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Gao S, Zhao J, Liu X, Liu L, Chen R. Metabolomics reveals serum metabolic signatures in H-type hypertension based on mass spectrometry multi-platform. Eur J Clin Invest 2023; 53:e14063. [PMID: 37458276 DOI: 10.1111/eci.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/14/2023] [Accepted: 06/03/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND H-type hypertension (HHT) is a disease combined with hyperhomocysteinaemia and hypertension (HT). This study aims to find specific metabolic changes and reveal the pathophysiological mechanism of HHT, which provide the theoretical basis for the early prevention and treatment of HHT. METHODS Serum samples from three groups including 53 HHT patients, 36 HT patients and 46 healthy controls (HC) were collected. The targeted and untargeted metabolomics analyses were performed to determine the metabolic changes. Based on multivariate statistical analysis, the serum potential metabolites were screened and different metabolic pathways were explored. RESULTS Our results demonstrated that there were 28 important potential metabolites for distinguishing HT from HHT patients. Metabolic pathway analysis showed that the different metabolic pathways between HHT and HC group were arginine biosynthesis, arginine and proline metabolism, and tyrosine metabolism. The changed metabolic pathway of HT and HC group included linoleic acid metabolism. The specific metabolic pathways of HT-HHT comparison group had phenylalanine metabolism; phenylalanine, tyrosine and tryptophan biosynthesis; glycine, serine and threonine metabolism. CONCLUSIONS Metabolomics analysis by mass spectrometry multi-platform revealed the differences of metabolic profiles between HHT and HT subjects. This work laid the groundwork for understanding the aetiology of HHT, and these findings may provide the useful information for explaining the HHT metabolic alterations and try to prevent HHT.
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Affiliation(s)
- Siqi Gao
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
| | - Jinhui Zhao
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
| | - Xiaowei Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
| | - Liyan Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
| | - Rui Chen
- Department of Orthopedics, Jiangnan University Medical Center, Wuxi, China
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Zhang D, Liu Z, Guo W, Lu Q, Zhang H, Lei Z, Liu P, Huang C, Wang J, Chang Q, Lin X, Wang F, Wu S. Serum homocysteine level is an independent risk factor for 1-year stroke recurrence in patients with acute ischemic stroke and H-type hypertension: results from the Xi'an stroke registry study of China. Front Neurol 2023; 14:1161318. [PMID: 37143996 PMCID: PMC10151713 DOI: 10.3389/fneur.2023.1161318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/31/2023] [Indexed: 05/06/2023] Open
Abstract
Background H-type hypertension has a high prevalence in China. However, the association of serum homocysteine levels with 1-year stroke recurrence in patients with acute ischemic stroke (AIS) and H-type hypertension has not been studied. Methods A prospective cohort study of patients with AIS admitted to hospitals between January and December 2015 in Xi'an, China, was conducted. Serum homocysteine levels, demographic data, and other relevant information were collected from all patients upon admission. Stroke recurrences were routinely tracked at 1, 3, 6, and 12 months after discharge. The blood homocysteine level was studied as a continuous variable and tertiles (T1-T3). A multivariable Cox proportional hazard model and a two-piecewise linear regression model were utilized to evaluate the association and ascertain the threshold effect regarding the serum homocysteine level and 1-year stroke recurrence in patients with AIS and H-type hypertension. Results Overall, 951 patients with AIS and H-type hypertension were enrolled, of whom 61.1% were male. After adjusting for confounders, patients in T3 had a significantly increased risk of recurrent stroke within 1 year, compared with those in T1 as the reference (hazard ratio = 2.24, 95% confidence interval: 1.01-4.97, p = 0.047). Curve fitting showed that serum homocysteine levels were positively curvilinearly correlated with 1-year stroke recurrence. Threshold effect analysis showed that an optimal threshold of serum homocysteine level <25 μmol/L was effective in reducing the risk of 1-year stroke recurrence in patients with AIS and H-type hypertension. Elevated homocysteine levels in patients with severe neurological deficits on admission significantly increased the risk of 1-year stroke recurrence (p for interaction = 0.041). Conclusions In patients with AIS and H-type hypertension, the serum homocysteine level was an independent risk factor for 1-year stroke recurrence. A serum homocysteine level of ≥25 μmol/L significantly increased the risk of 1-year stroke recurrence. These findings can inform the creation of a more precise homocysteine reference range for the prevention and treatment of 1-year stroke recurrence in patients with AIS and H-type hypertension and provide a theoretical foundation for the individualized prevention and treatment of stroke recurrence.
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Affiliation(s)
- Dandan Zhang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Zhongzhong Liu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Epidemiology and Biostatistics, School of Public Health of Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Weiyan Guo
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Qingli Lu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Huan Zhang
- College of Life Science, Northwest University, Xi'an, China
| | - Zhen Lei
- College of Life Science, Northwest University, Xi'an, China
| | - Pei Liu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Congli Huang
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Traditional Chinese Medicine, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Jing Wang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Qiaoqiao Chang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Xuemei Lin
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Fang Wang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Songdi Wu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- College of Life Science, Northwest University, Xi'an, China
- *Correspondence: Songdi Wu
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Wang S, Zhang L, Qi H, Zhang(F) L, Fang Q, Qiu L. Pan-Immune-Inflammatory Value Predicts the 3 Months Outcome in Acute Ischemic Stroke Patients after Intravenous Thrombolysis. Curr Neurovasc Res 2023; 20:464-471. [PMID: 37921190 PMCID: PMC10825792 DOI: 10.2174/0115672026276427231024045957] [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: 08/08/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND PURPOSE Immune and inflammatory response plays a central role in the clinical outcomes of stroke. This study is aimed to explore the clinical significance of the new inflammation index named pan-immune-inflammation value (PIV) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis therapy (IVT). METHODS Data were collected from 717 patients who received IVT at the First Affiliated Hospital of Soochow University. Baseline data were collected before intravenous thrombolysis. Multivariate logistic regression analysis was used to assess the association between PIV and 3 months clinical outcome after intravenous thrombolysis. We also used receiver operating characteristic (ROC) curves analysis to assess the discriminative ability of PIV, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting 3 months poor outcome. RESULTS Of 717 patients, 182 (25.4%) patients had poor outcomes at 3 months. Patients with 3 months of poor outcome had significantly higher PIV levels compared to those with favorable outcomes [316.32 (187.42-585.67) vs. 223.80 (131.76-394.97), p < 0.001)]. After adjusting for potential confounders, the risk of 3 months of poor outcome was significantly higher among patients whose PIV fell in the third quartile (244.21-434.49) and the fourth quartile (> 434.49) than those in the first quartile (< 139.93) (OR = 1.905, 95% CI: 1.040-3.489; OR = 2.229, 95%CI: 1.229-4.044). The area under the ROC curve of PIV to predict 3 months of poor outcome was 0.607 (95%CI: 0.560-0.654; p < 0.001). The optimal cut-off values of PIV were 283.84 (59% sensitivity and 62% specificity). CONCLUSION The higher levels of PIV were independently associated with 3 months of poor outcomes in AIS patients receiving IVT. PIV like other inflammatory factors (PLR, NLR, and SII), can also predict adverse outcomes after IVT in AIS patients.
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Affiliation(s)
- Shan Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lulu Zhang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huan Qi
- Department of General Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lulu Zhang(F)
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Lanfeng Qiu
- Department of Emergency, The First Affiliated Hospital of Soochow University, Suzhou, China
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du Plessis JP, Lammertyn L, Schutte AE, Nienaber-Rousseau C. H-Type Hypertension among Black South Africans and the Relationship between Homocysteine, Its Genetic Determinants and Estimates of Vascular Function. J Cardiovasc Dev Dis 2022; 9:jcdd9120447. [PMID: 36547444 PMCID: PMC9783379 DOI: 10.3390/jcdd9120447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Elevated homocysteine (Hcy) increases cardiovascular disease (CVD) risk. Our objective was to emphasize Hcy’s contribution in hypertension and CVD management by determining H-type hypertension (hypertension with Hcy ≥ 10 µmol/L) and associations between Hcy, blood pressure (BP) and estimates of vascular function among Black South Africans. We included 1995 adults (63% female). Plasma Hcy and cardiovascular measures (systolic and diastolic BP (SBP, DBP), pulse pressure, heart rate (HR), carotid-radialis pulse wave velocity (cr-PWV), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1) were quantified. Five Hcy-related polymorphisms (cystathionine β-synthase (CBS 844ins68, T833C, G9276A); methylenetetrahydrofolate reductase (MTHFR C677T) and methionine synthase (MTR A2756G)) were genotyped. Hcy was >10 µmol/L in 41% (n = 762), and of the 47% (n = 951) hypertensives, 45% (n = 425) presented with H-type. Hcy was higher in hypertensives vs. normotensives (9.86 vs. 8.78 µmol/L, p < 0.0001, effect size 0.56) and correlated positively with SBP, DBP, cr-PWV and ICAM-1 (r > 0.19, p < 0.0001). Over Hcy quartiles, SBP, DBP, HR, cr-PWV and ICAM-1 increased progressively (all p-trends ≤ 0.001). In multiple regression models, Hcy contributed to the variance of SBP, DBP, HR, cr-PWV and ICAM-1. H-type hypertensives also had the lowest MTHFR 677 CC frequency (p = 0.03). Hcy is positively and independently associated with markers of vascular function and raised BP.
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Affiliation(s)
- Jacomina P. du Plessis
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2520, South Africa
| | - Leandi Lammertyn
- Hypertension in Africa Research Team, North-West University, Potchefstroom 2520, South Africa
- Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom Campus, Potchefstroom 2520, South Africa
| | - Aletta E. Schutte
- Hypertension in Africa Research Team, North-West University, Potchefstroom 2520, South Africa
- Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom Campus, Potchefstroom 2520, South Africa
- School of Population Health, University of New South Wales, The George Institute of Global Health, Sydney, NSW 2000, Australia
| | - Cornelie Nienaber-Rousseau
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2520, South Africa
- Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom Campus, Potchefstroom 2520, South Africa
- Correspondence:
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Risk factors and their correlation with severity of cerebral microbleed in acute large artery atherosclerotic cerebral infarction patients. Clin Neurol Neurosurg 2022; 221:107380. [DOI: 10.1016/j.clineuro.2022.107380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/24/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
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Li D, Qiao H, Yang X, Li J, Dai W, Chen X, Shen J, Zhao X. Co-existing Hypertension and Hyperhomocysteinemia Increases the Risk of Carotid Vulnerable Plaque and Subsequent Vascular Event: An MR Vessel Wall Imaging Study. Front Cardiovasc Med 2022; 9:858066. [PMID: 35433864 PMCID: PMC9005821 DOI: 10.3389/fcvm.2022.858066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose This study sought to determine the associations of co-existing hypertension and hyperhomocysteinemia (H-Hcy) with carotid vulnerable plaque features and subsequent vascular events. Methods Symptomatic patients with carotid atherosclerosis were enrolled and underwent carotid magnetic resonance (MR) vessel wall imaging. The patients were divided into the following groups: co-existing hypertension and H-Hcy group; isolated hypertension group; isolated H-Hcy group; and control group. The morphological and compositional characteristics of carotid plaques were assessed on MR images and compared among different groups. Univariate and multivariate cox regressions were used to calculate the hazard ratio (HR) and corresponding 95% confidence interval (CI) of co-existing hypertension and H-Hcy in predicting subsequent vascular events after at least 1-year followed-up. Results In total, 217 patients (mean age, 59.4 ± 11.9 years; 154 males) were recruited. Patients in co-existing hypertension and H-Hcy group had a significantly higher prevalence of carotid lipid-rich necrotic core (LRNC) than isolated H-Hcy and control group (73.2 vs. 43.3 vs. 50%, p = 0.015). During the median follow-up time of 12.2 ± 4.3 months, 61 (39.8%) patients experienced vascular events. After adjusting for baseline confounding factors, co-existing hypertension and H-Hcy (HR, 1.82; 95% CI, 1.01–3.27; p = 0.044), presence of carotid LRNC (HR, 2.25; 95% CI, 1.09–4.65; p = 0.029), and combination of co-existing hypertension and H-Hcy and carotid LRNC (HR, 2.39; 95% CI, 1.26–4.43; p = 0.007) were significantly associated with subsequent vascular events. Conclusions Co-existing hypertension and H-Hcy are associated with carotid vulnerable plaque features, such as LRNC. Combining co-existing hypertension and H-Hcy with carotid vulnerable plaque features has a stronger predictive value for subsequent vascular events than each measurement alone.
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Affiliation(s)
- Dongye Li
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Huiyu Qiao
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China
| | - Xieqing Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jin Li
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wei Dai
- Department of Neurology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Xiaoyi Chen
- Department of Radiology, Beijing Geriatric Hospital, Beijing, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- *Correspondence: Jun Shen
| | - Xihai Zhao
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China
- Xihai Zhao
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Correlation between the B-type Natriuretic Peptide before thrombolysis and prognosis in patients with ischemic stroke. Clin Neurol Neurosurg 2021; 211:107021. [PMID: 34808477 DOI: 10.1016/j.clineuro.2021.107021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Elevated levels of B-type natriuretic peptide (BNP) can predict the prognosis of patients with acute ischemic stroke (AIS). However, the association between BNP levels and the clinical outcome in patients with AIS receiving intravenous thrombolysis treatment remains controversial. Therefore, this study aimed to analyse the role of BNP in patients with ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) therapy. METHODS This retrospective study involved 251 patients who were diagnosed with ischemic stroke and had undergone intravenous thrombolysis. The BNP level in blood was assessed before the treatment of thrombolysis. Outcome events include poor functional outcome, and mortality defined as modified Rankin Scale (mRS) scores of 3-6,and 6 respectively. RESULTS In multivariate logistic regression, BNP > 78 pg/mL (odds ratio, 2.726 [95% CI, 1.440-5.159]; P = 0.002) was an independent risk factor for 3-month poor outcomes in patients with ischemic stroke treated with thrombolysis, whereas BNP > 103 pg/mL (odds ratio, 4.204 [95% CI, 1.382-12.788]; P = 0.011) was significantly associated with the 3-month mortality. The area under the curve (AUC) of BNP before thrombolysis to predict poor functional outcomes at 3 months were 0.679 (95% CI, 0.618-0.737; P < 0.001), and mortality at 3 months was 0.802 (95% CI, 0.747-0.849; P < 0.001), respectively. CONCLUSION An early increase in BNP levels before intravenous thrombolysis was independently associated with 3-month poor outcomes and mortality. Moreover, the pre-thrombolytic BNP level may serve as a more reliable marker for predicting mortality in patients with ischemic stroke.
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Zhao X, Zhao M, Pang B, Zhu Y, Liu J. Diagnostic value of combined serological markers in the detection of acute cerebral infarction. Medicine (Baltimore) 2021; 100:e27146. [PMID: 34516506 PMCID: PMC8428755 DOI: 10.1097/md.0000000000027146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/17/2021] [Indexed: 01/05/2023] Open
Abstract
To evaluate the value of the combination schemes of 10 serological markers in the clinical diagnosis of acute cerebral infarction.The level of total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, homocysteine (HCY), lipoprotein-related phospholipase A2, ischemia-modified albumin, complement C1q, and lipoprotein a were analyzed in 154 patients with acute ischemic cerebral infarction. The optimized diagnostic combination for acute cerebral infarction was explored by calculating the maximum area under the receiver operating characteristic curves (AUC).The levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, HCY, lipoprotein-related phospholipase A2, ischemia-modified albumin, complement C1q, and lipoprotein a were significantly higher in the patient vs the control group. Moreover, the positive rate of HCY reached 89.9%. The analysis of the receiver operating characteristic curve of each index and their combinations showed that the minimum AUC of HDL-C alone was 0.543, while the maximum AUC of HCY was 0.853. A multiple logistic regression analysis indicated that HDL-C was a slightly significant variate in the diagnosis of acute cerebral infarction.The value of individual serological markers in the diagnosis of acute cerebral infarction was slightly significant, while the combination of the markers significantly improved the efficiency of its diagnosis.
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Affiliation(s)
- Xiaowen Zhao
- Department of Clinical Laboratory, Liaocheng People's Hospital, Shandong, China
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Shandong, China
| | - Min Zhao
- Department of Clinical Laboratory, Liaocheng People's Hospital, Shandong, China
| | - Baojun Pang
- Department of Clinical Laboratory, Liaocheng People's Hospital, Shandong, China
| | - Yingnan Zhu
- Department of Clinical Laboratory, Liaocheng People's Hospital, Shandong, China
| | - Jizhu Liu
- Department of Clinical Laboratory, Liaocheng People's Hospital, Shandong, China
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Qian XL, Cao H, Zhang J, Gu ZH, Tang WQ, Shen L, Hu JL, Yao ZF, Zhang L, Tang MN, Lv XC, Zhou J, Jin XJ, Hong B, Cui ZQ, Ge JB. The prevalence, relative risk factors and MTHFR C677T genotype of H type hypertension of the elderly hypertensives in Shanghai, China: a cross-section study : Prevalence of H type hypertension. BMC Cardiovasc Disord 2021; 21:376. [PMID: 34348647 PMCID: PMC8336333 DOI: 10.1186/s12872-021-02151-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/25/2021] [Indexed: 12/27/2022] Open
Abstract
Background H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Studies demonstrated that the existence of hyperhomocysteine (HHcy) in hypertensive exacerbates the poor outcome of cardiocerebral incidents. This study was to investigate the current epidemic situation of H type hypertension and determine the risk factors in order to find intervention targets for H type hypertensives. Methods We conducted a cross-sectional study using cluster sampling design in Shanghai, China from July 2019 and April 2020. 23,652 patients with primary hypertension were enrolled in this study. Their medical information was recorded, and the level of Hcy concentrations and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms were detected. Results In total, 22,731 of 23,652 patients were recorded. The mean age was 68.9 ± 8.6 y and 43% were men. 80.0% of the enrolled patients had H type hypertension. The frequency of allele T was 40.9%, and the proportions of the CC, CT, and TT genotypes were 36.1%, 46.0%, and 17.9%, respectively. Compared with the TT genotype, the plasma Hcy concentration levels were lower in patients with the CC/CT genotype (18.96 ± 13.48 μmol/L vs. 13.62 ± 5.20/14.28 ± 5.36, F = 75.04, p < 0.01). The risk for H type hypertension was higher in elderly people. Men had ~ 5.55-fold odds of H type hypertension compared with women. Patients with CT genotype and TT genotype had ~ 1.36- and ~ 2.76-fold odds of H type hypertension compared with those with CC genotype, respectively. Smoking and diabetes were not significantly associated with H type hypertension. Conclusions The prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China. Age, gender, and MTHFR C677T polymorphisms rather than smoking and diabetes were independently associated with H type hypertension.
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Affiliation(s)
- Xiao-Lin Qian
- Department of Cardiology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, QingPu District Central Hospital Shanghai, Shanghai, China
| | - Hong Cao
- Department of Cardiology, QingPu District Jinze Community Health Center, Shanghai, China
| | - Jun Zhang
- Department of Cardiology, QingPu District Xujing Community Health Center, Shanghai, China
| | - Zhi-Hui Gu
- Department of Cardiology, QingPu District Zhujiajiao Community Health Center, Shanghai, China
| | - Wei-Qin Tang
- Department of Cardiology, QingPu District Xianghuaqiao Community Health Center, Shanghai, China
| | - Lei Shen
- Department of Cardiology, QingPu District Yingpu Community Health Center, Shanghai, China
| | - Jia-Lu Hu
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Zhi-Feng Yao
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Lei Zhang
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Min-Na Tang
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Xu-Cheng Lv
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Jun Zhou
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Xue-Juan Jin
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China
| | - Bin Hong
- Department of Cardiology, Shanghai Zhujiajiao People's Hospital, Shanghai, China.
| | - Zhao-Qiang Cui
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China.
| | - Jun-Bo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease and Zhongshan Hospital Fudan University, Shanghai, China.
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Chumachenko MS, Waseem TV, Fedorovich SV. Metabolomics and metabolites in ischemic stroke. Rev Neurosci 2021; 33:181-205. [PMID: 34213842 DOI: 10.1515/revneuro-2021-0048] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/09/2021] [Indexed: 12/27/2022]
Abstract
Stroke is a major reason for disability and the second highest cause of death in the world. When a patient is admitted to a hospital, it is necessary to identify the type of stroke, and the likelihood for development of a recurrent stroke, vascular dementia, and depression. These factors could be determined using different biomarkers. Metabolomics is a very promising strategy for identification of biomarkers. The advantage of metabolomics, in contrast to other analytical techniques, resides in providing low molecular weight metabolite profiles, rather than individual molecule profiles. Technically, this approach is based on mass spectrometry and nuclear magnetic resonance. Furthermore, variations in metabolite concentrations during brain ischemia could alter the principal neuronal functions. Different markers associated with ischemic stroke in the brain have been identified including those contributing to risk, acute onset, and severity of this pathology. In the brain, experimental studies using the ischemia/reperfusion model (IRI) have shown an impaired energy and amino acid metabolism and confirmed their principal roles. Literature data provide a good basis for identifying markers of ischemic stroke and hemorrhagic stroke and understanding metabolic mechanisms of these diseases. This opens an avenue for the successful use of identified markers along with metabolomics technologies to develop fast and reliable diagnostic tools for ischemic and hemorrhagic stroke.
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Affiliation(s)
- Maria S Chumachenko
- Department of Biochemistry, Faculty of Biology, Belarusian State University, Kurchatova St., 10, Minsk220030, Belarus
| | | | - Sergei V Fedorovich
- Department of Biochemistry, Faculty of Biology, Belarusian State University, Kurchatova St., 10, Minsk220030, Belarus
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11
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Leão LL, Felício LFF, Engedal K, Tangen GG, Kristiansen KM, Santos SHS, de Paula AMB, Monteiro-Junior RS. The Link between Exercise and Homocysteine in the Alzheimer's Disease: A Bioinformatic Network Model. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2021; 20:814-821. [PMID: 34852739 DOI: 10.2174/1871527320666210706122618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 06/13/2023]
Abstract
Elevated peripheral expression of homocysteine (Hcy) is associated with an increased risk of coronary heart disease and stroke, diabetes, and cancer. It is also associated with cognitive impairment as it has been reported that high levels of Hcy cause cognitive dysfunction and memory deficit. Among several etiological factors that contribute to the pathogenesis of neurodegenerative diseases, including Alzheimer's disease (AD), Hcy seems to directly contribute to the generation of neurotoxicity factors. This study aims to hypothesize the molecular mechanism by which exercise can reduce the risk of neurological complications promoted by hyperhomocysteinemia (HHcy), and discuss how exercise could reduce the risk of developing AD by using bioinformatics network models. According to the genes network, there are connections between proteins and amino acids associated with Hcy, exercise, and AD. Studies have evidenced that exercise may be one of several processes by which acid nitric availability can be maximized in the human body, which is particularly important in reducing cell loss and tau pathology and, thereby, leading to a reduced risk of complications associated with HHcy and AD.
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Affiliation(s)
- Luana Lemos Leão
- Graduate Program of Health Sciences, State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Gro Gujord Tangen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Kari Midtbø Kristiansen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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12
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Wang X, Cao Q, Lai Y, Liu X, Zhou Y, Yang L, Zhang L. Association Between Plasma Total Homocysteine Levels and Risk of Early Hemorrhagic Transformation in Patients with Acute Ischemic Stroke: A Hospital-Based Study. J Stroke Cerebrovasc Dis 2020; 30:105538. [PMID: 33341563 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/28/2020] [Accepted: 12/06/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTS In this study, we investigated the association between plasma total homocysteine(tHcy) levels and the risk of early hemorrhagic transformation(HT) in patients with acute ischemic stroke(AIS). METHODS Consecutive hospitalized participants who met the inclusion criteria were enrolled and grouped according to plasma tHcy levels. Participants were divided into a low homocysteine level(L-tHcy) group (<12 µmol/L) and a high homocysteine level group(H-tHcy) (≥ 12 µmol/L). Baseline computed tomography (CT) examination was performed. HT was determined via CT or magnetic resonance imaging within 1 to 3 days after admission. RESULTS A total of 1858 patients were screened and 1378 patients completed the this study(797 patients in the H-tHcy group and 581 patients in the L-tHcy group). HT incidence was 5.2% (30/581,) in the L-tHcy group and 11.2% (90/797) in the H-tHcy group(P<0.05). Binary logistic regression analysis showed that initial NIHSS score, tHcy levels, treatment with recombinant tissue plasminogen activator thrombolysis, systolic blood pressure on admission, glucose level on admission, smoking status and estimated glomerular filtration rate were independent risk factors for HT. Receiver operating characteristic analysis showed that tHcy level was a moderately sensitive and specific index to predict the incidence of HT, and the optimal cutoff was 16.56 μmol/L (sensitivity 63.3%, specificity 41.3%). CONCLUSION Our study findings reveal that high plasma tHcy level is one independent risk factor associated with increased risk of early HT in patients with AIS.
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Affiliation(s)
- Xin Wang
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China
| | - Qiuju Cao
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China.
| | - Yali Lai
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China.
| | - Xindong Liu
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China
| | - Yi Zhou
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China.
| | - Le Yang
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China
| | - Lijuan Zhang
- Department of Neurology, the Second Affiliated Hospital of Chengdu Medical College, (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China.
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13
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Zhang T, Jiang Y, Zhang S, Tie T, Cheng Y, Su X, Man Z, Hou J, Sun L, Tian M, Zhang Y, Li J, Ma Y. The association between homocysteine and ischemic stroke subtypes in Chinese: A meta-analysis. Medicine (Baltimore) 2020; 99:e19467. [PMID: 32195946 PMCID: PMC7220264 DOI: 10.1097/md.0000000000019467] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The findings on the association between elevated plasma homocysteine levels and the risk of the trial of org 10172 in acute stroke treatment (TOAST) of ischemic stroke have been inconsistent in Chinese. So far, there is no meta-analysis about the association between Hcy and the TOAST subtypes of ischemic stroke in Chinese. This study; therefore, aimed to evaluate whether elevated homocysteine levels are associated with the TOAST subtypes of ischemic stroke using a meta-analysis. MATERIALS AND METHODS A systematic search of electronic databases were conducted for studies reporting homocysteine levels in ischemic stroke and the TOAST of ischemic stroke to April 18, 2018. The data were extracted after the application of inclusion and exclusion criteria. All the data were analyzed using Stata software version 9.0 (Stata Corp LP, College Station, TX). The standardized mean difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables. RESULTS Thirteen studies comprising 3114 participants (2243 patients and 871controls) met the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that the ischemic stroke group had significantly higher levels of homocysteine than controls (SMD = 1.15, 95% CI = 0.85-1.45, P < .05). The subgroup analyses suggested that the groups of patients with large-artery atherosclerosis, small-vessel occlusion, cardioembolism, stroke of other determined etiology and stroke of undetermined etiology had significantly higher levels of homocysteine compared to those in the control group (large-artery atherosclerosis: SMD = 2.12, 95% CI = 1.40-2.84, P < .05; small-vessel occlusion: SMD = 1.10, 95% CI = 0.72-1.48, P < .05; CE: SMD = 1.17, 95% CI = 0.64-1.71, P < .05; stroke of other determined etiology: SMD = 0.88, 95% CI = 0.53-1.24, P < .05; stroke of undetermined etiology: SMD = 1.50, 95% CI = 0.66-2.33, P < .05, respectively). CONCLUSION This meta-analysis found that ischemic stroke patients and the TOAST of ischemic stroke patients in Chinese had significantly higher homocysteine levels than the controls, suggesting that serum homocysteine levels may be a risk factor for ischemic stroke and the TOAST subtypes of ischemic stroke in Chinese.
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Affiliation(s)
- Tao Zhang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yuan Jiang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Shuhua Zhang
- Tengzhou Central People's Hospital, Zaozhuang, Shandong province, China
| | - Tingting Tie
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yan Cheng
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Xiaoming Su
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Zhu Man
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Jing Hou
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Li Sun
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Meiyuan Tian
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yaogang Zhang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Jianhua Li
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yanyan Ma
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
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14
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Luo Y, Jin H, Guo ZN, Zhang P, Zhang LY, Chen J, Yu Y, Wang Y, Liu J, He QY, Sun X, Yang Y. Effect of Hyperhomocysteinemia on Clinical Outcome and Hemorrhagic Transformation After Thrombolysis in Ischemic Stroke Patients. Front Neurol 2019; 10:592. [PMID: 31249548 PMCID: PMC6584786 DOI: 10.3389/fneur.2019.00592] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/20/2019] [Indexed: 01/01/2023] Open
Abstract
Background and Purpose: Hyperhomocysteinemia (Hhcy) is a well-known risk factor for ischemic stroke. However, the role of Hhcy in the clinical outcome of ischemic stroke has not been fully elucidated. In addition, previous studies have found that Hhcy was implicated in the disruption of the blood-brain barrier, which may increase the risk of hemorrhagic transformation (HT) after thrombolysis. Thus, the aim of this study was to investigate the effect of Hhcy on the clinical outcome and HT after thrombolysis in ischemic stroke patients. Methods: Patients who were diagnosed with ischemic stroke and received intravenous thrombolytic therapy between January 2016 and September 2018 were included in this study. Multivariate logistic regression analysis was used to assess the association between Hhcy, clinical outcome, and HT after thrombolysis. Furthermore, the potential interaction between Hhcy and hypertension on the clinical outcome and HT after thrombolysis was also assessed. Results: Of 568 patients, 455 (80.1%) had Hhcy, 66 (11.6%) had HT, and 219 (38.6%) had poor outcome. Patients with Hhcy had a higher incidence of poor outcome than the patients with non-Hhcy (40.9 vs. 29.2%, p = 0.022). However, there was no significant difference in the incidence of HT (11.9 vs. 10.6%, p = 0.711) between patients with Hhcy and non-Hhcy. After adjustment for major covariates, multivariate logistic regression analysis disclosed that Hhcy was independently associated with increased risk of poor outcome (OR = 1.760; 95% CI: 1.069–2.896) but was not associated with the risk of HT (OR = 1.017; 95% CI: 0.495–2.087). In addition, we found no significant interaction between Hhcy and hypertension on the clinical outcome (p = 0.513) or HT (p = 0.170) after thrombolysis. Conclusion: We found that Hhcy was an independent risk factor for poor outcome, but not an independent risk factor for HT after thrombolysis in ischemic stroke patients. In addition, there was no significant interaction of Hhcy and hypertension on the clinical outcome or HT after thrombolysis.
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Affiliation(s)
- Yun Luo
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Hang Jin
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Zhen-Ni Guo
- Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, China
| | - Peng Zhang
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Li-Yue Zhang
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Jie Chen
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Yao Yu
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Yan Wang
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Jie Liu
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Qian-Yan He
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Xin Sun
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
| | - Yi Yang
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, China
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15
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Zhang Y, Wang L, Zhou X, Geng J, Li X. The immunomodulatory mechanism of brain injury induced by hyperhomocysteinemia in spontaneously hypertensive rats. J Cell Biochem 2019; 120:9421-9429. [PMID: 30681198 DOI: 10.1002/jcb.28217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/15/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Elevated plasma homocysteine (Hcy) concentration is considered as the diagnostic criteria of Hyperhomocysteinemia (HHcy), which is associated with the inflammatory response and blood-brain barrier disruption. Previous studies have proposed that HHcy with hypertension was associated with the brain injury by enhancing the cerebrovascular permeability, however, the immune mechanism remains obscure. The purpose of the study is to explore the immunomodulatory mechanism of brain injury in spontaneously hypertensive rats (SHRs) induced by HHcy. MATERIALS AND METHODS Sixty SHRs were randomly assigned to three groups: SHR-C (control group), SHR-M (methionine group) and SHR-T (treatment group). Physical examination of body weight, systolic blood pressure (SBP) and plasma Hcy content was measured every 4 weeks. Besides, T-helper cell 17 and regulatory T cells (Treg)-related inflammatory cytokines (interleukin [IL]-6, IL-17, IL-10, and transforming growth factor beta [TGF-β]) and genes (RORγt and FoxP3) were detected by enzyme-linked immunosorbent assay, quantitative polymerase chain reaction , Western blot, and immunohistochemistry. RESULTS High methionine diet could cause weight loss, SBP rising, and plasma Hcy content significantly elevated. IL-16 and IL-17A levels in peripheral blood and in brain tissue both lifted, while IL-10 and TGF-β levels dropped; RORγt expression raised in brain, nevertheless, FoxP3 levels were the opposite. After the intervention with vitamin B6, B12, and folic acid in SHR-T group, these trends would be eased or completely changed. Furthermore, brain tissue slices showed that IL-17-positive cells tended to decrease, and IL-10-positive cells increased in SHR-T group, which was reversed in SHR-M group. CONCLUSIONS HHcy may promote inflammation that can lead to brain lesions and down-regulate immune response to protect the brain.
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Affiliation(s)
- Yu Zhang
- Department of Geriatric, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Lin Wang
- Department of Geriatric, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Zhou
- Department of Cardiovascular disease and heart center, Pingjin Hospital, Logistics university of the Chinese people's armed police forces, Tianjin, China
| | - Jie Geng
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Xin Li
- Department of Geriatric, the Second Hospital of Tianjin Medical University, Tianjin, China
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16
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Yuan M, Wang B, Tan S. Mecobalamin and early functional outcomes of ischemic stroke patients with H-type hypertension. ACTA ACUST UNITED AC 2018; 64:428-432. [PMID: 30304141 DOI: 10.1590/1806-9282.64.05.428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 08/05/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the effect of mecobalamin on the early-functional outcomes of patients with ischemic stroke and H-type hypertension. METHODS From October of 2014 to October of 2016, 224 cases of ischemic stroke and H-type hypertension were selected. The patients were randomly divided into treatment control groups, with 112 patients in each group. The control group was treated with the conventional therapy. The observation group was treated with 500 µg of mecobalamin three times a day in addition to the conventional therapy. We compared serum homocysteine (Hcy), hs-CRP levels, carotid plaques, and NIHSS scores between the two groups on the 2nd day and at 4 weeks, 8 weeks, 3 months, and 6 months. RESULTS After 4 weeks, 8 weeks, 3 months and 6 months, the difference of serum Hcy level between the two groups was statistically significant (t = 4.049, 3.896, 6.052, 6.159, respectively. All P <0.05). After the treatment, at 4 weeks, 8 weeks, 3 months and 6 months, the levels of hs-CRP in the treatment group were significantly lower than those in the control group (t = 37.249, 28.376, 26.454, 20.522, respectively. All P <0.01). After 3 months and 6 months, the carotid artery plaques were significantly reduced in the treatment group compared to those in the control group (t = 2.309 and 2.434. All P <0.05). After 3 months and 6 months, the NIHSS score was significantly higher in the treatment group compared to those in the control group (t = 2.455 and 2.193. All P <0.05). CONCLUSION Mecobalamin can reduce the level of plasma homocysteine, then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques, resulting in more significant functional recovery.
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Affiliation(s)
- Meixia Yuan
- Department of gerontology, shanghai sixth people's hospital affiliated to Shanghai Jiao Tong University, Shanghai China
| | - Beiyun Wang
- Department of gerontology, shanghai sixth people's hospital affiliated to Shanghai Jiao Tong University, Shanghai China
| | - Shijin Tan
- Department of gerontology, shanghai sixth people's hospital affiliated to Shanghai Jiao Tong University, Shanghai China
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17
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Tao LX, Yang K, Wu J, Mahara G, Zhang J, Zhang JB, Ping Z, Guo X. Association between plasma homocysteine and hypertension: Results from a cross-sectional and longitudinal analysis in Beijing's adult population from 2012 to 2017. J Clin Hypertens (Greenwich) 2018; 20:1624-1632. [PMID: 30362656 DOI: 10.1111/jch.13398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 12/22/2022]
Abstract
Plasma homocysteine (Hcy) levels are associated with elevated blood pressure. However, the causal association between Hcy levels and the risk of hypertension remains ambiguous. Taking the study design effect into consideration, this study aimed to investigate this issue through a cross-sectional and longitudinal analysis. Data were obtained from the Beijing Health Management Cohort study, which conducted routine health check-ups from 2012 to 2017. Multivariate logistic regression was used for the cross-sectional analysis, and a quadratic inference function approach was performed for the longitudinal analysis. A total of 30 376 subjects (mean age = 50.0 years) were included in the cross-sectional analysis, and a subgroup of 3913 subjects without hypertension at baseline was included in the longitudinal analysis. After adjusting for potential confounders, the risk of hypertension increased with Hcy levels in the cross-sectional analysis using the traditional definition of hypertension (OR = 1.262, 95% CI: 1.155-1.378, Q2 vs Q1; OR = 1.458, 95% CI: 1.335-1.593, Q3 vs Q1; OR = 1.520, 95% CI: 1.388-1.664, Q4 vs Q1) and the 2017 hypertension definition (OR = 1.159, 95% CI: 1.067-1.259, Q2 vs Q1; OR = 1.328, 95% CI: 1.221-1.445, Q3 vs Q1; OR = 1.328, 95% CI: 1.217-1.449, Q4 vs Q1). The longitudinal analysis showed that hypertension risk increased in the third quartile of Hcy (OR = 1.268, 95% CI: 1.030-1.560, Q3 vs Q1). Elevated total plasma Hcy may be used as a predictive biomarker for hypertension. Attention should be paid to gender-specific mechanisms when issuing precise precautions.
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Affiliation(s)
- Li-Xin Tao
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Kun Yang
- Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Wu
- Department of Clinical Medicine, Peking Union Medical College, Tsinghua University, Beijing, China
| | - Gehendra Mahara
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Jie Zhang
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | | | - Zhao Ping
- Beijing Xiao-Tang-Shan Hospital, Beijing, China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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18
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Association of H-Type Hypertension with Stroke Severity and Prognosis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8725908. [PMID: 30271787 PMCID: PMC6151242 DOI: 10.1155/2018/8725908] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/24/2018] [Accepted: 08/28/2018] [Indexed: 11/25/2022]
Abstract
Background. The correlation between H-type hypertension and acute ischemic stroke remains uncertain. Objective. The present study was designed to explore the possible relationship between H-type hypertension and severity and prognosis of acute ischemic stroke. Method. We included 372 patients with acute ischemic stroke and divided them into four groups: H-type hypertension group, simple hypertension group, simple hyperhomocysteinemia (HHcy) group, and the control group. NIHSS score was measured at both admission and two weeks later. mRS score, stroke recurrence, cardiovascular event, or all-cause mortality was recorded at 3-month and 1-year follow-up. Result. The results showed that the NIHSS score on admission in the H-type hypertension group (6.32 ± 5.91) was significantly higher than that in the control group (3.97 ± 3.59) (P < 0.05), while there was no obvious association between H-type hypertension and NIHSS score after 2-week treatment (P = 0.106). Endpoint events incidence in H-type hypertension group was the highest; however, in the cox regression model of multiple factor analysis, H-type hypertension was not an independent risk factor. Conclusion. H-type hypertension may result in early functional deterioration and higher incidence rate of endpoint events but not act as an independent risk factor.
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19
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Zhou Z, Liang Y, Qu H, Zhao M, Guo F, Zhao C, Teng W. Plasma homocysteine concentrations and risk of intracerebral hemorrhage: a systematic review and meta-analysis. Sci Rep 2018; 8:2568. [PMID: 29416106 PMCID: PMC5803270 DOI: 10.1038/s41598-018-21019-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/29/2018] [Indexed: 12/27/2022] Open
Abstract
Intracerebral hemorrhage (ICH) has the highest mortality rate in all strokes. However, controversy still exists concerning the association between plasma homocysteine (Hcy) and ICH. A systematic review and meta-analysis was conducted using Pubmed, Embase, and Web of Science up to April 18, 2017. Standard mean difference (SMD) for mean differences of plasma Hcy levels with 95% confidence intervals (CI) was calculated. Seven studies including 667 ICH patients and 1821 ischemic stroke patients were identified for meta-analysis. Our results showed that Hcy levels in ICH patients were significantly higher than those in healthy controls (SMD = 0.59, 95% CI = 0.51–0.68, P < 0.001); no statistic differences were found in the comparisons of Hcy levels between ICH and ischemic stroke (SMD = −0.03, 95% CI = −0.13–0.06, P > 0.05); further subgroup analysis of ethnicity (Asians: SMD = 0.57, 95% CI = 0.48–0.66, P < 0.001; Caucasians: SMD = 0.77, 95% CI = 0.51–1.02, P < 0.001) and sample size (small samples: SMD = 0.55, 95% CI = 0.30–0.80, P < 0.001; large samples size: SMD = 0.60, 95% CI = 0.51–0.69, P < 0.001) in relation to Hcy levels between ICH and healthy controls did not change these results. In conclusion, Hcy level may be an aggravating factor in atherosclerosis, which is positively associated with high risk of ICH. Race-specific differences between Asians and Caucasians have no impact on the risk of ICH.
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Affiliation(s)
- Zhike Zhou
- Department of Geriatrics, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yifan Liang
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Huiling Qu
- 3Department of Neurology, The People's Hospital of Liaoning Province, Shenyang, 110016, Liaoning, PR China
| | - Mei Zhao
- Department of Cardiology, The Shengjing Affiliated Hospital, China Medical University, Shenyang, 110004, Liaoning, PR China
| | - Feng Guo
- Department of Neurology, Fuxin Central Hospital, fuxin, 123000, Liaoning, PR China
| | - Chuansheng Zhao
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China.
| | - Weiyu Teng
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China.
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20
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Zhang Y, Wang H, Xu K, Wang P, Li XY, Zhao JB, Tang Y. Ambulatory blood pressure variability within the first 24 hours after admission and outcomes of acute ischemic stroke. ACTA ACUST UNITED AC 2018; 12:195-203. [PMID: 29396105 DOI: 10.1016/j.jash.2017.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/02/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
Our purpose was to evaluate the value of blood pressure variability within the first 24 hours after admission in predicting outcomes of patients with acute ischemic stroke (AIS). A greater variability in systolic blood pressure (adjusted odds ratio [OR] = 1.801, 95% confidence interval [CI] = 1.167-2.779) was associated with poor discharge outcome, especially for nondiabetics (adjusted OR = 1.948, 95% CI = 1.184-3.205) and cardioembolism-related patients with AIS (OR = 7.650, 95% CI = 1.370-42.713). However, this correlation was not observed with a long-term (3-month or 6-month) outcome in patients with AIS. There was no association between diastolic blood pressure variability within the first 24 hours after admission and outcome. In conclusion, systolic blood pressure variability within the first 24 hours after admission is a critical predictor for short-term outcome of patients with AIS.
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Affiliation(s)
- Yu Zhang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China
| | - Hong Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China
| | - Ke Xu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China
| | - Ping Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China
| | - Xin-Yan Li
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China
| | - Jing-Bo Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China.
| | - Ying Tang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, P. R. China.
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21
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Shang J, Wang W, Feng J, Luo GG, Dang Y, Sun J, Yang YQ, Ruan LT. Carotid Plaque Stiffness Measured with Supersonic Shear Imaging and Its Correlation with Serum Homocysteine Level in Ischemic Stroke Patients. Korean J Radiol 2018; 19:15-22. [PMID: 29353995 PMCID: PMC5768496 DOI: 10.3348/kjr.2018.19.1.15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/24/2016] [Indexed: 11/15/2022] Open
Abstract
Objective To ascertain the feasibility of using shear wave velocity (SWV) in assessing the stiffness of carotid plaque by supersonic shear imaging (SSI) and explore preliminary clinical value for such evaluation. Materials and Methods Supersonic shear imaging was performed in 142 patients with ischemic stroke, including 76 males and 66 females with mean age of 66 years (range, 45-80 years). The maximum, minimum, and mean values of SWV were measured for 129 carotid plaques. SWVs were compared between echolucent and echogenic plaques. Correlations between SWVs and serum homocysteine levels were investigated. Based on neurological symptom, the surrogate marker of vulnerable plaque (VP), binary logistic regression was performed and area under curve (AUC) of homocysteine only and homocysteine combing SWVmean was calculated respectively. Results Echogenic plaques (n = 51) had higher SWVs than echolucent ones (n = 78) (SWVmin 3.91 [3.24-4.17] m/s vs. 1.51 [1.04-1.94] m/s; SWVmean, 4.29 [3.98-4.57] m/s vs. 2.09 [1.69-2.41] m/s; SWVmax, 4.67 [4.33-4.86] m/s vs. 2.62 [2.32-3.31] m/s all p values < 0.01). Pearson correlation analysis showed that stiffness of plaques was negatively correlated with homocysteine level. R values for SWVmin, SWVmean, and SWVmax were -0.205, -0.213, and -0.199, respectively. Binary logistic regression analysis showed that sex (p = 0.008), low-density lipoprotein (p = 0.015), triglycerides (p = 0.011), SWVmean (p = 0.004), and hyper-homocysteinemia (p = 0.010) were significantly associated with symptomatic ischemic stroke. Receiver operating characteristic curves revealed that SWVmean combing serum homocysteine level (AUC = 0.67) presented better diagnostic value than serum homocysteine only (AUC = 0.60) for symptomatic ischemic stroke. Conclusion Supersonic shear imaging could be used to quantitatively evaluate stiffness of both echolucent and echogenic carotid plaques. More importantly, SWVs of plaques were not only correlated to serum homocysteine level, but also associated with symptomatic ischemic stroke, suggesting that SSI might be useful for understanding more about VP.
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Affiliation(s)
- Jing Shang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - Wen Wang
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Jun Feng
- Department of Neurology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - Guo-Gang Luo
- Department of Neurology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - Ying Dang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - Jian Sun
- Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - Yan-Qiu Yang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - Li-Tao Ruan
- Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
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22
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Jia J, Wang A, Wang J, Wu J, Yan X, Zhou Y, Chen S, Zhao X. Homocysteine and Its Relationship to Asymptomatic Carotid Stenosis in a Chinese Community Population. Sci Rep 2016; 6:37361. [PMID: 27869211 PMCID: PMC5116757 DOI: 10.1038/srep37361] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/26/2016] [Indexed: 12/03/2022] Open
Abstract
Little is known about the association between homocysteine (Hcy) and asymptomatic CAS in the healthy population. The purpose of this study was to investigate the relationship between Hcy levels and asymptomatic CAS in a Chinese community population. The current study included 5393 participants who were age of 40 years or older, and free of stroke, transient ischemic attack, and coronary artery disease. Demographic and clinical variables were investigated, and the presence of CAS was assessed by Color Doppler Ultrasound. A multivariate logistic regression was used to examine the association between Hcy levels and asymptomatic CAS. 361 (6.69%) participants were diagnosed with asymptomatic CAS, who had higher Hcy levels compared with those without (p-value for trend = 0.0001). After adjusting other possible risk factors, Hcy > 19.3μmol/L was considered as an independent indicator of asymptomatic CAS (OR 1.53, 95%CI 1.05–2.23; p-value for trend = 0.0265), but with a difference between participants with diabetes and without [OR (95%CI): 2.89(1.02–8.22) vs. 1.42(0.95–2.12); P interaction < 0.05]. In this large-population, community-based study, Hcy is an independent indicator of asymptomatic CAS, especially in patients with diabetes.
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Affiliation(s)
- Jiaokun Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Jianwei Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xiujuan Yan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yong Zhou
- Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shengyun Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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23
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Qureshi MI, Vorkas PA, Coupland AP, Jenkins IH, Holmes E, Davies AH. Lessons from Metabonomics on the Neurobiology of Stroke. Neuroscientist 2016; 23:374-382. [PMID: 28345376 DOI: 10.1177/1073858416673327] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The application of metabonomic science to interrogate stroke permits the study of metabolite entities, small enough to cross the blood-brain barrier, that provide insight into neuronal dysfunction, and may serve as reservoirs of biomarker discovery. This systematic review examines the applicability of metabolic profiling in ischemic stroke research. Six human studies utilizing metabolic profiling to analyze biofluids from ischemic stroke patients have been included, employing 1H-NMR and/or mass spectrometry to analyze plasma, serum, and/or urine in a targeted or untargeted fashion. Three are diagnostic studies, and one investigates prognostic biomarkers of stroke recurrence following transient ischemic attack. Two studies focus on metabolic distinguishers of depression or cognitive impairment following stroke. Identified biomarkers from blood and urine predominantly relate to homocysteine and folate, branched chain amino acid, and lipid metabolism. Statistical models are well fitted and reproducible, with excellent validation outcomes, demonstrating the feasibility of metabolic profiling to study a complex disorder with multicausal pathology, such as stroke.
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Affiliation(s)
- Mahim I Qureshi
- 1 Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, London, UK.,2 Computational & Systems Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Panagiotis A Vorkas
- 2 Computational & Systems Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Alexander P Coupland
- 1 Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, London, UK
| | - I Harri Jenkins
- 3 Department of Neurology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Elaine Holmes
- 2 Computational & Systems Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Alun H Davies
- 1 Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, London, UK
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24
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Yao ES, Tang Y, Xie MJ, Wang MH, Wang H, Luo X. Elevated Homocysteine Level Related to Poor Outcome After Thrombolysis in Acute Ischemic Stroke. Med Sci Monit 2016; 22:3268-73. [PMID: 27629768 PMCID: PMC5034885 DOI: 10.12659/msm.900010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Hyperhomocysteinemia (HHcy) is a well-known risk factor for ischemic stroke. However, whether HHcy can influence the treatment outcome of acute ischemic stroke (AIS) patients has yet to be fully determined. In this study, we investigated the relationship between serum homocysteine (Hcy) level and prognosis in AIS patients who received tissue plasminogen activator (tPA) treatment. Material/Methods Patients were recruited according to the research criteria and grouped by their serum Hcy levels. Neurological outcome was evaluated by National Institute of Health Stroke Scale (NIHSS) score system before and 1 week after treatment, and functional outcome was evaluated by modified Rankin Scale (MRS) score system after 3 months. All patients took CT/MRI examination to detect cerebral hemorrhage in 24 hours after tPA treatment. Receiver operating characteristic curve (ROC) was employed to assess if serum homocysteine level can be used as an index to predict the outcome after tPA treatment. Results The mean (±SD) serum Hcy level of 194 patients was 22.62±21.23 μmol/L. After 1-week tPA treatment, the NIHSS scores of high Hcy level group were significantly higher than those of low level group (p<0.05), meantime the high Hcy group showed obvious symptomatic intracerebral hemorrhage risk after 24 hours (p<0.05). Poor outcome was presented in mRS score results after 3 months in high Hcy level group, which compared with low Hcy level group (p<0.01). The ROC showed that Hcy level was a moderately sensitive and specific index to predict the prognosis with an optimal cut-off value at 19.95 μmol/L (sensitivity [58.2%], specificity [80.3%]). Conclusions High serum homocysteine level could potentially predict poor prognosis in acute ischemic stroke patients after tPA treatment.
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Affiliation(s)
- En-Sheng Yao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Yan Tang
- Department of Geriatric, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China (mainland)
| | - Min-Jie Xie
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Ming-Huan Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Hong Wang
- Department of Neurology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China (mainland)
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
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25
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Forti P, Maioli F, Arnone G, Coveri M, Pirazzoli GL, Zoli M, Procaccianti G. Homocysteinemia and early outcome of acute ischemic stroke in elderly patients. Brain Behav 2016; 6:e00460. [PMID: 27096104 PMCID: PMC4828585 DOI: 10.1002/brb3.460] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/23/2016] [Accepted: 02/28/2016] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Plasma total homocysteine (tHcy) is a risk factor for ischemic stroke (IS) but its relationship with IS outcome is uncertain. Moreover, previous studies underrepresented older IS patients, although risk of both hyperhomocysteinemia and IS increases with age. We investigated whether, in elderly patients with acute IS, tHcy measured on admission to the Stroke Unit (SU) is an independent predictor of SU discharge outcomes. MATERIALS AND METHODS Data are for 644 consecutive patients aged 80.3 ± 8.7 years, admitted to an Italian SU with diagnosis of acute IS. Plasma tHcy was measured on SU admission. Investigated outcomes included mortality during SU stay and poor functional status (modified Rankin Scale score ≥3) at SU discharge for survivors. The association of plasma tHcy with the study outcomes was assessed using Odds Ratios (OR) and their corresponding 95% confidence intervals (95%CI) from logistic regression models adjusted for demographics, pre-stroke features, IS severity, and laboratory data on SU admission (serum C-reactive protein, serum albumin, and renal function). RESULTS Median plasma tHcy was 16.7 μmol/L (interquartile range, 13.0-23.3 μmol/L). Outcome incidence was 5.3% for mortality and 49.7% for poor functional status. Plasma tHcy was unrelated to mortality in both univariate and multivariable-adjusted analyses. Conversely, plasma tHcy was associated with poor functional status of survivors in univariate analyses (P = 0.014). Multivariable-adjusted analyses showed that, compared to normal homocysteinemia (tHcy <16 μmol/L), risk of being discharged with poor functional status significantly increased for moderate (tHcy ≥30 mol/L) but not mild (16.0-29.9 μmol/L) hyperhomocysteinemia. CONCLUSIONS In elderly patients with acute IS, high admission plasma tHcy is unrelated to mortality during SU stay but is an independent predictor of poor functional status at SU discharge in survivors. The association, however, is limited to patients with moderate hyperhomocysteinemia.
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Affiliation(s)
- Paola Forti
- Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy
| | - Fabiola Maioli
- Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy
| | - Giorgia Arnone
- Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy
| | - Maura Coveri
- Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy
| | - Gian Luca Pirazzoli
- Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy
| | - Marco Zoli
- Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy
| | - Gaetano Procaccianti
- Neurology Stroke Unit Institute of Neurological Sciences (IRCCS) Maggiore Hospital Bologna Italy
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26
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Cao Q, Zhou S, Cai B, Wang Q, Zhang J, Shi R, Liu K, Liu X, Xu G. The impacts of premorbid hypertension treatment on functional outcomes of ischemic stroke. J Neurol Sci 2016; 363:1-4. [DOI: 10.1016/j.jns.2016.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 11/25/2022]
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27
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Zhong C, Xu T, Xu T, Peng Y, Wang A, Wang J, Peng H, Li Q, Geng D, Zhang D, Zhang Y, Zhang Y, Gao X, He J. Plasma Homocysteine and Prognosis of Acute Ischemic Stroke: a Gender-Specific Analysis From CATIS Randomized Clinical Trial. Mol Neurobiol 2016; 54:2022-2030. [PMID: 26910818 DOI: 10.1007/s12035-016-9799-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/16/2016] [Indexed: 11/24/2022]
Abstract
Elevated total homocysteine level (tHcy) has been hypothesized to be associated with morbidity and mortality of stroke; however, results regarding the association between plasma tHcy status and prognosis of acute ischemic stroke are inconsistent. Moreover, the gender effect on this association has yet to be explored. We thus prospectively investigated whether higher tHcy concentrations predicted poor stroke prognosis in Chinese adults. A total of 3309 acute ischemic stroke patients were included in this prospective multicenter study from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Baseline tHcy concentrations were quantitatively determined via enzymatic cycling assay. The primary outcome was a combination of death and major disability at 3 months (modified Rankin scale scores 3-6) after hospitalization. Multivariate logistic regression models with restricted cubic splines were used to determine the association between baseline plasma tHcy and the subsequent outcome. Higher plasma tHcy concentrations were associated with increased risks of the primary outcome in women but not in men (P interaction = 0.016). Adjusted odds ratios comparing two extreme tHcy quartiles were 1.83 (95 % confidence interval 1.12-2.98; P trend = 0.02) in women and 0.87 (95 % confidence interval 0.61-1.25; P trend = 0.37) in men. The significant association between baseline tHcy status and stroke prognosis in women, but not in men, persisted in further subgroup analyses, stratified by age, baseline systolic blood pressure, and other pre-specified factors. Elevated tHcy is positively associated with poor prognosis of acute ischemic stroke in women, but not in men. Further studies are needed to replicate our findings and to clarify the potential sex-specific mechanisms.
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Affiliation(s)
- Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China.,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Tian Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China.,Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China
| | - Jinchao Wang
- Department of Neurology, Yutian County Hospital, Hebei, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China
| | - Qunwei Li
- Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China
| | - Deqin Geng
- Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China
| | - Dongsheng Zhang
- Department of Neurology and Cardiology, Dongping County People's Hospital, Dongping, Shandong, China
| | - Yuming Zhang
- Department of Neurology, Wenshang County Hospital of Traditional Chinese Medicine, Shandong, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China. .,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
| | - Xiang Gao
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA, USA.
| | - Jiang He
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province, 215123, China. .,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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28
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Tang SC, Yeh SJ, Tsai LK, Hu CJ, Lien LM, Peng GS, Yang WS, Chiou HY, Jeng JS. Cleaved but not endogenous secretory RAGE is associated with outcome in acute ischemic stroke. Neurology 2015; 86:270-6. [PMID: 26683643 DOI: 10.1212/wnl.0000000000002287] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/18/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the expression patterns of 2 soluble isoforms of receptor for advanced glycation end-product (RAGE), including endogenous secretory RAGE (esRAGE) and cleaved RAGE (cRAGE), and their associations with outcome in acute ischemic stroke (IS). METHODS Acute IS patients (n = 106) and age- and sex-matched controls (n = 150) were recruited. Plasma levels of total soluble RAGE (sRAGE) and esRAGE in patients at <48 hours and 48-72 hours after IS and in controls were measured by ELISA. The level of cRAGE was calculated by subtracting the level of sRAGE from that of esRAGE. Poor outcome was defined as modified Rankin Scale score >2 at 3 months after stroke. RESULTS The plasma levels of cRAGE were significantly higher and correlated to those of esRAGE (p < 0.001). The plasma levels of esRAGE and cRAGE were both significantly higher in IS patients <48 hours and 48-72 hours after onset than in controls, but only level of cRAGE at <48 hours was independently associated with poor outcome after adjusting for clinical variables (odds ratio 2.44; 95% confidence interval 1.16-5.16; p = 0.019). CONCLUSION The plasma level of cRAGE at <48 hours after IS, rather than esRAGE, is a significant predictor of acute IS outcome.
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Affiliation(s)
- Sung-Chun Tang
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Shin-Joe Yeh
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Li-Kai Tsai
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Li-Ming Lien
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Giia-Sheun Peng
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Wei-Shiung Yang
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Jiann-Shing Jeng
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan.
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Hu S, Ren L, Wang Y, Zhang R, Zhao X, Liu L, Li W, Wang Y. Homocysteine-lowering therapy and early functional outcomes of ischemic patients with H-type hypertension: a retrospective analysis of CNSR. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2015; 38:785-91. [PMID: 26643782 DOI: 10.1007/s13246-015-0406-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
Abstract
Recently, elevated levels of homocysteine and early neurological deterioration due to acute ischemic stroke have been reported to be strongly correlated. However, the role of homocysteine-lowering therapy (HLT) in the prognosis of acute ischemic stroke patients has remained unclear. This study evaluated the effects of HLT during hospitalization on the early outcomes of the 792 ischemic stroke patients with H-type hypertension from the China National Stroke Registry. The subjects were divided into HLT and non-HLT groups. Demographic and laboratory information were collected, while the functional outcome at discharge and at 90 days follow-up were assessed by National Institutes of Health Stroke Scale and modified Rankin Scale (mRS) in both groups. We found that in the univariate analysis, the proportions of patients with good functional outcomes (mRS = 0-2) were 31.68 versus 29.36 % (OR 0.90, 95 % CI 0.66-1.22, p = 0.45) at discharge and 27.02 versus 28.30 % (OR 1.06, 95 % CI 0.77-1.45, p = 0.72) at 90 days follow-up for the HLT and non-HLT groups, respectively. After multivariate analysis, there was still no significant difference in the outcomes at discharge (OR 0.85, 95 % CI 0.53-1.36, p = 0.49) or at 90 days follow-up (OR 0.98, 95 % CI 0.60-1.60, p = 0.93) for the two groups. The findings of this study indicated that patients with HLT or not during hospitalization had no significant difference in early prognosis. We concluded that HLT during hospitalization did not improve the early functional outcomes of ischemic stroke patients who also had H-type hypertension.
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Affiliation(s)
- Shiyu Hu
- Department of Neurology, Shenzhen University 1st Affiliated Hospital, Shenzhen Second People's Hospital, Sungang West Road, Shenzhen, Guangdong, China
| | - Lijie Ren
- Department of Neurology, Shenzhen University 1st Affiliated Hospital, Shenzhen Second People's Hospital, Sungang West Road, Shenzhen, Guangdong, China.
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Runhua Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Weiping Li
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen University 1st Affiliated Hospital, Shenzhen, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Wang C, Han L, Wu Q, Zhuo R, Liu K, Zhao J, Zhang L, Hao Y, Fan R, Liu Y, Li R, Chen Z, Zhang T, Chen S, Ma J, Liu S, Peng X, Duan S. Association between homocysteine and incidence of ischemic stroke in subjects with essential hypertension: a matched case-control study. Clin Exp Hypertens 2015; 37:557-62. [PMID: 25992490 DOI: 10.3109/10641963.2015.1026039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To assess the association between total plasma homocysteine (tHcy) and ischemic stroke (IS) in hypertensive subjects in a matched case-control study. METHODS This is a 1:2 matched and population-based case-control study, all of the participants were recruited from the 60 communities in Shenzhen, China. Demographic and socioeconomic characteristics, medical records, lifestyle risk factors and other clinical characteristics were obtained from all of the subjects. The association between tHcy and incidence of IS was analyzed by using conditional logistic regression models. RESULTS The median values of plasma tHcy were significantly higher in IS subjects than in non-IS subjects, especially in women. After adjusted for the confounding factors in Model 2, compared with the lowest quartile of tHcy, the odds ratios (ORs) and 95% CIs of the highest quartile of tHcy for IS were 0.83 (0.36-1.90) in men, 4.51 (1.29-15.7) in women and 1.31 (0.70-2.47) in the total subjects; the ORs and 95% CIs for IS per 5 μmol/L increase in homocysteine were 1.11 (0.99-1.22), 1.25 (1.03-1.58) and 1.15 (1.01-1.28) in men, women and total subjects, respectively. We observed significant associations in crude model, Model 1 and Model 2 in women for the comparison of tHcy ≥ 15 μmol/L versus < 15 μmol/L. Interaction analysis showed that the association of tHcy with IS was significant in women (p-interaction = 0.04). CONCLUSION This matched case-control study indicates that tHcy may increase the susceptibility to IS in essential hypertension subjects, especially in women. Further large prospective cohort studies are needed to confirm our findings.
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Affiliation(s)
- Changyi Wang
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Liyuan Han
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Qunhong Wu
- c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and
| | - Renjie Zhuo
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Kui Liu
- d Department of Science Research and Information Management , Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , China
| | - Jinshun Zhao
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Lina Zhang
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Yanhua Hao
- c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and
| | - Rui Fan
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Yanfen Liu
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Runhua Li
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Zhongwei Chen
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Tao Zhang
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Sihan Chen
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Jianping Ma
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Shengyuan Liu
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Xiaolin Peng
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Shiwei Duan
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
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31
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Fu HJ, Zhao LB, Xue JJ, Wu ZX, Huang YP, Liu W, Gao Z. Elevated Serum Homocysteine (Hcy) Levels May Contribute to the Pathogenesis of Cerebral Infarction. J Mol Neurosci 2015; 56:553-61. [DOI: 10.1007/s12031-015-0497-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 01/14/2015] [Indexed: 11/24/2022]
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