badri S, Vahdat S, Seirafian S, Pourfarzam M, Gholipur-Shahraki T, Ataei S. Homocysteine-Lowering Interventions in Chronic Kidney Disease. J Res Pharm Pract 2021; 10:114-124. [PMID: 35198504 PMCID: PMC8809459 DOI: 10.4103/jrpp.jrpp_75_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/25/2021] [Indexed: 12/20/2022] Open
Abstract
The incidence of cardiovascular events and mortality is higher in patients with chronic kidney disease (CKD) compared to the general population. Homocysteine (Hcy) appears to be an independent risk factor for cardiovascular diseases in general populations and patients with CKD. Further, hyperhomocysteinemia can cause endothelial damage and increase the activity and production of coagulation factors, and its prevalence among patients with end-stage renal disease is approximately 85%-100%. Most treatments, which lower Hcy levels and have been considered in previous studies, include folic acid, B vitamins, omega-3 fatty acids, and N-acetylcysteine. However, the effect of therapies that can decrease Hcy levels and thus cardiovascular events in these patients is still unclear. The results are conflicting and require further investigation. To guide treatment decisions and improve patient outcomes, multiple databases were searched, including Web of Science, PubMed, and Medline to summarize the available evidence (i.e., clinical trial and meta-analyses) on Hcy-lowering interventions and cardiovascular events.
Collapse
Affiliation(s)
- Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Vahdat
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Seirafian
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Pourfarzam
- Department of Clinical Biochemistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Gholipur-Shahraki
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Ataei
- Department of Clinical Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
6
|
Figueroa-Torres AG, Matias-Aguilar LO, Coria-Ramirez E, Bonilla-Gonzalez E, Gonzalez-Marquez H, Ibarra-Gonzalez I, Hernandez-Lopez JR, Hernandez-Juarez J, Dominguez-Reyes VM, Isordia-Salas I, Majluf-Cruz A. Cystathionine β-synthase and methylenetetrahydrofolate reductase mutations in Mexican individuals with hyperhomocysteinemia. SAGE Open Med 2020; 8:2050312120974193. [PMID: 33282308 PMCID: PMC7682208 DOI: 10.1177/2050312120974193] [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: 05/19/2020] [Accepted: 10/26/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Hyperhomocysteinemia, a thrombotic risk factor, may have several causes. Among the genetic causes of hyperhomocysteinemia, there are polymorphisms in the enzymes methylenetetrahydrofolate reductase (C677T) and cystathionine β-synthase (C699T, C1080T, and 844ins68). Although the frequency of hyperhomocysteinemia in our country is high, there is no evidence about the frequencies of these polymorphisms. Methods: We analyzed 80 healthy individuals from several regions in our country. We evaluated the fasting and post-oral methionine load plasma Hcy and the genotypes in order to obtain the allele frequencies of the polymorphisms C677T of methylenetetrahydrofolate reductase and C699T, C1080T, and 844ins68 of the cystathionine β-synthase. Results: No individual had deficiency of folic acid, vitamins B12, or B6, but 80% had post-oral methionine load hyperhomocysteinemia. We found a significant increase in the Hcy plasma concentration associated with age and gender. Only the polymorphism C1080T was significantly associated with hyperhomocysteinemia. Conclusion: There is an association between fasting and post-oral methionine load plasma Hcy concentrations with the allelic frequencies of the polymorphisms C669T, 844ins68, and C1080T of the cystathionine β-synthase and C667T of the methylenetetrahydrofolate reductase in healthy Mexican individuals. As compared with individuals with normal fasting or post-oral methionine load Hcy plasma levels, only C1080T was significantly associated with hyperhomocysteinemia.
Collapse
Affiliation(s)
- Anahi Guadalupe Figueroa-Torres
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.,División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Ciudad de México, México
| | - Lisneth Osiris Matias-Aguilar
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Erika Coria-Ramirez
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Edmundo Bonilla-Gonzalez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Ciudad de México, México
| | | | - Isabel Ibarra-Gonzalez
- Unidad de Genética de la Nutrición, Instituto de Investigaciones Biomédica UNAM-Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, México
| | - Jose Rubicel Hernandez-Lopez
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Jesus Hernandez-Juarez
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Victor Manuel Dominguez-Reyes
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Irma Isordia-Salas
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Abraham Majluf-Cruz
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| |
Collapse
|
7
|
Nedelcu C, Ionescu M, Pantea-Stoian A, Niţă D, Petcu L, Mazilu L, Suceveanu AI, Tuţă LA, Parepa IR. Correlation between plasma homocysteine and first myocardial infarction in young patients: Case-control study in Constanta County, Romania. Exp Ther Med 2020; 21:101. [PMID: 33363612 DOI: 10.3892/etm.2020.9533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/30/2020] [Indexed: 11/06/2022] Open
Abstract
An elevated level of total plasma homocysteine has been associated with a higher risk of atherosclerosis and coronary heart disease. The aim of our research was to study the relation between homocysteine and myocardial infarction (MI) in young patients. We conducted a case-control study in Constanţa County, Romania including 61 patients, divided in two groups. The first group, the MI group, consisted of 28 patients, male (67.9%) and female (32.1%) aged less than 45 years who were consecutively admitted to the Intensive Coronary Care Unit of the Emergency County Hospital of Constanţa from September 1, 2017 to August 31, 2018 (12 months), with an established diagnosis of first acute MI. The second group, the control group, included 33 patients, male (75.8%) and female (24.2%) aged less than 45 years, with cardiovascular risk factors and/or stable angina pectoris that were consecutively addressed for ambulatory cardiac evaluation at the Outpatient Clinic of Emergency County Hospital of Constanţa during the same period. Fasting plasma homocysteine was determined in both groups, within 24 h after MI onset, respectively after first cardiac exam in the controls. High homocysteine was statistically confirmed to be a risk factor in the study group, especially in association with smoking, chronic kidney disease (CKD), and to a lesser extent with diabetes mellitus (DM) and hypertension. Data analysis was performed using IBM SPSS Statistics 23. The procedures used included descriptive statistics, parametric statistical tests (Independent sample t-test), non-parametric statistical tests [Chi-square test of the association, with the evaluation of odds ratio (OR)]; the significance level used in the analysis (P-value) was 0.05. After adjusting for variables, our study results pointed out a strong association between plasma homocysteine and first acute MI among young patients, emphasising plasma homocysteine as a possible risk factor for myocardial infarction.
Collapse
Affiliation(s)
- Cristina Nedelcu
- Cardiology Department, Constanta County Army Hospital, 900527 Constanţa, Romania
| | - Mihaela Ionescu
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanţa, 900527 Constanţa, Romania
| | - Anca Pantea-Stoian
- Department of Metabolic Diseases of the Clinical Emergency Hospital, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania
| | - Daniel Niţă
- Department of Interventional Cardiology, Army's Center for Cardiovascular Diseases, 010825 Bucharest, Romania
| | - Lucian Petcu
- Department of Biophysics, Faculty of General Medicine, 'Ovidius' University of Constanţa, 900527 Constanta, Romania
| | - Laura Mazilu
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanţa, 900527 Constanţa, Romania
| | - Andra-Iulia Suceveanu
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanţa, 900527 Constanţa, Romania
| | - Liliana-Ana Tuţă
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanţa, 900527 Constanţa, Romania
| | - Irinel-Raluca Parepa
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanţa, 900527 Constanţa, Romania
| |
Collapse
|
8
|
Urquhart BL, House AA. Assessing Plasma Total Homocysteine in Patients with End-Stage Renal Disease. Perit Dial Int 2020. [DOI: 10.1177/089686080702700502] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Elevated plasma total homocysteine (tHcy) is a risk factor for cardiovascular disease; however, in light of several recent randomized trials, the issue of causality has been cast into doubt. Patients with end-stage renal disease are particularly interesting as they consistently have elevated tHcy and their leading causes of morbidity and mortality are related to cardiovascular disease. In the present article, we review the early evidence for the homocysteine theory of atherosclerosis, homocysteine metabolism, mechanisms of toxicity, and pertinent available clinical investigations. Where appropriate, the sparse evidence of homocysteine in peritoneal dialysis is reviewed. We conclude by addressing the difficulties associated with lowering plasma tHcy in patients with end-stage renal disease and suggest some novel methods for lowering tHcy in this resistant population. Finally, to address the issue of causality, we recommend that clinicians and scientists await the results of the FAVORIT trial before abandoning homocysteine as a modifiable risk factor for cardiovascular disease, as this study has recruited patients from a population with consistently elevated plasma tHcy who are known to respond to vitamin therapy.
Collapse
Affiliation(s)
- Bradley L. Urquhart
- Departments of Medicine The University of Western Ontario, London, Ontario, Canada
- Physiology/Pharmacology, The University of Western Ontario, London, Ontario, Canada
| | - Andrew A. House
- Departments of Medicine The University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
9
|
Silla Y, Varshney S, Ray A, Basak T, Zinellu A, Sabareesh V, Carru C, Sengupta S. Hydrolysis of homocysteine thiolactone results in the formation of Protein-Cys-S-S-homocysteinylation. Proteins 2019; 87:625-634. [PMID: 30869815 DOI: 10.1002/prot.25681] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/31/2019] [Accepted: 02/17/2019] [Indexed: 11/07/2022]
Abstract
An increased level of homocysteine, a reactive thiol amino acid, is associated with several complex disorders and is an independent risk factor for cardiovascular disease. A majority (>80%) of circulating homocysteine is protein bound. Homocysteine exclusively binds to protein cysteine residues via thiol disulfide exchange reaction, the mechanism of which has been reported. In contrast, homocysteine thiolactone, the cyclic thioester of homocysteine, is believed to exclusively bind to the primary amine group of lysine residue leading to N-homocysteinylation of proteins and hence studies on binding of homocysteine thiolactone to proteins thus far have only focused on N-homocysteinylation. Although it is known that homocysteine thiolactone can hydrolyze to homocysteine at physiological pH, surprisingly the extent of S-homocysteinylation during the exposure of homocysteine thiolactone with proteins has never been looked into. In this study, we clearly show that the hydrolysis of homocysteine thiolactone is pH dependent, and at physiological pH, 1 mM homocysteine thiolactone is hydrolysed to ~0.71 mM homocysteine within 24 h. Using albumin, we also show that incubation of HTL with albumin leads to a greater proportion of S-homocysteinylation (0.41 mol/mol of albumin) than N-homocysteinylation (0.14 mol/mol of albumin). S-homocysteinylation at Cys34 of HSA on treatment with homocysteine thiolactone was confirmed using LC-MS. Further, contrary to earlier reports, our results indicate that there is no cross talk between the cysteine attached to Cys34 of albumin and homocysteine attached to lysine residues.
Collapse
Affiliation(s)
- Yumnam Silla
- Department of Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, New Delhi, Delhi, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi, Delhi, India
| | - Swati Varshney
- Department of Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, New Delhi, Delhi, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi, Delhi, India
| | - Arjun Ray
- Department of Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, New Delhi, Delhi, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi, Delhi, India
| | - Trayambak Basak
- Department of Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, New Delhi, Delhi, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi, Delhi, India
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Varatharajan Sabareesh
- Department of Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, New Delhi, Delhi, India
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Quality Control Unit, University Hospital of Sassari (AOU Sassari), Sassari, Italy
| | - Shantanu Sengupta
- Department of Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, New Delhi, Delhi, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi, Delhi, India
| |
Collapse
|
10
|
Assessment of Serum Folic Acid and Homocysteine in Thalassemia Major Patients Before and After Folic Acid Supplement Cessation. J Pediatr Hematol Oncol 2018; 40:504-507. [PMID: 30124548 DOI: 10.1097/mph.0000000000001295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Thalassemic patients have ineffective erythropoiesis. In recent treatment protocols, there are little data on folic acid supplementation for patients with thalassemia because it is supposed that regular blood transfusions prevent bone marrow hyperfunctioning. OBJECTIVE Investigators aimed to assess serum folic acid and homocysteine (Hcy) in thalassemia major patients before and after folic acid supplement cessation. PATIENTS AND METHODS This study was a before-after controlled clinical trial conducted in 17th Shahrivar Hospital, Rasht, North of Iran, during May to October 2016. The patients enrolled in this study had thalassemia major on regular blood transfusion and older than 2 years of age. They had at least a 6-month history of folic acid supplement consumption before enrollment in the study (1 mg/daily). Complete blood count, serum folic acid, and serum Hcy were measured before discontinuation of folic acid supplement. Then, patients did not receive folic acid for a month and after 1 month of folic acid cessation, the measurements were repeated. All data were entered in SPSS version 20.0 and analyzed. RESULTS Among the 40 patients in this study, 25 (62.5%) were female. The mean age of the participants was 21.39±11.17 years old. The mean of body mass index was 21.38±3.32 kg/m. Most of the participants had used folic acid supplement >5 years (29, 72.5%). The serum Hcy level was significantly increased (5.24±2.35 vs. 5.93±2.56; P=0.008) and serum folic acid level was decreased significantly (14.74±4.20 vs. 8.80±4.16; P<0.0001) from baseline. CONCLUSIONS Cessation of folic acid supplementations in beta thalassemia major patients can lead to a significant decrease in serum folic acid and increase in Hcy levels. According to our findings and efficacy of folic acid in patients with beta thalassemia major, it is recommended to use the supplementation in all patients.
Collapse
|
11
|
Gaiday AN, Tussupkaliyev AB, Bermagambetova SK, Zhumagulova SS, Sarsembayeva LK, Dossimbetova MB, Daribay ZZ. Effect of homocysteine on pregnancy: A systematic review. Chem Biol Interact 2018; 293:70-76. [PMID: 30053452 DOI: 10.1016/j.cbi.2018.07.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/17/2022]
Abstract
Research purpose was to put together the available pieces of present scientific data and to close the gap in the knowledge of Hcy levels in pregnancy and its association with some pregnancy complications. Scientific data were taken from research papers published between January 1990 and December 2017, and found on the Internet (PubMed, ClinicalKey and Embase databases) by the following tags entered in English, Russian, French and German languages: pregnancy, homocysteine, pregnancy complications, pregnancy loss, preeclampsia, intrauterine growth restriction, and placental abruption. The review showed that Hcy levels range in uncomplicated pregnancy. Upon that, Hcy level tends to decrease during the second and third trimesters. Some studies have revealed a link between polymorphism and abortion. Sufficient data were obtained indicating the relationship between HHcy and PE. Placental abruption was also associated with high Hcy levels increasing the risk 5.3-fold, but still there are data not supporting the hypothesis that Hcy levels correlate with placental abruption.
Collapse
Affiliation(s)
- Andrey N Gaiday
- West-Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan
| | | | | | | | | | | | | |
Collapse
|
12
|
Vanholder R, Argilés A, Baurmeister U, Brunet P, Clark W, Cohen G, Dedeyn P, Deppisch R, Descamps-Latscha B, Henle T, Jörres A, Massy Z, Rodriguez M, Stegmayr B, Stenvinkel P, Wratten M. Uremic Toxicity: Present State of the Art. Int J Artif Organs 2018. [DOI: 10.1177/039139880102401004] [Citation(s) in RCA: 192] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The uremic syndrome is a complex mixture of organ dysfunctions, which is attributed to the retention of a myriad of compounds that under normal condition are excreted by the healthy kidneys (uremic toxins). In the area of identification and characterization of uremic toxins and in the knowledge of their pathophysiologic importance, major steps forward have been made during recent years. The present article is a review of several of these steps, especially in the area of information about the compounds that could play a role in the development of cardiovascular complications. It is written by those members of the Uremic Toxins Group, which has been created by the European Society for Artificial Organs (ESAO). Each of the 16 authors has written a state of the art in his/her major area of interest.
Collapse
Affiliation(s)
- R. Vanholder
- The Nephrology Section, Department of Internal Medicine, University Hospital, Gent - Belgium
| | - A. Argilés
- Institute of Human Genetics, IGH-CNRS UPR 1142, Montpellier - France
| | | | - P. Brunet
- Nephrology, Internal Medicine, Ste Marguerite Hospital, Marseille - France
| | - W. Clark
- Baxter Healthcare Corporation, Lessines - Belgium
| | - G. Cohen
- Division of Nephrology, Department of Medicine, University of Vienna, Vienna - Austria
| | - P.P. Dedeyn
- Department of Neurology, Middelheim Hospital, Laboratory of Neurochemistry and Behaviour, University of Antwerp - Belgium
| | - R. Deppisch
- Gambro Corporate Research, Hechingen - Germany
| | | | - T. Henle
- Institute of Food Chemistry, Technical University, Dresden - Germany
| | - A. Jörres
- Nephrology and Medical Intensive Care, UK Charité, Campus Virchow-Klinikum, Medical Faculty of Humboldt-University, Berlin - Germany
| | - Z.A. Massy
- Division of Nephrology, CH-Beauvais, and INSERM Unit 507, Necker Hospital, Paris - France
| | - M. Rodriguez
- University Hospital Reina Sofia, Research Institute, Cordoba - Spain
| | - B. Stegmayr
- Norrlands University Hospital, Medical Clinic, Umea - Sweden
| | - P. Stenvinkel
- Nephrology Department, University Hospital, Huddinge - Sweden
| | | |
Collapse
|
13
|
Fu S, Yao Y, Zhao Y, Luan F. Relationships of Hyperhomocysteinemia and Hyperuricemia With Metabolic Syndrome and Renal Function in Chinese Centenarians. Front Endocrinol (Lausanne) 2018; 9:502. [PMID: 30271378 PMCID: PMC6142902 DOI: 10.3389/fendo.2018.00502] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022] Open
Abstract
As the first time worldwide, this study aimed to investigate the relationships of hyperhomocysteinemia and hyperuricemia with metabolic syndrome (MetS) and renal function in Chinese centenarians. The China Hainan Centenarian Cohort Study was performed in 18 cities and counties of the Hainan Province. Home interview, physical examination, and blood analysis were performed on 808 centenarians following standard procedures. All centenarians had a median age of 102 (100-115) years. Prevalence of hyperhomocysteinemia and hyperuricemia was 91.6% (740 centenarians) and 28.5% (230 centenarians), respectively. The MetS was present in 117 centenarians (14.5%). In simple correlation analyses, hyperhomocysteinemia and hyperuricemia were significantly correlated with MetS and glomerular filtration rate (GFR) < 60 ml/min/1.73 m2 (P < 0.05 for all). Serum homocysteine levels were significantly correlated with GFR, waist circumference (WC), and triglyceride levels, while serum uric acid levels were significantly correlated with these variables plus high-density lipoprotein cholesterol (HDL-C) levels (P < 0.05 for all). In logistic regression analyses, hyperhomocysteinemia and hyperuricemia were significantly associated with MetS and GFR < 60 ml/min/1.73 m2 (P < 0.05 for all). In linear regression analyses, serum homocysteine levels were significantly associated with GFR, WC, and triglyceride, while serum uric acid levels were significantly associated with these variables plus HDL-C (P < 0.05 for all). Both hyperhomocysteinemia and hyperuricemia had important relationships with MetS and renal function in Chinese centenarians. Hyperuricemia and hyperhomocysteinemia that could help identify, while also affecting, the development of MetS and renal function may unfold complex relationships between MetS, renal function, and cardiovascular risk and provide effective prevention strategies for these conditions.
Collapse
Affiliation(s)
- Shihui Fu
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
- Department of Cardiology and Hainan Branch, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yao Yao
- Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
- Beijing Key Laboratory of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yali Zhao
- Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China
- *Correspondence: Yali Zhao
| | - Fuxin Luan
- Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China
- Fuxin Luan
| |
Collapse
|
14
|
Yang B, Fan S, Zhi X, He J, Ma P, Yu L, Zheng Q, Sun G. Interactions of homocysteine and conventional predisposing factors on hypertension in Chinese adults. J Clin Hypertens (Greenwich) 2017; 19:1162-1170. [PMID: 28942612 PMCID: PMC8031033 DOI: 10.1111/jch.13075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 05/18/2017] [Accepted: 05/21/2017] [Indexed: 01/18/2023]
Abstract
This study aimed to investigate whether conventional predisposing factors modify the associations of homocysteine with blood pressure levels and hypertension. A total of 2615 adults were recruited from Liaoning province. An elevated homocysteine level was significantly associated with increased hypertension risk and blood pressure (all P<.05). Interaction analyses showed that homocysteine acted synergistically with age, overweight/obesity, dyslipidemia, and family history of hypertension to affect hypertension risk, and the relative excess risk due to interaction was 1.21 (95% confidence interval, 0.07-2.35), 0.72 (95% confidence interval, 0.07-1.36), 0.45 (95% confidence interval, 0.06-0.85), and 1.87 (95% confidence interval, 0.77-2.97), respectively. Increases in blood pressure were higher in patients who were overweight/obese or had a family history of hypertension than in their counterparts (all Pinteraction <.05). This study provides some strong evidence for interactions of homocysteine with conventional predisposing factors on hypertension.
Collapse
Affiliation(s)
- Boyi Yang
- Department of Preventive MedicineGuangzhou Key Laboratory of Environmental Pollution and Health Risk AssessmentSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Shujun Fan
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Xueyuan Zhi
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Jing He
- Department of Non‐Communicable DiseaseShenhe Center for Disease Control and PreventionShenyangLiaoningChina
| | - Ping Ma
- Department of Non‐Communicable DiseaseShenhe Center for Disease Control and PreventionShenyangLiaoningChina
| | - Luyang Yu
- Department of Non‐Communicable DiseaseShenhe Center for Disease Control and PreventionShenyangLiaoningChina
| | - Quanmei Zheng
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Guifan Sun
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| |
Collapse
|
15
|
Elango R, Humayun MA, Turner JM, Rafii M, Langos V, Ball RO, Pencharz PB. Total Sulfur Amino Acid Requirements Are Not Altered in Children with Chronic Renal Insufficiency, but Minimum Methionine Needs Are Increased. J Nutr 2017; 147:1954-1959. [PMID: 28855417 DOI: 10.3945/jn.116.244301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/18/2017] [Accepted: 07/31/2017] [Indexed: 11/14/2022] Open
Abstract
Background: The total sulfur amino acid (TSAA) and minimum Met requirements have been previously determined in healthy children. TSAA metabolism is altered in kidney disease. Whether TSAA requirements are altered in children with chronic renal insufficiency (CRI) is unknown.Objective: We sought to determine the TSAA (Met in the absence of Cys) requirements and minimum Met (in the presence of excess Cys) requirements in children with CRI.Methods: Five children (4 boys, 1 girl) aged 10 ± 2.6 y with CRI were randomly assigned to receive graded intakes of Met (0, 5, 10, 15, 25, and 35 mg · kg-1 · d-1) with no Cys in the diet. Four of the children (3 boys, 1 girl) were then randomly assigned to receive graded dietary intakes of Met (0, 2.5, 5, 7.5, 10, and 15 mg · kg-1 · d-1) with 21 mg · kg-1 · d-1 Cys. The mean TSAA and minimum Met requirements were determined by measuring the oxidation of l-[1-13C]Phe to 13CO2 (F13CO2). A 2-phase linear-regression crossover analysis of the F13CO2 data identified a breakpoint at minimal F13CO2 Urine samples collected from all study days and from previous studies of healthy children were measured for sulfur metabolites.Results: The mean and population-safe (upper 95% CI) intakes of TSAA and minimum Met in children with CRI were determined to be 12.6 and 15.9 mg · kg-1 · d-1 and 7.3 and 10.9 mg · kg-1 · d-1, respectively. In healthy school-aged children the mean and upper 95% CI intakes of TSAA and minimum Met were determined to be 12.9 and 17.2 mg · kg-1 · d-1 and 5.8 and 7.3 mg · kg-1 · d-1, respectively. A comparison of the minimum Met requirements between healthy children and children with CRI indicated significant (P < 0.05) differences.Conclusion: These results suggest that children with CRI have a similar mean and population-safe TSAA to that of healthy children, suggesting adequate Cys synthesis via transsulfuration, but higher minimum Met requirement, suggesting reduced remethylation rates.
Collapse
Affiliation(s)
- Rajavel Elango
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; .,Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad A Humayun
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Justine M Turner
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mahroukh Rafii
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Veronika Langos
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald O Ball
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada; and Departments of
| | - Paul B Pencharz
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics and.,Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
16
|
High Prevalence of Hyperhomocysteinemia and Its Association with Target Organ Damage in Chinese Patients with Chronic Kidney Disease. Nutrients 2016; 8:nu8100645. [PMID: 27775590 PMCID: PMC5084032 DOI: 10.3390/nu8100645] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/27/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023] Open
Abstract
Hyperhomocysteinemia (HHcy) is recognized as a risk factor for cardiovascular disease. However, the prevalence of HHcy and its role in association with target organ damage in patients with chronickidney disease (CKD) are not well understood. This cross-sectional study included 1042 CKD patients who were admitted to our hospital. Patients were divided into two groups: hyperhomocysteinemia and normohomocysteinemia. Multivariable linear regression analyses were used to evaluate the association between plasma homocysteine and renal/cardiovascular parameters. The prevalence of HHcy in patients with CKD was 52.78%, and the prevalence in CKD stage 1, stage 2, stage 3, stage 4 and stage 5 patients was 10.73%, 29.22%, 58.71%, 75.23% and 83.75%, respectively. Patients with HHcy had higher incidences of renal damage, left ventricular hypertrophy, left ventricular diastolic dysfunction and abnormal carotid intima-media thickness compared with patients with normohomocysteinemia (p < 0.05), while multivariable linear regression analyses showed plasma homocysteine was only associated with the estimated glomerular filtration rate (eGFR). eGFR, uric acid, albumin, gender, hemoglobin and calcium×phosphate were associated with levels of plasma homocysteine in these CKD patients. The prevalence of HHcy in Chinese patients with CKD was high, and serum homocysteine levels were associated with impaired renal function in these patients.
Collapse
|
17
|
Naseri M, Sarvari GR, Esmaeeli M, Azarfar A, Rasouli Z, Moeenolroayaa G, Jahanshahi S, Farhadi S, Heydari Z, Sagheb-Taghipoor N. High doses of oral folate and sublingual vitamin B12 in dialysis patients with hyperhomocysteinemia. J Renal Inj Prev 2016; 5:134-9. [PMID: 27689109 PMCID: PMC5039999 DOI: 10.15171/jrip.2016.28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/23/2016] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Folic acid and vitamin B12, alone or in combination have been used to reduce homocysteine (Hcy) levels in dialysis patients. OBJECTIVES We aimed to assess the efficacy of high doses of oral folate and vitamin B12 in reducing plasma Hcy levels after a 12-week treatment. PATIENTS AND METHODS Thirty-two dialysis patients aged 10-324 months screened for hyperhomocysteinuria. Then cases with hyperhomocysteinemia received oral folate 10 mg/day with sublingual methylcobalamin 1 mg/day for 12 weeks. In pre- and post-intervention phases plasma Hcy concentration, serum folate, and vitamin B12 levels were measured. Changes in plasma Hcy, serum folate, and vitamin B12 concentrations were analyzed by paired t tests, and P values < 0.05 were considered significant. RESULTS Eighteen (56.2%) patients had hyperhomocysteinuria. Vitamin B12 and folate levels were normal or high in all cases. Two patients were lost due to transplant or irregular drugs consumption. Plasma Hcy levels were reduced in all, and reached normal values in 50%. A statistically significant differences between first Hcy levels with levels after intervention was found (95% CI, 5.1-8.9, P = 0.0001). CONCLUSION Oral folate 10 mg/day in combination with sublingual vitamin B12, 1 mg/day can be considered as a favorable treatment for hyperhomocysteinemia in dialysis patients.
Collapse
Affiliation(s)
- Mitra Naseri
- Hemodialysis Section, Dr. Sheikh Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Jung KJ, Min KJ, Park JW, Park KM, Kwon TK. Carnosic acid attenuates unilateral ureteral obstruction-induced kidney fibrosis via inhibition of Akt-mediated Nox4 expression. Free Radic Biol Med 2016; 97:50-57. [PMID: 27212017 DOI: 10.1016/j.freeradbiomed.2016.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 05/03/2016] [Accepted: 05/18/2016] [Indexed: 11/29/2022]
Abstract
Fibrosis represents a common pathway to end-stage renal disease. Transforming growth factor-β (TGF-β) plays a critical role in the progression of kidney fibrosis. In the present study, we explored the effect of carnosic acid (CA) against TGF-β-induced fibroblast activation in vitro and unilateral ureteral obstruction (UUO)-induced kidney fibrosis in vivo. CA attenuated TGF-β-induced up-regulation of profibrogenic proteins, α-smooth muscle actin (α-SMA), collagen I (COLI), fibronectin (FN), and plasminogen activator inhibitor-1 (PAI-1) in kidney fibroblast cells (NRK-49F). CA inhibited TGF-β-induced hydrogen peroxide generation via inhibition of NADPH oxidase 4 (Nox4) expressions. In mice, CA-administration markedly mitigated the UUO-induced interstitial extension, collagen deposition, superoxide anion formation, hydrogen peroxide production, and lipid peroxidation. In addition, CA significantly attenuated the expression of α-SMA, COLI, FN, PAI-1, and Nox4 in UUO-induced kidneys. These results indicated that CA attenuated oxidative stress via inhibition of Nox4 expression in TGF-β-stimulated fibroblasts and UUO operated-kidneys, suggesting that CA may be useful for the treatment of fibrosis-related diseases.
Collapse
Affiliation(s)
- Kyong-Jin Jung
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, Republic of Korea
| | - Kyoung-Jin Min
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, Republic of Korea
| | - Jeen-Woo Park
- School of Life Sciences and Biotechnology, College of Natural Sciences, Kyungpook National University, Taegu 702-701, Republic of Korea
| | - Kwon Moo Park
- Department of Anatomy, School of Medicine, Kyungpook National University, Taegu 700-422, Republic of Korea
| | - Taeg Kyu Kwon
- Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, Republic of Korea.
| |
Collapse
|
19
|
Travica N, Ried K, Bujnowski R, Sali A. Integrative health check reveals suboptimal levels in a number of vital biomarkers. ADVANCES IN INTEGRATIVE MEDICINE 2015. [DOI: 10.1016/j.aimed.2015.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
20
|
Pushpakumar S, Kundu S, Sen U. Endothelial dysfunction: the link between homocysteine and hydrogen sulfide. Curr Med Chem 2015; 21:3662-72. [PMID: 25005183 DOI: 10.2174/0929867321666140706142335] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 04/23/2014] [Accepted: 07/01/2014] [Indexed: 12/30/2022]
Abstract
High level of homocysteine (hyperhomocysteinemia, HHcy) is associated with increased risk for vascular disease. Evidence for this emerges from epidemiological studies which show that HHcy is associated with premature peripheral, coronary artery and cerebrovascular disease independent of other risk factors. Possible mechanisms by which homocysteine causes vascular injury include endothelial injury, DNA dysfunction, proliferation of smooth muscle cells, increased oxidative stress, reduced activity of glutathione peroxidase and promoting inflammation. HHcy has been shown to cause direct damage to endothelial cells both in vitro and in vivo. Clinically, this manifests as impaired flow-mediated vasodilation and is mainly due to a reduction in nitric oxide synthesis and bioavailability. The effect of impaired nitric oxide release can in turn trigger and potentiate atherothrombogenesis and oxidative stress. Endothelial damage is a crucial aspect of atherosclerosis and precedes overt manifestation of disease. In addition, endothelial dysfunction is also associated with hypertension, diabetes, ischemia reperfusion injury and neurodegenerative diseases. Homocysteine is a precursor of hydrogen sulfide (H2S) which is formed by transulfuration process catalyzed by the enzymes, cystathionine β-synthase and cystathionine γ-lyase. H2S is a gasotransmitter that has emerged recently as a novel mediator in cardiovascular homeostasis. As a potent vasodilator, it plays several roles which include regulation of vessel diameter, protection of endothelium from redox stress, ischemia reperfusion injury and chronic inflammation. However, the precise mechanism by which it mediates these beneficial effects is complex and still remains unclear. Current evidence indicates H2S modulates cellular functions by a variety of intracellular signaling processes. In this review, we summarize the mechanisms of HHcy-induced endothelial dysfunction and the metabolism and physiological functions of H2S as a protective agent.
Collapse
Affiliation(s)
| | | | - Utpal Sen
- Department of Physiology & Biophysics, University of Louisville School of Medicine, 500 South Preston Street, A-1115; Louisville, KY-40292, USA.
| |
Collapse
|
21
|
Coskunfirat N, Hadimioglu N, Ertug Z, Akbas H, Davran F, Ozdemir B, Aktas Samur A, Arici G. Homocysteine levels after nitrous oxide anesthesia for living-related donor renal transplantation: a randomized, controlled, double-blind study. Transplant Proc 2015; 47:313-8. [PMID: 25648379 DOI: 10.1016/j.transproceed.2014.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/24/2014] [Accepted: 10/05/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Nitrous oxide anesthesia increases postoperative homocysteine concentrations. Renal transplantation candidates present with higher homocysteine levels than patients with no renal disease. We designed this study to investigate if homocysteine levels are higher in subjects receiving nitrous oxide for renal transplantation compared with subjects undergoing nitrous oxide free anesthesia. METHODS Data from 59 patients scheduled for living-related donor renal transplantation surgery were analyzed in this randomized, controlled, blinded, parallel-group, longitudinal trial. Patients were assigned to receive general anesthesia with (flowmeter was set at 2 L/min nitrous oxide and 1 L/min oxygen) or without nitrous oxide (2 L/min air and 1 L/min oxygen). We evaluated levels of total homocysteine and known determinants, including creatinine, folate, vitamin B12, albumin, and lipids. We evaluated factor V and von Willebrand factor (vWF) to determine endothelial dysfunction and creatinine kinase myocardial band (CKMB)-mass, troponin T to show myocardial ischemia preoperatively in the holding area (T1), after discontinuation of anesthetic gases (T2), and 24 hours after induction (T3). RESULTS Compared with baseline, homocysteine concentrations significantly decreased both in the nitrous oxide (22.3 ± 16.3 vs 11.8 ± 9.9; P < .00001) and nitrous oxide-free groups (21.5 ± 15.3 vs 8.0 ± 5.7; P < .0001) at postoperative hour 24. The nitrous oxide group had significantly higher mean plasma homocysteine concentrations than the nitrous oxide-free group (P = .021). The actual homocysteine difference between groups was 3.8 μmol/L. CONCLUSION This study shows that homocysteine levels markedly decrease within 24 hours after living-related donor kidney transplantation. Patients receiving nitrous oxide have a lesser reduction, but this finding is unlikely to have a clinical relevance.
Collapse
Affiliation(s)
- N Coskunfirat
- Anesthesiology and Reanimation Department, Antalya, Turkey.
| | - N Hadimioglu
- Anesthesiology and Reanimation Department, Antalya, Turkey
| | - Z Ertug
- Anesthesiology and Reanimation Department, Antalya, Turkey
| | - H Akbas
- Medical Biochemistry Department, Akdeniz University Hospital, Antalya, Turkey
| | - F Davran
- Medical Biochemistry Department, Akdeniz University Hospital, Antalya, Turkey
| | - B Ozdemir
- Antalya Education and Research, State Hospital, Antalya, Turkey
| | - A Aktas Samur
- Biostatistics and Medical Informatics Department, Akdeniz University Medical School, Antalya, Turkey
| | - G Arici
- Anesthesiology and Reanimation Department, Antalya, Turkey
| |
Collapse
|
22
|
Yang B, Fan S, Zhi X, Wang Y, Wang Y, Zheng Q, Sun G. Prevalence of hyperhomocysteinemia in China: a systematic review and meta-analysis. Nutrients 2014; 7:74-90. [PMID: 25551247 PMCID: PMC4303827 DOI: 10.3390/nu7010074] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 12/12/2014] [Indexed: 12/31/2022] Open
Abstract
Hyperhomocysteinemia (HHcy, total homocysteine concentrations > 15 μmol/L) has been associated with increased risk of many diseases. A systematic review was performed to summarize the prevalence of HHcy in China. We searched multiple international and Chinese scientific databases for relevant literature, and further manually screened reference lists and corresponded with original authors. Pooled prevalence of HHcy was calculated using random effects model. Subgroup analysis, meta-regression and sensitivity analysis were also performed. A total of 36 studies consisting 60,754 subjects (57.3% male; age range, 3–97 years) were finally included. The overall pooled prevalence of HHcy was 27.5%. Geographically, the prevalence was high in north areas, intermediate in central areas, and low in south areas, and was higher in inland versus coastal areas. The prevalence increased with age and was significantly higher in men than in women. Rural residents had a slightly higher HHcy prevalence than urban residents, and the studies conducted during 2006 to 2012 presented a higher HHcy prevalence than those during 1990 to 2005. In summary, the prevalence of HHcy in China is high, particularly in northern populations, the inlanders, males, and the elderly. Homocysteine-lowering strategies are necessary to reduce this highly preventable disorder.
Collapse
Affiliation(s)
- Boyi Yang
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang 110013, China.
| | - Shujun Fan
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang 110013, China.
| | - Xueyuan Zhi
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang 110013, China.
| | - Yinuo Wang
- Division of Molecular Preventive Medicine, Shanghai Institute of Targeted Therapy and Molecular Medicine, Shanghai 200433, China.
| | - Yanxun Wang
- Division of Molecular Preventive Medicine, Shanghai Institute of Targeted Therapy and Molecular Medicine, Shanghai 200433, China.
| | - Quanmei Zheng
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang 110013, China.
| | - Guifan Sun
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang 110013, China.
| |
Collapse
|
23
|
Pastore A, Noce A, Di Giovamberardino G, De Stefano A, Callà C, Zenobi R, Dessì M, Di Daniele N. Homocysteine, cysteine, folate and vitamin B₁₂ status in type 2 diabetic patients with chronic kidney disease. J Nephrol 2014; 28:571-6. [PMID: 25095762 DOI: 10.1007/s40620-014-0126-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 07/20/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hyperhomocysteinemia (hHcy) is a risk factor in the progression of chronic kidney disease (CKD). In type 2 diabetes (T2D), hHcy is strongly associated with increased risk of cardiovascular disease. Vitamin B12 and folic acid supplementation have been reported to lower homocysteine (tHcy) levels, but no data on plasma tHcy, cysteine (Cys), folate and vitamin B12 levels in T2D-CKD patients are reported. PROCEDURES tHcy and Cys levels were analyzed in 178 T2D-CKD patients by high performance liquid chromatography (HPLC) with fluorescence detection. In addition, we determined folate and vitamin B12 levels using a chemiluminescence method. RESULTS tHcy and Cys levels were increased in T2D patients, and this rise positively correlated with the CKD stage (P < 0.001). Folate levels were comparable to controls at various CKD stages, whereas vitamin B12 levels were lower, except at stage IV. We did not find any correlation between B-vitamins and levels of tHcy and Cys, regardless of the CKD stage. CONCLUSIONS This is the first study reporting tHcy, Cys and B-vitamins status in T2D-CKD patients. Although limited to our cohort of 178 patients, our findings could be helpful in clarifying the conflicting literature regarding B-vitamins supplementation. Further studies are necessary before any Hcy-lowering therapy can be safely established in T2D-CKD subjects.
Collapse
Affiliation(s)
- Anna Pastore
- Metabolomic and Proteomic Unit, Children's Hospital "Bambino Gesù", IRCCS, P.zza S. Onofrio, 4, 00165, Rome, Italy.
| | - Annalisa Noce
- Department of Internal Medicine, Nephrology and Hypertension Unit, "Tor Vergata" University Hospital, Rome, Italy
| | - Gianna Di Giovamberardino
- Metabolomic and Proteomic Unit, Children's Hospital "Bambino Gesù", IRCCS, P.zza S. Onofrio, 4, 00165, Rome, Italy
| | | | - Cinzia Callà
- Department of Laboratory Medicine, "Policlinico Gemelli" University Hospital, Rome, Italy
| | - Rossella Zenobi
- Department of Laboratory Medicine, "Tor Vergata" University Hospital, Rome, Italy
| | - Mariarita Dessì
- Department of Laboratory Medicine, "Tor Vergata" University Hospital, Rome, Italy
| | - Nicola Di Daniele
- Department of Internal Medicine, Nephrology and Hypertension Unit, "Tor Vergata" University Hospital, Rome, Italy
| |
Collapse
|
24
|
Rafeq Z, Roh JD, Guarino P, Kaufman J, Joseph J. Adverse myocardial effects of B-vitamin therapy in subjects with chronic kidney disease and hyperhomocysteinaemia. Nutr Metab Cardiovasc Dis 2013; 23:836-842. [PMID: 22902185 DOI: 10.1016/j.numecd.2012.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 06/18/2012] [Accepted: 07/03/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND & AIMS Hyperhomocysteinaemia (HHCY), a common finding in patients with chronic kidney disease (CKD), has been shown to contribute to adverse cardiac remodelling and failure. We hypothesised that in human subjects with CKD, HHCY would be associated with myocardial dysfunction, and that homocysteine (HCY)-lowering therapy would improve myocardial remodelling and heart-failure (HF) outcomes. METHODS AND RESULTS Post hoc analysis of the Homocysteinemia in Kidney and End Stage Renal Disease (HOST) trial (n=2056) was performed to determine if HCY-lowering therapy with high dose B vitamins affects HF outcomes in patients with CKD. In addition, effects on myocardial remodelling were assessed in a subgroup of 220 trial subjects who had transthoracic echocardiograms done before study randomisation and during the course of the study as part of their routine clinical care. HF outcomes were not significantly affected by treatment compared to the placebo. HCY levels were inversely correlated with diastolic function (R=-0.21; p=0.038). Vitamin therapy resulted in a significant increase in left atrial size (+0.15±0.8 cm vs. -0.13±0.07 cm; p=0.0095). No other echocardiographic parameters were significantly associated with baseline HCY levels or changes with vitamin therapy. CONCLUSION HHCY is associated with diastolic dysfunction in patients with CKD. However, B-vitamin therapy did not improve HF outcomes despite lowering of plasma HCY levels, and was associated with an increase in left atrial size, which is a surrogate for worsening left ventricular diastolic dysfunction. These findings suggest that high-dose B vitamin therapy may be harmful in patients with CKD.
Collapse
Affiliation(s)
- Z Rafeq
- Veteran Affairs Boston Healthcare System, Department of Medicine, Boston, MA, USA
| | | | | | | | | |
Collapse
|
25
|
Bamashmoos SA, Al-Nuzaily MA, Al-Meeri AM, Ali FH. Relationship between total homocysteine, total cholesterol and creatinine levels in overt hypothyroid patients. SPRINGERPLUS 2013; 2:423. [PMID: 24024107 PMCID: PMC3766507 DOI: 10.1186/2193-1801-2-423] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/23/2013] [Indexed: 11/10/2022]
Abstract
Hypothyroidism is associated with an increased risk for cardiovascular disease, which can not be fully explained by the atherogenic lipid profile, particularly total cholesterol and LDL-C, and other pathogenic factors may be involved. Plasma total homocysteine (tHcy) is an independent risk factor for cardiovascular disease and accelerated atherosclerosis. The aim of this study was to investigate the serum total homocysteine (tHcy) levels and its relation to total cholesterol, creatinine and thyroid hormones fT3, fT4 and TSH levels in overt hypothyroid patients compared to control subjects. In this study thirty recently diagnosed, non-treated overt hypothyroid patients (f=27, m=3) and twenty normal volunteers control (f=18, m=2) were included and subjected to determination of serum tHcy by enzyme immunoassay (EIA) technique, fT3, fT4 and TSH by Elecsys cobas e 601 analyzer, total cholesterol by enzymatic method and creatinine by kinetic method. The data was statistically analysed by SPSS-10 and p values less than 0.05 were considered significant.Our results showed that there were a significant increase of tHcy, TSH, T.cholesterol and creatinine levels by 113%, 12-folds, 58% and 54%, respectively, and a significant decrease of fT4 and fT3 levels by 49.6% and 56.4% , respectively, in hypothyroid patients than in control group. For tHcy (Mean±SD, 24.45±5.50 μmol/l vs 11.48±3.03 μmol/l, respectively; P < 0.001). tHcy was significantly positively correlated with TSH, creatinine and age and negatively correlated with free thyroxine (fT4) and no significant correlations with fT3 and T.cholesterol. In conclusion, our study confirmed the observation of elevated serum tHcy, T.cholesterol and creatinine in overt hypothyroidism and the presence of an inverse relation between tHcy with fT4 and a positive relation with TSH.
Collapse
Affiliation(s)
- Saleh A Bamashmoos
- Haematology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | | | | | | |
Collapse
|
26
|
Big-endothelin 1 (big ET-1) and homocysteine in the serum of dogs with chronic kidney disease. Vet J 2013; 198:109-15. [PMID: 23899407 DOI: 10.1016/j.tvjl.2013.06.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 05/15/2013] [Accepted: 06/25/2013] [Indexed: 11/20/2022]
Abstract
This study was aimed at determining the serum concentration of homocysteine (Hcy) and big endothelin-1 (big ET-1, the precursor of endothelin) in dogs with chronic kidney disease (CKD) with and without hypertension, proteinuria and inflammation, in order to explore their role as biomarkers of hypertension associated with CKD. Hcy and big ET-1 were measured using an enzyme-linked immunosorbent assay and an enzymatic cyclic reaction, respectively, in dogs with CKD staged, as proposed by the International Renal Interest Society (IRIS), using serum creatinine, urinary protein to creatinine (UPC) ratio and systolic blood pressure, and classified as affected or not by inflammation based on the serum concentration of C-reactive protein (CRP). Serum Hcy was significantly higher in dogs of IRIS stages II, III and IV compared with controls and in proteinuric compared with non-proteinuric dogs. No differences relating to the degree of hypertension or to the CRP concentration were found. Serum big ET-1 significantly increased in dogs of IRIS stage IV compared with controls, in proteinuric compared with non-proteinuric dogs, in dogs with severe hypertension compared with those without hypertension, and in dogs with increased CRP compared to those with normal CRP concentrations. Hcy only correlated with serum creatinine but big ET-1 significantly correlated with serum creatinine, UPC ratio, systolic blood pressure, and increased CRP. In conclusion, both Hcy and big ET-1 increase in dogs with CKD. Although further research is needed, big ET-1, but not Hcy, may also be considered as a biomarker of hypertension.
Collapse
|
27
|
Jung KJ, Jang HS, Kim JI, Han SJ, Park JW, Park KM. Involvement of hydrogen sulfide and homocysteine transsulfuration pathway in the progression of kidney fibrosis after ureteral obstruction. Biochim Biophys Acta Mol Basis Dis 2013; 1832:1989-97. [PMID: 23846016 DOI: 10.1016/j.bbadis.2013.06.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 05/22/2013] [Accepted: 06/26/2013] [Indexed: 12/16/2022]
Abstract
Hydrogen sulfide (H2S) produced by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE) in the transsulfuration pathway of homocysteine plays a number of pathophysiological roles. Hyperhomocysteinemia is involved in kidney fibrosis. However, the role of H2S in kidney fibrosis remains to be defined. Here, we investigated the role of H2S and its acting mechanism in unilateral ureteral obstruction (UO)-induced kidney fibrosis in mice. UO decreased expressions of CBS and CSE in the kidney with decrease of H2S concentration. Treatment with sodium hydrogen sulfide (NaHS, a H2S producer) during UO reduced UO-induced oxidative stress with preservations of catalase, copper-zinc superoxide dismutase (CuZnSOD), and manganese superoxide dismutase (MnSOD) expression, and glutathione level. In addition, NaHS mitigated decreases of CBS and CSE expressions, and H2S concentration in the kidney. NaHS treatment attenuated UO-induced increases in levels of TGF-β1, activated Smad3, and activated NF-κB. This study provided the first evidence of involvement of the transsulfuration pathway and H2S in UO-induced kidney fibrosis, suggesting that H2S and its transsulfuration pathway may be a potential target for development of therapeutics for fibrosis-related diseases.
Collapse
Affiliation(s)
- Kyong-Jin Jung
- Department of Anatomy, Kyungpook National University School of Medicine, Daegu 700-422, Republic of Korea
| | | | | | | | | | | |
Collapse
|
28
|
Nienaber-Rousseau C, Pisa PT, Venter CS, Ellis SM, Kruger A, Moss SJ, Melse-Boonstra A, Towers GW. Nutritional Genetics: The Case of Alcohol and the MTHFR C677T Polymorphism in Relation to Homocysteine in a Black South African Population. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2013; 6:61-72. [DOI: 10.1159/000348839] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 02/08/2013] [Indexed: 01/07/2023]
|
29
|
Lai YJ, Tseng WL. Gold nanoparticle extraction followed by o-phthaldialdehyde derivatization for fluorescence sensing of different forms of homocysteine in plasma. Talanta 2012; 91:103-9. [DOI: 10.1016/j.talanta.2012.01.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/09/2012] [Accepted: 01/12/2012] [Indexed: 12/22/2022]
|
30
|
Dessì M, Noce A, Dawood KF, Galli F, Taccone-Gallucci M, Fabrini R, Bocedi A, Massoud R, Fucci G, Pastore A, Manca di Villahermosa S, Zingaretti V, Federici G, Ricci G. Erythrocyte glutathione transferase: a potential new biomarker in chronic kidney diseases which correlates with plasma homocysteine. Amino Acids 2011; 43:347-54. [DOI: 10.1007/s00726-011-1085-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 05/18/2011] [Indexed: 10/17/2022]
|
31
|
Abstract
In hypertension, an increase in arterial wall thickness and loss of elasticity over time result in an increase in pulse wave velocity, a direct measure of arterial stiffness. This change is reflected in gradual fragmentation and loss of elastin fibers and accumulation of stiffer collagen fibers in the media that occurs independently of atherosclerosis. Similar results are seen with an elevated level of homocysteine (Hcy), known as hyperhomocysteinemia (HHcy), which increases vascular thickness, elastin fragmentation, and arterial blood pressure. Studies from our laboratory have demonstrated a decrease in elasticity and an increase in pulse wave velocity in HHcy cystathionine β synthase heterozygote knockout (CBS(-/+)) mice. Nitric oxide (NO) is a potential regulator of matrix metalloproteinase (MMP) activity in MMP-NO-TIMP (tissue inhibitor of metalloproteinase) inhibitory tertiary complex. We have demonstrated the contribution of the NO synthase (NOS) isoforms, endothelial NOS and inducible NOS, in the activation of latent MMP. The differential production of NO contributes to oxidative stress and increased oxidative/nitrative activation of MMP resulting in vascular remodeling in response to HHcy. The contribution of the NOS isoforms, endothelial and inducible in the collagen/elastin switch, has been demonstrated. We have showed that an increase in inducible NOS activity is a key contributor to HHcy-mediated collagen/elastin switch and resulting decline in aortic compliance. In addition, increased levels of Hcy compete and suppress the γ-amino butyric acid-receptor, N-methyl-d-aspartate-receptor, and peroxisome proliferator-activated receptor. The HHcy causes oxidative stress by generating nitrotyrosine, activating the latent MMPs and decreasing the endothelial NO concentration. The HHcy causes elastinolysis and decrease elastic complicance of the vessel wall. The treatment with γ-amino butyric acid-receptor agonist (muscimol), N-methyl-d-aspartate-receptor antagonist (MK-801), and peroxisome proliferator-activated receptor agonists (ciprofibrate and ciglitazone) mitigates the cardiovascular dysfunction in HHcy [corrected].
Collapse
Affiliation(s)
- Mesia M Steed
- Department of Physiology and Biophysics, University of Louisville School of Medicine, 500 South Preston Street, Louisville, KY 40202, USA
| | | |
Collapse
|
32
|
Khatri M, Nickolas T, Moon YP, Paik MC, Rundek T, Elkind MSV, Sacco RL, Wright CB. CKD associates with cognitive decline. J Am Soc Nephrol 2009; 20:2427-32. [PMID: 19729443 DOI: 10.1681/asn.2008101090] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Cognitive impairment and chronic kidney disease (CKD) will become increasingly prevalent in the aging US population. Although evidence exists that CKD is a risk factor for cognitive decline, longitudinal studies are limited and largely have excluded ethnically diverse populations. The Northern Manhattan Study includes a population-based, prospective, stroke-free cohort. We assessed global cognitive function annually using the modified Telephone Interview for Cognitive Status (TICS-m) and estimated kidney function using Cockcroft-Gault creatinine clearance (CCl), Modification of Diet in Renal Disease estimated GFR (eGFR), and serum creatinine (sCr). We examined the association between CKD and change in TICS-m scores over time, adjusting for sociodemographic and vascular risk factors. Of 2172 subjects (mean age 71.5 yr, mean follow-up 2.9 yr), 59% were Hispanic, 20% were black, and 63% were women. Participants with a CCl <60 ml/min and those with a CCl between 60 and 90 ml/min performed significantly worse on the TICS-m over time than those with a CCl >90 ml/min, adjusting for potential confounders. Our results were similar when we used eGFR or sCr to estimate kidney function. In conclusion, decreased kidney function associates with greater cognitive decline, even in those with mild CKD. Kidney disease may represent a novel mechanism leading to cognitive impairment and a target for early intervention.
Collapse
Affiliation(s)
- Minesh Khatri
- Department of Internal Medicine, University of Washington, Seattle, Washington, USA
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Apeland T, Kristensen O, Mansoor MA. The aminothiol redox status in haemodialysis patients does not improve with folate therapy. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 69:265-71. [DOI: 10.1080/00365510802521143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
34
|
Endothelial nitric oxide synthetase, methylenetetrahydrofolate reductase polymorphisms, and cardiovascular complications in Tunisian patients with nondiabetic renal disease. Clin Biochem 2009; 42:958-64. [DOI: 10.1016/j.clinbiochem.2009.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 04/04/2009] [Accepted: 04/11/2009] [Indexed: 11/18/2022]
|
35
|
Kerkeni M, Letaief A, Achour A, Miled A, Trivin F, Maaroufi K. Hyperhomocysteinemia, paraoxonase concentration and cardiovascular complications in Tunisian patients with nondiabetic renal disease. Clin Biochem 2009; 42:777-82. [PMID: 19233152 DOI: 10.1016/j.clinbiochem.2009.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 02/09/2009] [Accepted: 02/09/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Hyperhomocysteinemia is associated with an increased risk of cardiovascular diseases. We determine homocysteine levels (Hcy), paraoxonase (PON1) concentration and their relationship on cardiovascular complications in patients with chronic renal disease (CRD). DESIGN AND METHODS The study population included 100 CRD patients and 120 healthy controls. Renal function was assessed using the eGFR by the MDRD study equation. Patients were considered to have CRD when the eGFR was <60 mL/min/1.73 m(2). Hcy concentrations were determined by direct chemiluminescence assay. PON1 concentration was measured spectrophotometrically using phenylacetate as a substrate. RESULTS We found an increased Hcy levels and a decreased eGFR and PON1 concentration in CRD patients compared to the control group (P<0.001, P<0.001, P<0.01 respectively). Patients with cardiovascular complications showed an increased Hcy levels and a lower PON1 concentration than patients without cardiovascular complications (P<0.001, P<0.01 respectively). CONCLUSION We showed that hyperhomocysteinemia and low PON1 concentration are associated with CRD and markedly associated in patients with cardiovascular complications. Additional effects contribute to the severity of renal disease and increase the incidence of cardiovascular disease.
Collapse
Affiliation(s)
- Mohsen Kerkeni
- Research Unit 03/UR/08-14, Faculty of Pharmacy, 5000-Monastir, Tunisia.
| | | | | | | | | | | |
Collapse
|
36
|
Falcao S, Bisotto S, Gutkowska J, Lavoie JL. Hyperhomocysteinemia is not sufficient to cause preeclampsia in an animal model: the importance of folate intake. Am J Obstet Gynecol 2009; 200:198.e1-5. [PMID: 19110222 DOI: 10.1016/j.ajog.2008.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 08/08/2008] [Accepted: 10/02/2008] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of our study was to determine whether methylenetetrahydrofolate reductase (Mthfr)-deficient mice develop preeclampsia (PE). STUDY DESIGN Mice were placed on a normal or low-folate/high-methionine (LF/HM) diet to assess the impact of mild and severe homocysteinemia. Blood pressure and proteinuria were measured throughout gestation in Mthfr-deficient and control mice on both diets, by radiotelemetry and by determining the urinary albumin/creatinine ratio by enzyme-linked immunosorbent assay, respectively. RESULTS Although Mthfr-deficient mice have endothelial dysfunction, they do not develop hypertension or proteinuria during gestation. The LF/HM diet induced proteinuria, growth restriction, and a decrease in the number of pups per litter in all mice without any effect on the placenta. CONCLUSION Our study clearly demonstrates that hyperhomocysteinemia is not sufficient to cause PE in this animal model. Furthermore, it confirms the importance of folate intake on pregnancy outcomes.
Collapse
Affiliation(s)
- Stéphanie Falcao
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM) -Technopôle Angus, Montreal, QC, Canada; Department of Biomedical Sciences, Université de Montréal, Montreal, QC, Canada
| | | | | | | |
Collapse
|
37
|
Ipcioglu OM, Ozcan O, Gultepe M, Ates A, Basoglu C, Cakir E. Reduced urinary excretion of homocysteine could be the reason of elevated plasma homocysteine in patients with psychiatric illnesses. Clin Biochem 2008; 41:831-5. [DOI: 10.1016/j.clinbiochem.2008.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 04/01/2008] [Accepted: 04/08/2008] [Indexed: 12/18/2022]
|
38
|
Yi F, Li PL. Mechanisms of homocysteine-induced glomerular injury and sclerosis. Am J Nephrol 2007; 28:254-64. [PMID: 17989498 DOI: 10.1159/000110876] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 09/13/2007] [Indexed: 12/25/2022]
Abstract
Hyperhomocysteinemia (hHcys) has been recognized as a critical risk or pathogenic factor in the progression of end-stage renal disease (ESRD) and in the development of cardiovascular complications related to ESRD. Recently, evidence is accumulating that hHcys may directly act on glomerular cells to induce glomerular dysfunction and consequent glomerular sclerosis, leading to ESRD. In this review, we summarize recent findings that reveal the contribution of homocysteine as a pathogenic factor to the development of glomerular sclerosis or ESRD. In addition, we discuss several important mechanisms mediating the pathogenic action of homocysteine in the glomeruli or in the kidney, such as local oxidative stress, endoplasmic reticulum stress, homocysteinylation, and hypomethylation. Understanding these mechanisms may help design new approaches to develop therapeutic strategies for treatment of hHcys-associated end-organ damage and for prevention of deterioration of kidney function and ultimate ESRD in patients with hypertension and diabetes mellitus or even in aged people with hHcys.
Collapse
Affiliation(s)
- Fan Yi
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298, USA
| | | |
Collapse
|
39
|
Khatri M, Wright CB, Nickolas TL, Yoshita M, Paik MC, Kranwinkel G, Sacco RL, DeCarli C. Chronic kidney disease is associated with white matter hyperintensity volume: the Northern Manhattan Study (NOMAS). Stroke 2007; 38:3121-6. [PMID: 17962588 DOI: 10.1161/strokeaha.107.493593] [Citation(s) in RCA: 173] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE White matter hyperintensities have been associated with increased risk of stroke, cognitive decline, and dementia. Chronic kidney disease is a risk factor for vascular disease and has been associated with inflammation and endothelial dysfunction, which have been implicated in the pathogenesis of white matter hyperintensities. Few studies have explored the relationship between chronic kidney disease and white matter hyperintensities. METHODS The Northern Manhattan Study is a prospective, community-based cohort of which a subset of stroke-free participants underwent MRIs. MRIs were analyzed quantitatively for white matter hyperintensities volume, which was log-transformed to yield a normal distribution (log-white matter hyperintensity volume). Kidney function was modeled using serum creatinine, the Cockcroft-Gault formula for creatinine clearance, and the Modification of Diet in Renal Disease formula for estimated glomerular filtration rate. Creatinine clearance and estimated glomerular filtration rate were trichotomized to 15 to 60 mL/min, 60 to 90 mL/min, and >90 mL/min (reference). Linear regression was used to measure the association between kidney function and log-white matter hyperintensity volume adjusting for age, gender, race-ethnicity, education, cardiac disease, diabetes, homocysteine, and hypertension. RESULTS Baseline data were available on 615 subjects (mean age 70 years, 60% women, 18% whites, 21% blacks, 62% Hispanics). In multivariate analysis, creatinine clearance 15 to 60 mL/min was associated with increased log-white matter hyperintensity volume (beta 0.322; 95% CI, 0.095 to 0.550) as was estimated glomerular filtration rate 15 to 60 mL/min (beta 0.322; 95% CI, 0.080 to 0.564). Serum creatinine, per 1-mg/dL increase, was also positively associated with log-white matter hyperintensity volume (beta 1.479; 95% CI, 1.067 to 2.050). CONCLUSIONS The association between moderate-severe chronic kidney disease and white matter hyperintensity volume highlights the growing importance of kidney disease as a possible determinant of cerebrovascular disease and/or as a marker of microangiopathy.
Collapse
Affiliation(s)
- Minesh Khatri
- Division of Stroke and Critical Care, Department of Neurology, College of Physicians and Surgeons of Columbia University, NI-Room 640, 710 W 168th Street, New York, NY 10032, USA
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Aksoy N, Aksoy M, Cakmak M, Gergerlioglu HS, Davutoglu V, Soydinc S, Meram I. Increased homocysteine in heart failure: a result of renal impairment? Clin Chem Lab Med 2007; 44:1324-9. [PMID: 17087643 DOI: 10.1515/cclm.2006.245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hyperhomocysteinemia may constitute a risk factor for patients with severe heart failure. This study examines the relationship between plasma homocysteine concentration and left ventricular ejection fraction with renal function in heart failure patients free of coronary artery disease. METHODS Left ventricular ejection fraction was documented in 62 patients with advanced heart failure who had no proven significant coronary artery stenosis. Glomerular filtration rate was measured using the Cockroft-Gault equation. RESULTS Elevated homocysteine levels (>or=15 micromol/L) were detected in 22 patients. Low glomerular filtration rate was observed in patients who had normal serum creatinine concentration. Homocysteine was strongly correlated with age, duration of disease, left ventricular ejection fraction, serum creatinine, and glomerular filtration rate. Statistically significant trends were observed across respective homocysteine quartiles. However, by multivariate regression, the strongest predictor of homocysteine was the glomerular filtration rate. CONCLUSIONS Impaired renal function leads to a diminished clearance rate, which can be a prominent pathophysiological mechanism in the elevation of homocysteine concentration in heart failure.
Collapse
Affiliation(s)
- Nur Aksoy
- Department of Medical Laboratory, Vocational School of Higher Education for Health Services, University of Gaziantep, Gaziantep, Turkey.
| | | | | | | | | | | | | |
Collapse
|
41
|
Srinath Reddy K, Katan MB. Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Public Health Nutr 2007; 7:167-86. [PMID: 14972059 DOI: 10.1079/phn2003587] [Citation(s) in RCA: 286] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractCardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases like coronary heart disease (CHD) and stroke and are also linked to other cardiovascular risk factors like diabetes, high blood pressure and obesity. The interpretation of evidence needs to involve a critical appraisal of methodological issues related to measurement of exposures, nature of outcome variables, types of research design and careful separation of cause, consequence and confounding as the basis for observed associations.Adequate evidence is available, from studies conducted within and across populations, to link several nutrients, minerals, food groups and dietary patterns with an increased or decreased risk of CVD. Dietary fats associated with an increased risk of CHD include trans–fats and saturated fats, while polyunsaturated fats are known to be protective. Dietary sodium is associated with elevation of blood pressure, while dietary potassium lowers the risk of hypertension and stroke. Regular frequent intake of fruits and vegetables is protective against hypertension, CHD and stroke. Composite diets (such as DASH diets, Mediterranean diet, ‘prudent’ diet) have been demonstrated to reduce the risk of hypertension and CHD. Sufficient knowledge exists to recommend nutritional interventions, at both population and individual levels, to reduce cardiovascular risk. That knowledge should now be translated into policies which promote healthy diets and discourage unhealthy diets. This requires coordinated action at the level of governments, international organizations, civil society and responsible sections of the food industry.
Collapse
Affiliation(s)
- K Srinath Reddy
- Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
| | | |
Collapse
|
42
|
Herrmann W, Herrmann M, Joseph J, Tyagi SC. Homocysteine, brain natriuretic peptide and chronic heart failure: a critical review. ACTA ACUST UNITED AC 2007; 45:1633-44. [DOI: 10.1515/cclm.2007.360] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractChronic heart failure (CHF) is a major public health problem causing considerable morbidity and mortality. Recently, plasma homocysteine (HCY) has been suggested to be significantly increased in CHF patients. This article reviews the relation between hyperhomocysteinemia (HHCY) and CHF. Clinical data indicate that HHCY is associated with an increased incidence, as well as severity, of CHF. In addition, HCY correlates with brain natriuretic peptide (BNP), a modern biochemical marker of CHF, which is used for diagnosis, treatment guidance and risk assessment. Animal studies showed that experimental HHCY induces systolic and diastolic dysfunction, as well as an increased BNP expression. Moreover, hyperhomocysteinemic animals exhibit an adverse cardiac remodeling characterized by accumulation of interstitial and perivascular collagen. In vitro superfusion experiments with increasing concentrations of HCY in the superfusion medium stimulated myocardial BNP release independent from myocardial wall stress. Thus, clinical and experimental data underline a correlation between HHCY and BNP supporting the role of HHCY as a causal factor for CHF. The mechanisms leading from an elevated HCY level to reduced pump function and adverse cardiac remodeling are a matter of speculation. Existing data indicate that direct effects of HCY on the myocardium, as well as nitric oxide independent vascular effects, are involved. Preliminary data from small intervention trials have initiated the speculation that HCY lowering therapy by micronutrients may improve clinical as well as laboratory markers of CHF.In conclusion, HHCY might be a potential etiological factor in CHF. Future studies need to explore the pathomechanisms of HHCY in CHF. Moreover, larger intervention trials are needed to clarify whether modification of plasma HCY by B-vitamin supplementation improves the clinical outcome in CHF patients.Clin Chem Lab Med 2007;45:1633–44.
Collapse
|
43
|
Righetti M. Homocysteine-lowering vitamin B treatment decreases cardiovascular events in hemodialysis patients. ACTA ACUST UNITED AC 2007; 45:1586-9. [DOI: 10.1515/cclm.2007.335] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractIn Italy, the mortality rate of hemodialysis patients is approximately 14% per year. Cardiovascular disease is the most important cause of morbidity and mortality in hemodialysis patients. High plasma homocysteine levels are commonly detected in these patients, but hyperhomocysteinemia and cardiovascular mortality are not always strictly correlated. The Dialysis Outcomes and Practice Pattern Study (DOPPS) showed a direct association between regular use of water-soluble vitamins and lower cardiovascular mortality. We recently performed a long-term prospective trial to study the effects of folic acid therapy on cardiovascular events in hemodialysis patients. We observed not only a lower rate of combined cardiovascular events in patients treated with folate, but also a direct correlation between hyperhomocysteinemia and cardiovascular morbidity. On the contrary, the distribution of deaths was similar in treated and untreated patients, because, almost certainly, sudden death is not always due to atherosclerotic events, and non-cardiovascular deaths, such as cachexia, septicemia and malignancy were characterized by low levels of homocysteine, which may be, in addition, a nutritional index similar to albumin and protein catabolic rate. As it is known that diabetic hemodialysis patients have a higher mortality rate, but lower homocysteine levels as compared to non-diabetic patients, we performed an equal allocation of diabetic patients in treated and untreated groups. We observed a similar homocysteine reduction rate in diabetic patients as compared to non-diabetic patients, and a trend towards a lower rate of composite cardiovascular events in treated diabetic patients as compared to untreated diabetic patients. To summarize, the strong relationship between homocysteine and nutritional, inflammatory markers may hide its association with cardiovascular disease. Homocysteine-lowering vitamin B therapy may lower cardiovascular events in dialysis patients. It is mandatory to perform large prospective trials to confirm our results.Clin Chem Lab Med 2007;45:1586–9.
Collapse
|
44
|
Lewerin C, Ljungman S, Nilsson-Ehle H. Glomerular filtration rate as measured by serum cystatin C is an important determinant of plasma homocysteine and serum methylmalonic acid in the elderly. J Intern Med 2007; 261:65-73. [PMID: 17222169 DOI: 10.1111/j.1365-2796.2006.01732.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To explore the dependence of glomerular filtration rate (GFR) on plasma total homocysteine (tHcy) and serum methylmalonic acid (MMA), as well as the consequences for the diagnosis of cobalamin and/or folic acid deficiency in an elderly community-dwelling population. DESIGN AND SETTING Population-based study of 209 community-dwelling subjects, mean age 76 years. INTERVENTIONS Four months' treatment study with oral vitamin B(12), folic acid and B(6) or placebo. MAIN OUTCOME MEASURES Determinants of tHcy and MMA: cystatin C as a marker of GFR and serum/plasma concentrations of vitamin B(12) and folate, age and sex. RESULTS Elevated cystatin C (>1.55 mg L(-1)) was found in 31.3% (men) and 13.0% (women). Elevated tHcy (> or = 16 micromol L(-1)) occurred in 53% and elevated MMA (> or = 0.34 micromol L(-1)) in 11% of all subjects. When GFR was taken into consideration, the proportion of elevated tHcy was reduced to 10% (20/209), whilst the proportion of elevated MMA was unchanged. Cystatin C was correlated with tHcy (r = 0.45, P < 0.001) and with MMA (r =0.28, P < 0.001), independently of vitamin B(12)- and folate status. According to multiple regression, independent predictors for tHcy were plasma folate (15%), cystatin C (11%) and vitamin B(12) (4%), and for MMA, cystatin C (8%) and vitamin B(12) (2%). CONCLUSIONS The prevalence of elevated tHcy may be overestimated in elderly populations unless GFR is taken into account. Nomograms for evaluation of tHcy and MMA in relation to both cystatin C and serum creatinine are presented.
Collapse
Affiliation(s)
- C Lewerin
- Department of Medicine, Salhgrenska Academy at Göteborg University, Göteborg, Sweden.
| | | | | |
Collapse
|
45
|
Lin YH, Pao KY, Wu VC, Lin YL, Chien YF, Hung CS, Chen YJ, Liu CP, Tsai IJ, Gau CS, Wu KD, Hwang JJ. The influence of estimated creatinine clearance on plasma homocysteine in hypertensive patients with normal serum creatinine. Clin Biochem 2006; 40:230-4. [PMID: 17222811 DOI: 10.1016/j.clinbiochem.2006.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 11/02/2006] [Accepted: 11/03/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To examine the relation of estimated creatinine clearance (eCrCl) and plasma total homocysteine (tHcy) in hypertensive patients with a normal serum creatinine level. DESIGN AND METHODS A total of 137 hypertensive patients (mean age 66.6 years, 69 men) with serum creatinine level </=1.5 mg/dL gave 10-h fasting blood samples for measurement of tHcy, serum folic acid, and serum vitamin B(12). RESULTS 95 patients fell into a chronic renal insufficiency (CRI) group (eCrCl< or =60 mL/min/1.73 m(2)) and 42 into a normal renal function (NRF) group (eCrCl>60 mL/min/1.73 m(2)). The CRI group was older (p<0.001), had higher tHcy (p<0.001), higher serum urea nitrogen (p<0.001), higher serum creatinine (p<0.001), lower eCrCl (p<0.001), and lower diastolic blood pressure (p=0.001). In univariate analysis, eCrCl had the strongest correlation with tHcy (r=-0.453, p<0.001). Significant correlations, ranging in decreasing order from r=-0.418, p<0.001 to r=-0.170, p=0.047, were also noted between tHcy and twelve other variables. In multivariate analysis, only eCrCl (p<0.001), usage of fibrate (p<0.001), serum level of vitamin B(12) (p=0.002), serum level of folic acid (p=0.009), and smoking (p=0.027) were independent predictors of tHcy. CONCLUSION eCrCl is a strong independent predictor of tHcy in hypertensive patients with normal serum creatinine.
Collapse
Affiliation(s)
- Yen-Hung Lin
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Herrmann M, Taban-Shomal O, Hübner U, Böhm M, Herrmann W. A review of homocysteine and heart failure. Eur J Heart Fail 2006; 8:571-6. [PMID: 16504575 DOI: 10.1016/j.ejheart.2005.11.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Revised: 09/23/2005] [Accepted: 11/29/2005] [Indexed: 10/25/2022] Open
Abstract
Chronic heart failure (CHF) is a major public health problem causing considerable morbidity and mortality. Recently, plasma homocysteine (HCY) has been suggested to be increased in CHF patients potentially representing a newly recognized risk marker. This manuscript reviews the existing literature regarding hyperhomocysteinemia (HHCY) and CHF. Clinical data indicate that HHCY is associated with an increased incidence of CHF as well as with the severity of the disease. Mechanistic studies of HHCY and CHF are rare. However, preliminary results suggest that HHCY causes adverse cardiac remodelling characterized by interstitial and perivascular fibrosis resulting in increased myocardial stiffness. In addition, HHCY seems to affect the pump function of the myocardium. The mechanisms leading from an elevated HCY level to reduced pump function and adverse cardiac remodelling are a matter of speculation. Existing data indicate that direct effects of HCY on the myocardium as well as NO independent vascular effects are involved. In conclusion, HHCY might be a potential aetiological factor in CHF. Future studies need to clarify the mechanistic role of HHCY in CHF as a useful paradigm with most interesting therapeutic implications, because HCY lowering therapy could favourably influence the prognosis in CHF patients.
Collapse
Affiliation(s)
- Markus Herrmann
- Institut für Klinische Chemie und Laboratoriumsmedizin/Zentrallabor, Universitätsklinikum des Saarlandes, D-66421 Homburg/Saar, Germany
| | | | | | | | | |
Collapse
|
47
|
Yi F, Zhang AY, Li N, Muh RW, Fillet M, Renert AF, Li PL. Inhibition of ceramide-redox signaling pathway blocks glomerular injury in hyperhomocysteinemic rats. Kidney Int 2006; 70:88-96. [PMID: 16688115 DOI: 10.1038/sj.ki.5001517] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Ceramide-activated NAD(P)H oxidase has been reported to participate in homocysteine (Hcys)-induced abnormal metabolism of the extracellular matrix (ECM) in rat glomerular mesangial cells. However, it remains unknown whether this ceramide-redox signaling pathway contributes to glomerular injury induced by hyperhomocysteinemia (hHcys) in vivo. The present study was designed to address this question, defining the role of ceramide and activated NAD(P)H oxidase in the development of hHcys-induced glomerular injury. Uninephrectomized Sprague-Dawley rats were fed a folate-free diet for 8 weeks to produce hHcys and the de novo ceramide synthesis inhibitor myriocin or the NAD(P)H oxidase inhibitor apocynin was administrated. Rats with folate-free diet significantly increased plasma Hcys levels, renal ceramide levels, and NAD(P)H oxidase activity accompanied by marked glomerular injury. Treatment of rats with myriocin significantly reduced ceramide levels and improved glomerular injury, as shown by decreased urinary albumin excretion and reduced glomerular damage index. ECM components changed towards to normal levels with decreased tissue inhibitor of metalloproteinase-1 and increased matrix metalloproteinase-1 activity. NAD(P)H oxidase activity and Rac GTPase activity were reduced by 69 and 66%, respectively. In rats treated with apocynin, similar beneficial effects in protecting glomeruli from hHcys-induced injury were observed. These results support the view that de novo ceramide production is involved in Hcys-induced NAD(P)H oxidase activity in the kidney of hHcys rats and indicate the important role of ceramide-mediated redox signaling in hHcys-induced glomerular injury in rats.
Collapse
Affiliation(s)
- F Yi
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | | | | | | | | |
Collapse
|
48
|
Bernasconi AR, Liste A, Del Pino N, Rosa Diez GJ, Heguilén RM. Folic acid 5 or 15 mg/d similarly reduces plasma homocysteine in patients with moderate-advanced chronic renal failure. Nephrology (Carlton) 2006; 11:137-41. [PMID: 16669976 DOI: 10.1111/j.1440-1797.2006.00536.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Hyperhomocysteinaemia is an independent risk factor for cardiovascular disease with a remarkable prevalence in patients with chronic renal failure (CRF). Low doses of folic acid (FA) with or without vitamin B6 and B12 has been shown to effectively reduce plasma homocysteine (Hcy). The aim of this study was to compare the short-term effects of two different oral doses of FA (5 vs 15 mg/d) on plasma Hcy levels in subjects suffering from moderate-severe CRF. METHODS A double-blind, double-dummy, comparative, two-stage randomised study was performed. Seventeen patients aged 45-71 years, with glomerular filtration rates between 15.4-50 mL/min 1.73/m2 were randomly assigned to receive FA 5 mg/d (FA-5, n: 8) or FA 15 mg/d (FA-15, n: 9) for 30 days. At the end of this 30-day double-blind period, all the participants were placed on FA 5 mg/d (open period), for 5 additional months. Both groups were also supplemented with vitamins B1, B6 and B12 throughout the trial. Blood samples were drawn at 0, 15, 30, 90 and 180 days to assess Hcy, complete blood count (CBC) and sequential multichannel analysis (SMA). Chest X-ray and a 12-lead electrocardiogram (ECG) were also performed. RESULTS Plasma Hcy (mean +/- SEM) decreased from 27.9 +/- 1.4 (baseline) to 15.1 +/- 0.6, 13.3 +/- 0.9, 14.1 +/- 0.5 and 13.8 +/- 0.5 micromol/L (FA-5) and from 28.8 +/- 2.7 to 15.6 +/- 1.2, 14.4 +/- 1.3, 13.0 +/- 0.7 and 13.1 +/- 0.6 micromol/L (FA-15) at days 15, 30, 90 and 180, respectively. (P < 0.01 from day 15 to 180 vs baseline for both groups with no differences between them). Renal function remained stable throughout the entire period of the study in all but one patient in whom it deteriorated to pre-end stage disease. No adverse cardiovascular events developed during the trial. CONCLUSION Both folic acid doses induced a significant and similar decrease in plasma Hcy in subjects with moderate-severe chronic renal failure. The possible dose-related effect of this approach in reducing the risk of accelerated sclerotic vascular disease and cardiovascular events in this especially vulnerable population should be a matter of further investigation.
Collapse
|
49
|
Zoungas S, McGrath BP, Branley P, Kerr PG, Muske C, Wolfe R, Atkins RC, Nicholls K, Fraenkel M, Hutchison BG, Walker R, McNeil JJ. Cardiovascular morbidity and mortality in the Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) in chronic renal failure: a multicenter, randomized, controlled trial. J Am Coll Cardiol 2006; 47:1108-16. [PMID: 16545638 DOI: 10.1016/j.jacc.2005.10.064] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Revised: 09/30/2005] [Accepted: 10/03/2005] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) aimed to establish whether high-dose folic acid would slow the progression of atherosclerosis and reduce cardiovascular events in patients with chronic renal failure (CRF). BACKGROUND Hyperhomocysteinemia is a potential contributor to the high rates of cardiovascular morbidity and mortality in patients with CRF. METHODS A total of 315 subjects with CRF, mean age 57 years (range 24 to 79 years) were randomized to 15 mg folic acid daily or placebo and followed for a median of 3.6 years. The primary intima-media thickness (IMT) and clinical end points were: rate of progression of mean maximum carotid IMT and a composite of myocardial infarction (MI), stroke, and cardiovascular death. Secondary end points included all cardiovascular events and change in pulse wave velocity, systemic arterial compliance and augmentation index. Data were analyzed by intention-to-treat. RESULTS Plasma total homocysteine was reduced by 19% in the folic acid group. There was no significant difference between the treatment groups in rate of change of IMT or any measure of artery function. Seventy-seven events occurred in the folic acid group (14.9 per 100 patient-years) as compared with 86 in the placebo group (16.3 per 100 patient-years). The rates of the primary and secondary clinical end points at five years were not significantly different after adjustment for baseline differences between the groups (adjusted hazard ratio for MI, stroke, and cardiovascular death: 0.98 [95% confidence interval: 0.66 to 1.47]; p = 0.94; for all cardiovascular events: 0.95 [95% confidence interval: 0.69 to 1.30]; p = 0.75). CONCLUSIONS High-dose folic acid does not slow atheroma progression or improve cardiovascular morbidity or mortality in patients with CRF.
Collapse
Affiliation(s)
- Sophia Zoungas
- Department of Vascular Sciences and Medicine, Centre for Vascular Health, Monash University, Dandenong Hospital, Dandenong, Victoria, Australia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Fakhrzadeh H, Ghotbi S, Pourebrahim R, Nouri M, Heshmat R, Bandarian F, Shafaee A, Larijani B. Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults: the Tehran homocysteine survey (2003-2004)/a cross-sectional population based study. BMC Public Health 2006; 6:29. [PMID: 16472406 PMCID: PMC1403764 DOI: 10.1186/1471-2458-6-29] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2004] [Accepted: 02/13/2006] [Indexed: 01/30/2023] Open
Abstract
Background Elevated plasma total homocysteine is an independent risk factor for cardiovascular disease and a sensitive marker of the inadequate vitamin B12 and folate insufficiency. Folate and vitamin B12 have a protective effect on cardiovascular disease. This population based study was conducted to evaluate the plasma total homocysteine, folate, and vitamin B12 in healthy Iranian individuals. Methods This study was a part of the Cardiovascular Risk Factors Survey in the Population Lab Region of Tehran University has been designed and conducted based on the methodology of MONICA/WHO Project. A total of 1214 people aged 25–64 years, were recruited and assessed regarding demographic characteristics, homocysteine, folate, and vitamin B12 levels with interview, questionnaires, examination and blood sampling. Blood samples were gathered and analyzed according to standard methods. Results The variables were assessed in 1214 participants including 428 men (35.3%) and 786 women (64.7%). Age-adjusted prevalence of hyperhomocysteinemia (Hcy≥15 μmol/L) was 73.1% in men and 41.07% in women (P < 0.0001). Geometric mean of plasma homocysteine was 19.02 ± 1.46 μmol/l in men and 14.05 ± 1.45 μmol/l in women (P < 0.004) which increased by ageing. Age-adjusted prevalence of low serum folate level was 98.67% in men and 97.92% in women. Age-adjusted prevalence of low serum vitamin B12 level was 26.32% in men and 27.2% in women. Correlation coefficients (Pearson's r) between log tHcy and serum folate, and vitamin B12 indicated an inverse correlation (r = -0.27, r = -0.19, P < 0.0001, respectively). Conclusion These results revealed that the prevalence of hyperhomocysteinemia, low folate and vitamin B12 levels are considerably higher than other communities. Implementation of preventive interventions such as food fortification with folic acid is necessary.
Collapse
Affiliation(s)
- Hossein Fakhrzadeh
- Assistant Professor of Cardiology, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghotbi
- Researcher, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasoul Pourebrahim
- Researcher, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Nouri
- PhD candidate of Epidemiology, Epidemiology and Biostatistics Dep., Public Health School, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- PhD candidate of Health Services Management, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bandarian
- Researcher, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shafaee
- MD laboratory, Researcher, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Professor of Internal Medicine and Endocrinology, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|