title: Prevalence and risk factors of hyperhomocysteinemia in Tunisian patients with Crohn's disease.
abstract: OBJECTIVE
  The role of hyperhomocysteinemia (HHC) and its determinants in Crohn's disease (CD) remain uncertain. This study was aimed to determine the prevalence of HHC and its main risk factors in Tunisian patients with CD.
  
  
  METHODS
  This study included 89 patients with CD and 103 age- and sex-matched healthy subjects. Fasting venous blood was collected in all subjects allowing the assessment of homocysteine, folate, vitamin B(12), C-reactive protein and creatinine levels. Logistic regression models were applied to identify factors associated with HHC in CD patients.
  
  
  RESULTS
  Plasma homocysteine was higher (13.69 ± 4.84μmol/l vs. 10.77 ± 2.80μmol/l; p<0.01) and HHC was more frequent (31.5% vs. 7.8%; p<0.001) in patients compared with controls. The association between HHC and CD persisted after adjustment for smoking, body mass index and serum folate, vitamin B(12), creatinine and C-reactive protein. In patients with CD, multivariate analysis showed that HHC was positively associated with age [multi-adjusted odds-ratio (95% confidence interval): 1.14 (1.06-1.24); p<0.001], active disease [7.54 (1.15-49.3); p=0.03], disease duration >2 years [8.69 (1.53-49.3); p=0.02] and inversely related to plasma folate [0.64 (0.48-0.84); p=0.002] and vitamin B(12) (0.993 (0.987-0.999); p=0.02].
  
  
  CONCLUSIONS
  HHC is common in Tunisian patients with CD and is related to B vitamins deficit, as well as disease activity and duration. Further studies should test the effect of correction of HHC by vitamin B supplementation on progression and complications of CD.
authors: UR 99/08-34, Service of Gastroenterology A, Rabta Hospital, 1007 Jebbari, Tunis, Tunisia. lamia_kallel@yahoo.fr
authors: Lamia
authors: L
authors: Kallel
authors: Moncef
authors: M
authors: Feki
authors: Wirak
authors: W
authors: Sekri
authors: Lamia
authors: L
authors: Segheir
authors: Monia
authors: M
authors: Fekih
authors: Jalel
authors: J
authors: Boubaker
authors: Naziha
authors: N
authors: Kaabachi
authors: Azza
authors: A
authors: Filali
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking; D014416:Tunisia / Q000453:epidemiology; D014805:Vitamin B 12 / Q000097:blood; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein; D005492:Folic Acid; D003404:Creatinine; D014805:Vitamin B 12