Hyperhomocysteinaemia and associated disease.
An elevated plasma homocysteine level may result from various environmental and genetic factors. Herediatary causes of severe hyperhomo-cysteinaemia are very rare and usually lead to disease in childhood or adolescence. Common pathology consists of early atherosclerotic vascular changes, arterioocclusive complications and venous thrombosis. Mildly elevated genetically determined plasma homocysteine levels are observed in 5% of the general population. In the last two decades research has shown mild hyperhomocysteinaemia to be linked to an increased risk of premature atherosclerosis, pregnancies complicated by neural tube defects and early pregnancy loss, and venous thrombosis. Homozygosity for thermolabile MTHFR deficiency has been identified as one important genetic factor, which expression is modified by dietary folate intake. Although mild hyperhomocysteinaemia can easily be treated by vitamin supplementation the beneficial effects of such treatment remains to be shown.
Bakker
R C
RC
Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Brandjes
D P
DP
D045103:5,10-Methylenetetrahydrofolate Reductase (FADH2); D001161:Arteriosclerosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006712:Homocystinuria / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D006720:Homozygote; D006801:Humans; D008190:Lyases / Q000172:deficiency; D008661:Metabolism, Inborn Errors / Q000097:blood* / Q000209:etiology / Q000235:genetics / Q000503:physiopathology; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D009436:Neural Tube Defects / Q000453:epidemiology / Q000209:etiology; D010088:Oxidoreductases / Q000172:deficiency*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology; D013924:Thrombophlebitis / Q000453:epidemiology / Q000209:etiology
D006710:Homocysteine; D010088:Oxidoreductases; D045103:5,10-Methylenetetrahydrofolate Reductase (FADH2); D042965:Methylenetetrahydrofolate Reductase (NADPH2); D008190:Lyases; C019965:cystathionine beta-lyase