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Homocysteın As A Rısk Factor In Acute Ischemic and Acute Hemorrhagic Cerebral Stroke

Year 2008, Volume: 15 Issue: 3, 181 - 185, 01.06.2008

Abstract

Objective : Elevated level of serum homocystein is accepted as a risk factor which is indefinite, changeable and independent for ischemic strokes. However such a relationship in the hemorrhagic strokes has not been vastly discussed. The goal of this study is to investigate whether the elevated serum homocystein level, as a risk factor for the acute ischemic and acute hemorrhagic strokes, shows a meaningful difference or not. Material and Methods : 32 patients who were hospitalized with diagnosis of acute ischemic stroke and 32 patients who were hospitalized with diagnosis of acute hemorrhagic stroke in the Neurology Department of Taksim Training and Research Hospital between February 2005 and June 2006 were included in the study group. None of these patients belonging to the two groups defined a stroke history. The results were evaluated by using the following statistical methods; Mann Whitney U, One-way Variance Analysis, Q square test, Pearson Correlation Analysis, Dunn's Multiple Comparison Test. Results : The average of serum homocystein level in ischemic stroke group and in hemorrhagic stroke group were 15,9 +/- 5.4 μmol/l, 15,8 +/- 6.1 μmol/l respectively (normal adult serum homocystein level is 5-14 μmol/l). No meaningful difference with respect to homocystein level found between two groups. (P>0.05) Conclusion : This study supported that there is no meaningful difference with respect to the elevation of homocystein level between the studied two-groups. Key words: Homocysteine, Acute ischemic cerebrovascular disease, Acute hemorrhagic cerebrovascular disease

References

  • Stanfer MJ,Malino MR et al.A prospective Study of Plasma Homocystein and risk of myocardial infarctıon in US physicians.JAMA 1992;268:877-81
  • Abbot RD, Rodriguez BL, Burchfield CM, et aL. Physical activity in older middle aged men and reduced risk of stroke : The Honolulu Heart Program. Am J Epidemiol. 1994;139;881-93.
  • Adams J.r HP, Bendixen BR, Kapelle J. The TOAST inastigators. Classification of subtypes of acut ischemik stroke Definiation for use in multicenter clinical trial. Stroke.1993;24:35-41.
  • Ashok P, Radhakrishnan K, et al: Incidence and pattern of cerebrovascular disease in benghazi, Libya J Neurol, Neurosurgery psychiatry 1986;49: 519-53.
  • Charles G. C. Spencer, StevenC. et al: Relationship of homocysteine to markers of platelet and endothelial activation in 'high risk 'hypertensives. International Journal of Cardiology 94(2004) 293-300.
  • Velioglu Sibel K, Boz C, Arı N, Uydu Hüseyin A, Özmenoglu M. Skemik strokta akut ve subakut dönemde homosistein düzeyleri. Türk Serebrovasküler Hastalıklar Dergisi., 2003;9: 1-5.
  • Burchfield CM, Curb jD, Rodriguez BL et al. Glucose intolerance and 22 year stroke incidence, The Honolulu Heart program. Stroke.1994;25:951 -7.
  • Kang S, Wong PW, Malinow MR. Hyperhomocysteinemia as risk factor for occlusive vasculer disease. Ann Rev Nutr. 1992;12: 279-98.
  • Bushey CJ, Beresford Sa, Omenn GS, Motulsky AG. Aquantitative assesment of plasma homocysteine as a risk factor for vascular disease probable benefits of increasing folic acid intakes. JAMA. 1995; 274: 1049-57.
  • Bethany Van Guelpen et al, Folat, Vitamin B 12, and Risk of İschemic and Hemorrhagic Stroke: A Prospective, Nested Case-Referent Study of Plasma Concenration and Dietary Intake Stroke 2005 ;36; 1426-31.
  • Eliyahu H, Mizrahi MD, Shlomo Noy MD et al. Furter evidance of İnterrelation between homocysteine and hypertension in stroke patients. A cross sectional study. IMAJ. Volum 5 november, 2003; 791-4.
  • Lindgren A, Brattström l, Norrving B, et al.Plasma Homocysteine in Acute and Convalescent Phases After Stroke. Stroke,1995;26:795-8002.
  • Jun-Hyun Yoo, Chin-Sang Chung, Soo-Sang Kang. Relation of plasma Homocysteine to Cerebral Infarction and Cerebral Atherosclerosis. Stroke, 1998;29: 2478-83.
  • John C.Chambers, MD, et al. Improved Vascular Endothelial Function After Oral B Vitamins. Circulation 2000,102:2479-83.
  • Ka He, MD; Anwar Merchant, DMD; Eric B. Rimm, ScD; Bemard A. Rosner, PhD; Meir J. Stampfer, 110; Walter C. Willett, 110; Alberto Ascherio, MD Folate, Vitamin B6, and B12 Intakes in Relation to Risk of Stroke Among Men. Stroke Januar 2004:169-74.
  • Khamasta MA, Cuadreado MJ, Mujic F et al. The Management of tmonıbosis in the antiphospolipid-antibody sendrome. N Eng J. Med 1995;332:993- 7.
  • Kumral E,Kumral K:İnme risk faktörleri. Nöropsikiyatri arşivi. 1991;28: 55- 8.
  • Kumral E, Özkaya B, Sağduyu A, Şirin H, Vardarlı E, Pehlivan M, The stroke registry. A hospital based study in the Aegian Region, İzmir, Turkey. Analysis of 2000 patients.Cerebrovascular Dis.1998;8:278-88
  • L.Parnetti et al, mild hyperhomocysteinemia is a risk faktör in all etiological subtypes of stroke Neurol sci 2004;25: 13- 7.
  • Modi M, Prabhakar S,et aL. Hyperhomocysteinemia as a risk factor for ischemic stroke: An Indian scenario. Neurology India 2005;53: 297- 301.
  • Nygard O, Vollset SE, Refsum H, et al. Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA 1995;274:1526-33 .
  • Herman B, Leyten A, Van Lujik J et aL. Epiomiology of stroke in Tilburg; The Netherlands. Stroke.1982;13: 629- 34.
  • Hiroyasu Iso MD et al, serum total homosisteine consentrations and risk of strok and ts subtypes in Japanese Cireulation. 2004; 109:2766.
  • P.j KELLY, j.P. Kistler, et al: Inflammation Homocysteine and Vitamin B6 Status After Ischemic Stroke. Stroke 2004;35;12- 5. Özdemir G Ve ark. Türkiyede Beyin damar hastalıkları için major risk faktörleri; Türk çok merkezli strok çalışması. Türk BDH Derg. 2000;6;2: 31- 5 34.
  • James F.Toole, md, M.Rene Malinov, MD, et al: Lowering Homocysteine in Patients With Ischemic Stroke to Prevent Reeurrent Stroke,Myocardial Infarction, and Deth. JAMA.2004;291:565- 75.
  • Gravanis J\1B, Histopathology of artheriosclerosis. Braunwald E (ed) atlas of He art Diseases volume 10, 1996.
  • Manson JE, Stampfer MJ, Willet WC et al, Physical activity and incidence of coronary heart disease and stroke in women. Circulation 1995;9 (supp) 5 Abstract
  • Nencini P, et al, mcidence of stroke in young adults in Florence, Italy stroke 1988;19: 977- 81.
  • Fakhrzadeh H, S Ghotbi, R Pourebrahim. Plasma homocysteine concentration and blood pressure in healthy Iranian adults: the Tehran Homocysteine Survey, Journal of Human Hypertension (2005) 19,869- 76.
  • Malgrem R,et al,Geographical and seculer trends in stroke incidence Lancet 1987;2: 1196-201.
  • Hofmann MA, Lalla E, Lu Y. Hyperhomocysteinemia enhances vascular infiammation and acelerates atherosclerosis in a murine model. J Clin Invest. 2001; 107: 675- 83.
  • Patrizia Nencin, Crstina Sarti, et al: Acute Inflammatory Events and Ischemic Stroke Subtypes. Cerebrovasc Dis 2003; 15: 215- 21
  • Homocysteine and blood pressure in the Third National Health and Nutrition Examinasion Survey, 1988- 1994 Am J Epidemiol 2002;156:1105- 13.
  • Bejot Y, Caillier M, Rouaud O. Epidemiology of strokes. Impact on the treatment decision. Presse Med. 2007 Jan;36(1 Pt 2):117- 27. Epub 2006 Dec 11
  • Sazci A, Ergul E, Tuncer N. Methylenetetrahydrofolate reductase gene polymorphisms are associated with ischemic and hemorrhagic stroke: Dual effect of MTHFR polymorphisms C677T and A1298C. Brain Res Bull. 2006 Dec 11;71(1- 3):45- 50. Epub 2006 Aug 15

Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein

Year 2008, Volume: 15 Issue: 3, 181 - 185, 01.06.2008

Abstract

Amaç : Serum yüksek homosistein düzeyi, iskemik inmeler için bağımsız, değiştirilebilen, kesinleşmemiş bir risk faktörü olarak kabul edilmektedir. Hemorajik inmelerde ise, böyle bir ilişki çok tartışılmamıştır. Bu çalışmanın amacı, serum yüksek homosistein düzeyinin, akut iskemik inme ve akut hemorajik inmeli hastalarda risk faktörü olarak, anlamlı bir fark gösterip göstermeyeceğini değerlendirebilmekti. Gereç ve Yöntem: Taksim Eğitim ve Araştırma Hastanesi Nöroloji Kliniğine Şubat 2005 –Haziran 2006 tarihleri arasında yatırılan, daha önce herhangi bir inme geçirmemiş, akut hemorajik serebrovasküler hastalık tanısı alan 32 olgu ve yine akut iskemik serebrovasküler hastalık tanısı alan 32 olgu değerlendirildi. İstatistiksel olarak sonuçlar; Mann-Whitney-U testi, tek yönlü varyans analizi, ki kare testi, Pearson korelasyon analizi testi, Dunn's çoklu karşılaştırma testi aracılığı ile değerlendirildi. Sonuçlar : İskemik serebrovasküler hastalık grubunda, serum homosistein düzeyi ort: 15.9± 5.4 mmol /L, hemorajik grupta bu düzey ort:15.8± 6.1mmol /L olarak elde edildi. (normal erişkin serum homosistein düzeyi: 5-14 mmol / L). İskemik serebrovasküler hastalık grubundaki serum homosistein düzeyi ile hemorajik serebrovasküler hastalık grubundaki serum homosistein düzeyi arasında anlamlı fark bulunmadı( p>0.05). Yorum : Sonuç olarak yaptığımız çalışma, risk faktörü olarak yüksek serum homosistein düzeylerinin akut iskemik ve akut hemorajik serebrovasküler hastalıklar arasında anlamlı bir fark göstermediğini desteklemektedir. Anahtar kelimeler: Homosistein, Akut iskemik serebrovasküler hastalık, Akut hemorajik serebrovasküler hastalık

References

  • Stanfer MJ,Malino MR et al.A prospective Study of Plasma Homocystein and risk of myocardial infarctıon in US physicians.JAMA 1992;268:877-81
  • Abbot RD, Rodriguez BL, Burchfield CM, et aL. Physical activity in older middle aged men and reduced risk of stroke : The Honolulu Heart Program. Am J Epidemiol. 1994;139;881-93.
  • Adams J.r HP, Bendixen BR, Kapelle J. The TOAST inastigators. Classification of subtypes of acut ischemik stroke Definiation for use in multicenter clinical trial. Stroke.1993;24:35-41.
  • Ashok P, Radhakrishnan K, et al: Incidence and pattern of cerebrovascular disease in benghazi, Libya J Neurol, Neurosurgery psychiatry 1986;49: 519-53.
  • Charles G. C. Spencer, StevenC. et al: Relationship of homocysteine to markers of platelet and endothelial activation in 'high risk 'hypertensives. International Journal of Cardiology 94(2004) 293-300.
  • Velioglu Sibel K, Boz C, Arı N, Uydu Hüseyin A, Özmenoglu M. Skemik strokta akut ve subakut dönemde homosistein düzeyleri. Türk Serebrovasküler Hastalıklar Dergisi., 2003;9: 1-5.
  • Burchfield CM, Curb jD, Rodriguez BL et al. Glucose intolerance and 22 year stroke incidence, The Honolulu Heart program. Stroke.1994;25:951 -7.
  • Kang S, Wong PW, Malinow MR. Hyperhomocysteinemia as risk factor for occlusive vasculer disease. Ann Rev Nutr. 1992;12: 279-98.
  • Bushey CJ, Beresford Sa, Omenn GS, Motulsky AG. Aquantitative assesment of plasma homocysteine as a risk factor for vascular disease probable benefits of increasing folic acid intakes. JAMA. 1995; 274: 1049-57.
  • Bethany Van Guelpen et al, Folat, Vitamin B 12, and Risk of İschemic and Hemorrhagic Stroke: A Prospective, Nested Case-Referent Study of Plasma Concenration and Dietary Intake Stroke 2005 ;36; 1426-31.
  • Eliyahu H, Mizrahi MD, Shlomo Noy MD et al. Furter evidance of İnterrelation between homocysteine and hypertension in stroke patients. A cross sectional study. IMAJ. Volum 5 november, 2003; 791-4.
  • Lindgren A, Brattström l, Norrving B, et al.Plasma Homocysteine in Acute and Convalescent Phases After Stroke. Stroke,1995;26:795-8002.
  • Jun-Hyun Yoo, Chin-Sang Chung, Soo-Sang Kang. Relation of plasma Homocysteine to Cerebral Infarction and Cerebral Atherosclerosis. Stroke, 1998;29: 2478-83.
  • John C.Chambers, MD, et al. Improved Vascular Endothelial Function After Oral B Vitamins. Circulation 2000,102:2479-83.
  • Ka He, MD; Anwar Merchant, DMD; Eric B. Rimm, ScD; Bemard A. Rosner, PhD; Meir J. Stampfer, 110; Walter C. Willett, 110; Alberto Ascherio, MD Folate, Vitamin B6, and B12 Intakes in Relation to Risk of Stroke Among Men. Stroke Januar 2004:169-74.
  • Khamasta MA, Cuadreado MJ, Mujic F et al. The Management of tmonıbosis in the antiphospolipid-antibody sendrome. N Eng J. Med 1995;332:993- 7.
  • Kumral E,Kumral K:İnme risk faktörleri. Nöropsikiyatri arşivi. 1991;28: 55- 8.
  • Kumral E, Özkaya B, Sağduyu A, Şirin H, Vardarlı E, Pehlivan M, The stroke registry. A hospital based study in the Aegian Region, İzmir, Turkey. Analysis of 2000 patients.Cerebrovascular Dis.1998;8:278-88
  • L.Parnetti et al, mild hyperhomocysteinemia is a risk faktör in all etiological subtypes of stroke Neurol sci 2004;25: 13- 7.
  • Modi M, Prabhakar S,et aL. Hyperhomocysteinemia as a risk factor for ischemic stroke: An Indian scenario. Neurology India 2005;53: 297- 301.
  • Nygard O, Vollset SE, Refsum H, et al. Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA 1995;274:1526-33 .
  • Herman B, Leyten A, Van Lujik J et aL. Epiomiology of stroke in Tilburg; The Netherlands. Stroke.1982;13: 629- 34.
  • Hiroyasu Iso MD et al, serum total homosisteine consentrations and risk of strok and ts subtypes in Japanese Cireulation. 2004; 109:2766.
  • P.j KELLY, j.P. Kistler, et al: Inflammation Homocysteine and Vitamin B6 Status After Ischemic Stroke. Stroke 2004;35;12- 5. Özdemir G Ve ark. Türkiyede Beyin damar hastalıkları için major risk faktörleri; Türk çok merkezli strok çalışması. Türk BDH Derg. 2000;6;2: 31- 5 34.
  • James F.Toole, md, M.Rene Malinov, MD, et al: Lowering Homocysteine in Patients With Ischemic Stroke to Prevent Reeurrent Stroke,Myocardial Infarction, and Deth. JAMA.2004;291:565- 75.
  • Gravanis J\1B, Histopathology of artheriosclerosis. Braunwald E (ed) atlas of He art Diseases volume 10, 1996.
  • Manson JE, Stampfer MJ, Willet WC et al, Physical activity and incidence of coronary heart disease and stroke in women. Circulation 1995;9 (supp) 5 Abstract
  • Nencini P, et al, mcidence of stroke in young adults in Florence, Italy stroke 1988;19: 977- 81.
  • Fakhrzadeh H, S Ghotbi, R Pourebrahim. Plasma homocysteine concentration and blood pressure in healthy Iranian adults: the Tehran Homocysteine Survey, Journal of Human Hypertension (2005) 19,869- 76.
  • Malgrem R,et al,Geographical and seculer trends in stroke incidence Lancet 1987;2: 1196-201.
  • Hofmann MA, Lalla E, Lu Y. Hyperhomocysteinemia enhances vascular infiammation and acelerates atherosclerosis in a murine model. J Clin Invest. 2001; 107: 675- 83.
  • Patrizia Nencin, Crstina Sarti, et al: Acute Inflammatory Events and Ischemic Stroke Subtypes. Cerebrovasc Dis 2003; 15: 215- 21
  • Homocysteine and blood pressure in the Third National Health and Nutrition Examinasion Survey, 1988- 1994 Am J Epidemiol 2002;156:1105- 13.
  • Bejot Y, Caillier M, Rouaud O. Epidemiology of strokes. Impact on the treatment decision. Presse Med. 2007 Jan;36(1 Pt 2):117- 27. Epub 2006 Dec 11
  • Sazci A, Ergul E, Tuncer N. Methylenetetrahydrofolate reductase gene polymorphisms are associated with ischemic and hemorrhagic stroke: Dual effect of MTHFR polymorphisms C677T and A1298C. Brain Res Bull. 2006 Dec 11;71(1- 3):45- 50. Epub 2006 Aug 15
There are 35 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Türkan Gezici This is me

Ülgen Kökeş This is me

Fazilet Hız This is me

Semra Bilge This is me

Arif Çelebi This is me

Publication Date June 1, 2008
Published in Issue Year 2008 Volume: 15 Issue: 3

Cite

APA Gezici, T., Kökeş, Ü., Hız, F., Bilge, S., et al. (2008). Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein. Journal of Turgut Ozal Medical Center, 15(3), 181-185.
AMA Gezici T, Kökeş Ü, Hız F, Bilge S, Çelebi A. Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein. J Turgut Ozal Med Cent. June 2008;15(3):181-185.
Chicago Gezici, Türkan, Ülgen Kökeş, Fazilet Hız, Semra Bilge, and Arif Çelebi. “Akut İskemik Ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein”. Journal of Turgut Ozal Medical Center 15, no. 3 (June 2008): 181-85.
EndNote Gezici T, Kökeş Ü, Hız F, Bilge S, Çelebi A (June 1, 2008) Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein. Journal of Turgut Ozal Medical Center 15 3 181–185.
IEEE T. Gezici, Ü. Kökeş, F. Hız, S. Bilge, and A. Çelebi, “Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein”, J Turgut Ozal Med Cent, vol. 15, no. 3, pp. 181–185, 2008.
ISNAD Gezici, Türkan et al. “Akut İskemik Ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein”. Journal of Turgut Ozal Medical Center 15/3 (June 2008), 181-185.
JAMA Gezici T, Kökeş Ü, Hız F, Bilge S, Çelebi A. Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein. J Turgut Ozal Med Cent. 2008;15:181–185.
MLA Gezici, Türkan et al. “Akut İskemik Ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein”. Journal of Turgut Ozal Medical Center, vol. 15, no. 3, 2008, pp. 181-5.
Vancouver Gezici T, Kökeş Ü, Hız F, Bilge S, Çelebi A. Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein. J Turgut Ozal Med Cent. 2008;15(3):181-5.