Plasma homocysteine is elevated in COPD patients and is related to COPD severity.
BACKGROUND
Although recent studies have found that total plasma homocysteine (tHCY) and chronic obstructive pulmonary disease (COPD) are both risk factors for cardiac disease, there have been few studies of plasma homocysteine levels in COPD patients. We tested the hypothesis that total plasma homocysteine (tHCY) would be elevated in patients diagnosed with COPD compared with controls.


METHODS
We studied 29 COPD outpatients and 25 asymptomatic subjects (controls) over age 55 years with measurement of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), St. Georges Respiratory Questionnaire (SGRQ) score, tHCY and serum C-reactive protein (sCRP).


RESULTS
There was no difference between controls vs. COPD patients in mean age or gender but mean (SD) FEV1 was 2.25 (0.77) vs. 1.43 (0.60) L; FEV1% predicted 76.1 (17.2) vs. 49.1 (16.3) p < 0.001 in both cases. Median (IQR) tHCY was 8.22 (6.63, 9.55) in controls vs. 10.96 (7.56, 13.60) micromol/l for COPD, p = 0.006 and sCRP 0.89 (0.47, 2.55) vs. 2.05 (0.86, 6.19) mg/l, p = 0.023. tHCY(log) was also higher in (r, p) smokers (0.448, 0.001), patients with low FEV1% (-0.397, 0.003), males (0.475, < 0.001), but high SGRQ Total score (0.289, 0.034), and high sCRP (0.316, 0.038). tHCY(log) was independently related to (regression coefficient, p) sCRP(log) (0.087, 0.024), male gender (0.345, < 0.001) and presence of COPD (0.194, 0.031). Median (IQR) tHCY GOLD Stage I and II 8.05 (7.28, 11.04), GOLD Stage III and IV: 11.83 (9.30, 18.30); p = 0.023.


CONCLUSIONS
Plasma homocysteine is significantly elevated in COPD patients relative to age and sex-matched controls and is related to serum CRP and COPD severity.
Seemungal
Terence A R
TA
Department of Clinical Medical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago. tseemungal@aol.com
Lun
Johanna Cho Fook
JC
Davis
Gershwin
G
Neblett
Carlos
C
Chinyepi
Nkhabe
N
Dookhan
Christina
C
Drakes
Samantha
S
Mandeville
Elizabeth
E
Nana
Fatima
F
Setlhake
Seatshogeng
S
King
Celia Poon
CP
Pinto Pereira
Lexley
L
PintoPereira
Lexley
L
Delisle
Jerome
J
Wilkinson
Thomas M A
TM
Wedzicha
Jagwiga A
JA
D000368:Aged; D005247:Feeding Behavior; D005260:Female; D005541:Forced Expiratory Volume; D006710:Homocysteine / Q000032:analysis* / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011788:Quality of Life; D012720:Severity of Illness Index; D013147:Spirometry; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago
D006710:Homocysteine