Importance of hyperhomocysteinemia as a risk factor for venous thromboembolism in a Taiwanese population. A case-control study.
OBJECTIVE
To determine the current status of hyperhomocysteinemia, which is a known risk for venous thrombosis (DVT), in Taiwan.


METHODS
101 unselected patients with a minimum of one episode of deep leg DVT, either initial inpatients or current compliant outpatients in a teaching hospital.


METHODS
Various thrombophilic risks, gene polymorphism and clinical predisposition were evaluated.


CONCLUSIONS
Patients presented higher fast total plasma homocysteine (hcy) levels than age- and sex-matched controls did (14.1 vs. 9.94 microM). Based on the 95th percentile of control values, hyperhomocysteinemia had a four- to nine-fold risk for DVT, irrespective of clinical predisposition, as well as other thrombophilic risks surveyed. Polymorphism of a metabolizing enzyme, methylenetetrahydrofolate reductase (MTHFR), was not associated with DVT, although homozygous thermolabile mutation tended to have higher plasma hcy levels. Factor V Leiden was absent in analysis of 80 patients. In complete evaluation (hcy, antithrombin (AT), protein S (PS), protein C (PC), lupus anticoagulant (LA), anticardiolipin antibody) of a subset of 83 patients hyperhomocysteinemia was the most prevalent risk (33.7%), with PC or PS deficiencies following (22.9%). Thus, hyperhomocysteinemia is a prominent risk for DVT in Taiwan.
Hsu
T S
TS
First Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan. tshsu@cgmh.org.tw
Hsu
L A
LA
Chang
C J
CJ
Sun
C F
CF
Ko
Y L
YL
Kuo
C T
CT
Chiang
C W
CW
Lee
Y S
YS
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics; D005260:Female; D005838:Genotype; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000453:epidemiology; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D008875:Middle Aged; D009154:Mutation; D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics; D015995:Prevalence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis / Q000235:genetics; D020246:Venous Thrombosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology*
C095381:factor V Leiden; D006710:Homocysteine; D005165:Factor V; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)