Homocystine levels, polymorphisms and the risk of ischemic stroke in young Asian Indians.
BACKGROUND
Homocysteine has been for a fairly long time been debated to be a risk factor for stroke. Opinions are divided as to whether raised levels of homocysteine seen in stroke patients are the cause or consequence of stroke. A large number of studies have been conducted in the Caucasian as well as on the Oriental population, which tend to suggest contradictory findings at many times. However, there have been no reports forthcoming from the Asian Indian population, which is a genetically different population than the previously studied populations.


METHODS
In our present study, we looked at homocysteine levels and four commonly seen polymorphisms of homocysteine metabolizing enzymes and their respective prevalence in 120 acute onset ischemic stroke patients compared with an equal number of age and gender matched healthy population. We also tested the influence of folic acid dosage (5 mg OD) on the levels of homocysteine and the allied vitamin supplements, vitamin B12 and folate in smaller groups selected from the larger group.


CONCLUSIONS
We found homocysteine levels to be significantly raised in the stroke population compared with healthy controls [patients: 12 micromol/L (range: 5.3-39.1 micromol/L), controls: 11.2 micromol/L (range: 6.2-14.2 micromol/L); P =0.001]. There was an almost total response to folic acid dosage as all hyperhomocysteinemic patients showed lowering of homocysteine levels in response to the dosage. The MTHFR 677 C > T polymorphisms showed association with both homocysteine levels as well as stroke (P < 0.001). Nutritional deficiency plays a dominant role in hyperhomocysteinemic conditions in our stroke population, however. Genetic determinants of homocysteine level may also have some part in determining hyperhomocysteinemic conditions in the Asian Indian populations.
Biswas
Arijit
A
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
Ranjan
Ravi
R
Meena
Arvind
A
Akhter
Mohammad Suhail
MS
Yadav
Birendra Kumar
BK
Munisamy
Murali
M
Subbiah
Vivekanandhan
V
Behari
Madhuri
M
Saxena
Renu
R
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D004252:DNA Mutational Analysis; D004305:Dose-Response Relationship, Drug; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005820:Genetic Testing; D005838:Genotype; D006711:Homocystine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000188:drug therapy / Q000208:ethnology / Q000235:genetics*; D007194:India / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D011110:Polymorphism, Genetic / Q000235:genetics*; D044469:Racial Groups; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology; D055815:Young Adult
D006711:Homocystine; D005492:Folic Acid