Clinical Studies Of Homocysteine ​​and Cerebrovascular Disease Relationship

Objective To investigate whether elevated serum total homocysteine (tHcy) is associated with the prevalence ,type and conventional risk factors of cerebrovascular disease(CVD) in a Chinese population. Methods We conducted a hospital-based case-control study of 99 patients with cerebrovascular disease (28 patients with transient ischemic attacks, 46 patients with atherothrombotic brain infarction and 25 patients with cerebral haemorrhage) and 52 randomly selected control subjects matched by age and sex from the same region. Serum homocysteine was measured by high-performance liquid chromatography with fluorometric detection(HPLC-FD)in cases and controls. Results (1)The mean serum homocysteine level was significantly higher in cases than in controls(17.5±7.3umol/l verse 10.2±3.7umol/l,P＜0.001)；(2) The mean serum homocysteine level was no significant different among three subtypes of CVD；(3)Serum homocysteine level was inversely related to serum folic acid and serum vitamin B12 levels；(4)After adjustment for sex, age, smoking, cholesterol, coronary heart disease, hypertension, and diabetes mellitus, a serum homocysteine level >15.0umol/l was associated with an odds ratio for CVD of 3.2 (95%CI:1.0—6.9).Conclusions (1)Elevated serum homocysteine is strongly associated with an increased prevalence of cerebrovascular disease. This association is independent not only of traditional cerebrovascular risk factors but also of the types of cerebrovascular disease. (2) Folic acid and vitamin B12 are nongenetic determinations of homocysteine level.