title: Relationship between hyperhomocysteinemia and atherosclerosis in chronic hemodialysis patients.
abstract: BACKGROUND
  Hyperhomocysteinemia is an independent risk factor of coronary artery heart disease (CAHD) and atherosclerosis in a normal population. However, it is still controversial in end-stage kidney disease patients who underwent long-term dialysis. Carotid intima-media thickness (IMT) is the standard non-invasive measurement of atherosclerosis. The aims of the present study were to determine the homocysteine (Hcy) level, and to evaluate its role as a risk factor of atherosclerosis in hemodialysis (HD) patients.
  
  
  METHODS
  Clinical data and blood chemistries were assayed in 62 HD patients. Atherosclerosis was defined by clinical presentations of CAHD, cerebrovascular or peripheral vascular diseases, or carotid plaque by ultrasound. IMT was also measured by ultrasound
  
  
  RESULTS
  Plasma Hcy level in HD patients was significantly higher in HD patients than normal controls (28.3 +/- 8.3 vs 9.7 +/- 2.9 micromol/l, p < 0.001). Older age (p < 0.001), male sex (p = 0.05), longer duration of HD (p = 0.05), and higher plasma Hcy level (p = 0.01) correlated with atherosclerosis by univariate analysis, but plasma Hcy did not show significant correlation by multivariable analysis. There was also correlation between IMT and atherosclerosis in HD patients (p < 0.001) but no correlation was observed between plasma Hcy level and lMT.
  
  
  CONCLUSIONS
  Hyperhomocysteinemia is not an independent factor in the genesis of atherosclerosis in HD patients. Advanced age plays a major role of hyperhomocysteinemia and IMT is a useful marker of atherosclerosis in these patients.
authors.affiliation: Renal Division, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Puntapong
authors.initials: P
authors.lastname: Taruangsri
authors.forename: Leena
authors.initials: L
authors.lastname: Ong-Ajyooth
authors.forename: Sompong
authors.initials: S
authors.lastname: Ong-Ajyooth
authors.forename: Walailak
authors.initials: W
authors.lastname: Chaiyasoot
authors.forename: Wattana
authors.initials: W
authors.lastname: Leowattana
authors.forename: Suchai
authors.initials: S
authors.lastname: Sritippayawan
authors.forename: Kriengsak
authors.initials: K
authors.lastname: Vareesangthip
authors.forename: Thawee
authors.initials: T
authors.lastname: Chanchairujira
authors.forename: Somkiat
authors.initials: S
authors.lastname: Vasuvattakul
authors.forename: Chairat
authors.initials: C
authors.lastname: Shayakul
authors.forename: Supat
authors.initials: S
authors.lastname: Vanichakarn
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000209:etiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012307:Risk Factors; D014803:Vitamin B Complex / Q000097:blood
chemical_list: D006710:Homocysteine; D014803:Vitamin B Complex