title: Factors associated with hyperhomocysteinaemia in Mexican patients with rheumatoid arthritis.
abstract: BACKGROUND
  Hyperhomocysteinaemia is a factor related to the development of atherosclerosis in rheumatoid arthritis (RA). However, Hispanics with RA develop high rates of coronary disease; there are no studies about the frequency and factors related to high levels of homocysteine in Mexican patients.
  
  
  OBJECTIVE
  To evaluate the prevalence and characteristics associated with hyperhomocysteinaemia in Mexican patients with RA.
  
  
  METHODS
  One hundred and fifty-two patients with RA were compared with 153 controls. The assessment in RA included clinical characteristics, disease activity (RADAR), functioning (HAQ-Di and global functional status), comorbidity, and radiological damage. Laboratory determinations included total serum homocysteine (tHcy), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and lipid profile.
  
  
  RESULTS
  Median levels of homocysteine were higher in RA compared with controls (11.3 vs. 9.3, p<0.001). Twenty per cent of the patients with RA had hyperhomocysteinaemia (>15 micromol/L) compared with 6% in controls (p<0.001). There was statistical association between hyperhomocysteinaemia in RA with male gender (p<0.001), impairment in the global functional status (p = 0.004), higher radiological damage (p = 0.001), and CRP (p = 0.04). There was no association with RADAR, HAQ-Di, or RF, methotrexate dose or duration of use. In the adjusted multivariate model, the two variables associated with higher risk for hyperhomocysteinaemia were male gender (OR = 4.2, 95% CI 2 to 12, p = 0.006) and higher radiological damage (III-IV) (OR = 3.4, 95% CI 1.3 to 9, p = 0.01).
  
  
  CONCLUSIONS
  Our data show a high prevalence of hyperhomocysteinaemia in Mexican patients with RA. More effort is required to evaluate and treat earlier this coronary risk factor.
authors.affiliation: Department of Internal Medicine, Rheumatology, Hospital General Regional 110, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico.
authors.forename: M A
authors.initials: MA
authors.lastname: Lopez-Olivo
authors.forename: L
authors.initials: L
authors.lastname: Gonzalez-Lopez
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Gonzalez
authors.forename: A I
authors.initials: AI
authors.lastname: Villa-Manzano
authors.forename: A R
authors.initials: AR
authors.lastname: Cota-Sanchez
authors.forename: M
authors.initials: M
authors.lastname: Salazar-Paramo
authors.forename: E
authors.initials: E
authors.lastname: Varon-Villalpando
authors.forename: E G
authors.initials: EG
authors.lastname: Cardona-Muñoz
authors.forename: J I
authors.initials: JI
authors.lastname: Gamez-Nava
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000097:blood; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein; D012217:Rheumatoid Factor; D002784:Cholesterol