title: Plasma total homocysteine levels are associated with advanced leukoaraiosis but not with asymptomatic microbleeds on T2*-weighted MRI in patients with stroke.
abstract: Both leukoaraiosis and asymptomatic microbleeds are associated with small-artery diseases. Although an association between hyperhomocysteinemia and leukoaraiosis has been reported, no studies have evaluated the association between total homocysteine (tHcy) level and presence of microbleeds in stroke patients. We evaluated the association between tHcy level and leukoaraiosis or microbleeds in stroke patients. In 102 patients with stroke (69.5 +/- 10.3 years old, 54 men and 48 women), microbleeds on T2*-weighted MR images were counted, leukoaraiosis on T2-weighted images was graded and fasting plasma tHcy concentrations were measured. Plasma tHcy level was significantly higher in patients with advanced leukoaraiosis than in those without advanced leukoaraiosis (13.9 +/- 4.6 micromol/l vs. 10.2 +/- 3.4 micromol/l, P < 0.0001). Plasma tHcy level was not significantly different in patients with microbleeds and those without microbleeds (11.3 +/- 4.1 micromol/l vs. 11.4 +/- 4.3 micromol/l, P = 0.9441). Elevated tHcy level is significantly and independently associated with advanced leukoaraiosis [odds ratio (OR), 1.330; 95% CI, 1.130-1.565] but not with the presence of microbleeds. Elevated tHcy level appears to be associated with ischemic small-artery disease rather than with bleeding-prone small-artery disease.
authors.affiliation: Department of Neurology, Suiseikai Kajikawa Hospital, Showamachi, Hiroshima, Japan. hiromitsunaka@yahoo.co.jp
authors.forename: H
authors.initials: H
authors.lastname: Naka
authors.forename: E
authors.initials: E
authors.lastname: Nomura
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Wakabayashi
authors.forename: H
authors.initials: H
authors.lastname: Kajikawa
authors.forename: T
authors.initials: T
authors.lastname: Kohriyama
authors.forename: Y
authors.initials: Y
authors.lastname: Mimori
authors.forename: M
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000473:pathology*; D049292:Leukoaraiosis / Q000097:blood* / Q000150:complications / Q000473:pathology*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D020521:Stroke / Q000097:blood* / Q000150:complications
chemical_list: D006710:Homocysteine