Plasma S-adenosylhomocysteine: A potential risk marker for cerebral venous thrombosis.
BACKGROUND
Despite a plethora of studies suggesting that hyperhomocysteinemia is associated with an increased risk for arterial and venous thrombosis, there is paucity of data on the role of the S-adenosylhomocysteine (SAH), the metabolic precursor of homocysteine (Hcy) as a risk predictor for cerebral venous thrombosis (CVT).


METHODS
We estimated fasting plasma concentrations of total homocysteine (tHcy), SAH and S-adenosylmethionine (SAM), in 185 CVT patients and 248 healthy controls, by reverse-phase high performance liquid chromatography coupled with coulometric electrochemical detection.


RESULTS
Fasting tHcy, SAH and SAM were significantly higher in patients compared with controls. Increased tHcy and SAH concentrations were associated with 4.54-fold (95% CI, 2.74-7.53) and 35.77-fold (95% CI, 19.45-65.79) increase in risk for CVT, respectively. Receiver operating characteristic (ROC) curve analysis showed that the area under curve, sensitivity and specificity was higher for SAH compared to tHcy. Further, discriminant analysis to distinguish between tHcy and SAH showed that SAH had a significantly higher percentage classification, with lower Wilk's lambda and higher χ(2), compared to tHcy.


CONCLUSIONS
Increased plasma SAH may be a more sensitive risk marker for CVT than plasma tHcy.
Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India.
Venkata Pinnelli
VP
Bharatkumar
Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India.
Kondapura Jayadevappa
KJ
Rudreshkumar
Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India.
Dindagur
D
Nagaraja
Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India. Electronic address: rita@nimhans.kar.nic.in.
Rita
R
Christopher
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D055664:Electrochemical Techniques; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012435:S-Adenosylhomocysteine / Q000097:blood*; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis*
D015415:Biomarkers; D012435:S-Adenosylhomocysteine
Cerebral venous thrombosis; Homocysteine; Risk marker; S-Adenosylhomocysteine