title: Homocysteine Level Is Associated with White Matter Hyperintensity Locations in Patients with Acute Ischemic Stroke.
abstract: OBJECTIVE
  The relationship between plasma level of total homocysteine (tHcy) and white matter hyperintensities (WMHs), especially in patients with acute ischemic stroke (AIS), is controversial. The present study investigated the association between these two as well as WMH locations in a large cohort of patients with AIS.
  
  
  METHODS
  Consecutive patients were reviewed from a prospective ischemic stroke database. Clinical data, including tHcy level and WMHs, were assessed. WMHs were assessed using the Fazekas scale and Age-Related White Matter Changes (ARWMC) visual grading scale. The association between tHcy and WMH locations was investigated by using multivariate logistic regression analyses.
  
  
  RESULTS
  A total of 923 out of 1,205 patients were examined. The average age was 58.9 ± 11.9 years; 31.6% were female. Elevated tHcy level was significantly associated with WMHs. For the highest tHcy quartile, the odds ratio (OR) (95% confidence interval; CI) was 1.891 (1.257; 2.843) according to the Fazekas scale and 1.781 (1.185; 2.767) according to the ARWMC scale when compared to the lowest quartile. However, in a subgroup analysis, only WMHs in the periventricular area and left or right frontal areas were found to be independently associated with tHcy level. For the highest tHcy quartile, the OR (95% CI) was 1.761 (1.172; 2.648) for the periventricular WMHs, 1.768 (1.134; 2.756)for the left frontal WMHs, and 1.890 (1.206; 2.960)for the right frontal WMHs.
  
  
  CONCLUSIONS
  In patients with AIS, plasma tHcy level is related to WMHs, especially WMHs distributed within the periventricular and frontal areas.
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Wei
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Song
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Fang
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Shilei
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Xu
mesh_terms: D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D066127:White Matter / Q000378:metabolism / Q000473:pathology*
chemical_list: D006710:Homocysteine