title: Hyperhomocysteinemia associates with small vessel disease more closely than large vessel disease.
abstract: BACKGROUND
  Hyperhomocysteinemia was believed to be an independent risk factor for stroke and associate with small vessel disease (SVD) related stroke and large vessel disease (LVD) related stroke differently. However it's still unclear which type of stroke associated with homocysteine (HCY) more strongly because the conclusions of previous studies were contradictory. In this study we focused on the subclinical angiopathies of stroke, i.e., SVD and LVD instead of stroke subtypes and sought to compare the associations between HCY level and different angiopathies.
  
  
  METHODS
  324 non-stroke patients were enrolled. Sex, age, HCY level and other vascular risk factors were collected. MRI and angiographies were used to determine the type of angiopathies and their severity, i.e., the scores of leukoaraiosis (LA), plaques and numbers of silent brain infarctions (SBI). LVD was defined as the presence of atherosclerotic plaques of cerebral arteries. SVD was defined as the presence of either LA or SBI. 230 patients were deemed to have LVD; 180 patients were deemed to have SVD. Spearman's correlation test and logistic regression were used to analyze the association between HCY level and different angiopathies.
  
  
  RESULTS
  The correlation between HCY level and scores of plaques was weaker than that of the scores of LA and numbers of SBI. Hyperhomocysteinemia was an independent risk factor for SVD (OR = 1.315, P <0.001), whereas the association between HCY level and LVD was not that significant (OR = 1.058, P = 0.075).
  
  
  CONCLUSIONS
  HCY level associated with SVD more strongly than LVD.
authors.affiliation: Department of Neurology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Feng
authors.forename: Xue
authors.initials: X
authors.lastname: Bai
authors.forename: Yu
authors.initials: Y
authors.lastname: Xu
authors.forename: Ting
authors.initials: T
authors.lastname: Hua
authors.forename: Jing
authors.initials: J
authors.lastname: Huang
authors.forename: Xue-Yuan
authors.initials: XY
authors.lastname: Liu
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D049292:Leukoaraiosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D006710:Homocysteine
keywords: Hyperhomocysteinemia; homocysteine.; large vessel disease; small vessel disease