The Concentration of Plasma Homocysteine in Patients with Acute Cerebral Infarction and its Relationship with TOAST Subtypes_West China Medical Journal

Authors：

 ZHANGLi-yun ^1,2 , JIAYi ¹ , LIUJian-jun ¹ , DAIXiao-jie ¹ , ZHANGWei-xiong ¹ , LUOGuo-gang ²

1. Department of Neurology, Xi'an Gaoxin Hospital, Xi'an, Shaanxi 710075, P. R. China;
2. Department of Neurology, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China;

Corresponding author：

Keywords：

Cerebral infarction; Atherosclerotic; TOAST subtypes; Plasma homocysteine

DOI：

10.7507/1002-0179.20140061

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Objective To explore the concentration of the plasma homocysteine (Hcy) and the relationship with TOAST subtypes in patients with acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction (ACI) treated from April 2012 to April 2013 were enrolled into the ACI group.They were classified with Korean TOAST classification as five subtypes:atherothrombosis (AT) type,small artery disease (SAD) type,cardioembolism (CE) type,stroke of other disease (SOD) type,and stroke of undetermined etiology (SUE) type.The plasma Hcy concentrations in each group and in 60 heathy people who were selected into the control group were measured.Furthermore,the relationship between plasma Hcy concentration and their subtypes were analyzed. Results The plasma Hcy level in ACI group was significant higher than that in the control group (P<0.01).The levels of plasma Hcy were much higher in patients with AT,SAD,SOD,and CE than those in the control groups (P<0.01).In different subtypes,AT and SAD subtypes had higher homocysteine concentration than SUD and CE subtypes did.The concentration of Hcy in AT and SAD group had no significant difference. Conclusion ACI is related to hyperhomocysteinemia.The plasma Hcy level varies with different TOAST subtypes of ACI,specially elevating in the subtypes of AT and SAD,which may indicate that hyperhomocysteinemia may increase stroke risk through proatherogenic effect and endothelial dysfunction.

Citation： ZHANGLi-yun, JIAYi, LIUJian-jun, DAIXiao-jie, ZHANGWei-xiong, LUOGuo-gang. The Concentration of Plasma Homocysteine in Patients with Acute Cerebral Infarction and its Relationship with TOAST Subtypes. West China Medical Journal, 2014, 29(2): 202-205. doi: 10.7507/1002-0179.20140061 Copy

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1. Akpalu A,Nyame P.Plasma homocysteine as a risk factor for strokes in Ghanaian adults[J].Ghana Med J,2009,43(4):157-163.
2. 中华医学会神经科学会.第四届全国脑血管病学术会议通过的脑梗塞的诊断及评分[J].中华神经科杂志,1996,29(6):379-381.
3. Han SW,Kim SH,Lee JY,et al.A new subtype classification of ischemic stroke based on treatment and etiologic mechanism[J].Eur Neurol,2007,57(2):96-102.
4. Iso H,Moriyama Y,Sato S,et al.Serum total homocysteine concentrations and risk of stroke and its subtypes in Japanese[J].Circulation,2004,109(22):2766-2772.
5. Blom HJ,Kleinveld HA,Boers GH,et al.Lipid peroxidation and susceptibility of low-density lipoprotein to in vitro oxidation in hyperhomocysteinaemia[J].Eur J Clin Invest,1995,25(3):149-154.
6. Akalin A,Alatas O,Colak O.Relation of plasma homocysteine levels to atherosclerotic vascular disease and inflammation markers in type 2 diabetic patients[J].Eur J Endocrinol,2008,158(1):47-52.
7. Manrique I,Diaz A,Gavira JJ,et al.Pleliminary result of the effect of treatment of hyperhomocysteinemia and its relationship with inflammation,coagulation status,and endothelial function after renal transplantation[J].Transplant Proc,2005,37(9):3782-3784.
8. 周炯,张松照,章昀,等.脑卒中与血同型半胱氨酸水平的关系[J].中国康复理论与实践,2004,10(3):59-60.
9. Khan U,Crossley C,Kalra L,et al.Homocysteine and its relationship to stroke subtypes in a UK black population:the South London ethnicity and stroke study[J].Stroke,2008,39(11):2943-2949.
10. Hossain GS,van Thienen JV,Werstuck GH,et al.TDAG51 is induced by homocysteine,promotes detachment-mediated programmed cell death,and contributes to the cevelopment of atherosclerosis in hyperhomocysteinemia[J].J Biol Chem,2003,278(32):30317-30327.
11. Tan NC,Venketasubramanian N,Saw SM,et al.Hyperhomocyst (e) inemia and risk of ischemic stroke among young Asian adults[J].Stroke,2002,33(8):1956-1962.
12. Adams HP,Bendixen BH,Kappelle LJ,et al.Classification of subtype of acute ischemic stroke.Definitions for use in a multicenter clinical trial.TOAST.Trial of Org 10172 in Acute Stroke Treatment[J].Stroke,1993,24(1):35-41.
13. Mager A,Orvin K,Koren-Morag N,et al.Impact of homocysteine-lowering vitamin therapy on long-term outcome of patients with coronary artery disease[J].Am J Cardiol,2009,104(6):745-749.

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West China Medical Journal

The Concentration of Plasma Homocysteine in Patients with Acute Cerebral Infarction and its Relationship with TOAST Subtypes

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