[Correlation between plasma level of homocysteine and cerebral large-artery atherosclerosis].
OBJECTIVE
To identify whether high level of plasma homocysteine is an independent risk factor for potential cerebral large-artery atherosclerotic stenosis determined by digital subtraction angiography (DSA) in patients with ischemic stroke.


METHODS
276 adult patients with ischemic stroke experienced DSA were selected, and 224 patients with potential large-artery atherosclerotic stenosis (grade > 50%, not less than one of vascular) and 52 controls without stenosis or mild grade (grade < or = 50%) were included. Plasma homocysteine level was analyzed and conventional risk factors of cerebral stroke such as sex and age, hypertension, diabetes, long-smoking, long-alcohol and plasma levels of triglyceride, high-density lipoprotein, low-density lipoprotein was evaluated in 276 subjects.


RESULTS
The proportion of subjects with high level of plasma homocysteine (> 15 micromol/L) was significantly higher in patients with potential atherosclerotic stenosis than those without (38.8% versus 15.4%; OR 3.49, 95% CI 1.57 - 7.77, P = 0.001). Based on multivariable stepwise logistic regression model, the odds ratio of homocysteine levels was 4.10 (95% CI 1.80 - 9.32, P = 0.001) with additional adjustment for conventional risk factors. The effect of homocysteine was more pronounced in the presence of hypertension (OR = 4.89), old age (OR = 4.79) and low level of plasma high density lipoprotein (OR = 10.46).


CONCLUSIONS
It is suggested that high level of plasma homocysteine is an independent risk factor for cerebral large-artery atherosclerosis. The effect of homocysteine is more pronounced in the presence of other risk factors of ischemic stroke.
Wang
Gui-hong
GH
Department of Neurology, Beijing Tiantan Hospital, Capital University of Medical Science, Beijing 100050, China. guihongw@126.com
Wang
Yong-jun
YJ
He
Yao
Y
Jiang
Wei-jian
WJ
Du
Bin
B
Jin
Min
M
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
D006710:Homocysteine