The Relationship Between Hyperhomocysteinemia And Young Adult Cerebral Infarction

Objective To evaluate the relationship between hyperhomocysteinemia and cerebral infarction in the young adult persons and study the role of methionine loading test (MLT) for detecting latent hyperhomocysteinemia patients.Methods We studied 85 patients with acute cerebral infarction (CI) whose ages varies from 29 to 55 years(acted as CI group) and 44 normal people acted as control group, whose ages and gender were matched with those In CI patients. All the subjects were underwent an oral MLT (0.1g/kg body weight of L-methionine) after an overnight fast Plasma toal homocysteine (tHcy) levels( fasting and 4 hours after MLT )were detected with high-performance liquid chromatography (HPLC); chemiluminoimmunoassay (CLIA) were used to test Serum folic acid and cobalamin. TC TG LDL HDL fasting blood sugar, et al were also examined. Hyperhomocysteinemia was defined as a fasting tHcy contents and/or the tHcy level afer MLT exceeding the 95% percentile of the healthy control group.Results (1) The levels of plasma fasting and post-load tHcy in CI group were 22.49 9.80 mol/L and 48.07 11.20 mol/L respectively, both significantly higher than those In control group (13.08 2.33 mol/L and 37.23 3.48 mol/L , both P <0.01) . (2) Hyperhomocysteinemia patients was found in 58(68.24%) of the 85 CI patients: thirty-five (41.18%) were diagnosed by fasting tHcy concentration and tweenty-three (27.06%) were diagnosed only by the MLT . The incidence of hyperhomocysteinemia in CI group (68.24%) was significantly higher than it in control group (9.09%). (3) Folic acid and cobalamin in CI group(5.73 2.52ng/mL and 473.47 190.19pg/mL respectively) were significantly lower than those in control group(7.14 2.20 ng/mL and 576.70 212.05 pg/mL respectively,both P<0.01). (4) Negative correlations of Folic acid and cobalamin with both fasting and post-load tHcy levels were found(both P<0.01).Conclusion Hperhomocysteinemia is independently associated with the increased risk of young adult cerebral infarction and MLT is necessary for diagnosis of hyperhomocysteinemia, because a good manyof latent hyperhomocysteinemia people (27.06%) remain undiagnosed with the determination of the fasting tHcy contents alone.