Association of plasma homocysteine concentration with cerebral white matter hyperintensity on magnetic resonance images in stroke patients.
BACKGROUND
Homocysteine (Hcy) has been recognized as a risk factor for atherosclerosis. White matter hyperintensity (WMH) on MRI has been regarded as a hallmark for cerebral small vascular disease. The study is to investigate the relationship between plasma Hcy level and WMH on a hospital-based cohort of Taiwanese stroke patients.


RESULTS
A total of 352 consecutive stroke patients (64.7+/-11.2 years) were included. Severity of WMH was semi-quantitatively evaluated with a scoring system. The top WMH score tertile was defined as severe white matter change (sv-WMH). Associations between Hcy tertile levels and sv-WMH were examined, adjusting for demographics and atherosclerosis risk factors. Subjects in the top Hcy tertile (>10.25 micromol/L) had higher WMH scores and prevalence of sv-WMH than those in the middle and in the bottom tertile. The adjusted odds ratio of having sv-WMH was 2.04 (95% confidence interval 1.20-3.47, p=0.008) for the top Hcy level tertile than for the lower two tertiles combined.


CONCLUSIONS
Hcy is a risk factor for cerebral white matter lesion in stroke patients. Even mild hyperhomocysteinemia can significantly increase severity of cerebral microangiopathy.
Tseng
Yu-Lung
YL
Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang
Yung-Yee
YY
Liu
Jia-Shou
JS
Su
Chen-San
CS
Lai
Shung-Lon
SL
Lan
Min-Yu
MY
D000818:Animals; D001369:Axons / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002539:Cerebral Arterial Diseases / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000097:blood* / Q000209:etiology / Q000473:pathology; D013624:Taiwan / Q000453:epidemiology
D008055:Lipids; D006710:Homocysteine