Analysis Of The Relation Between Acute Ischemic Stroke Subtypes And Plasma Homocysteine Levels

Objective: To investigate the relation between acute ischemic stroke subtypes andplasma homocysteine levels．Methods: A case-control study in173patients hospitalized with the first acuteischemic stroke and56healthy individuals，their plasma homocysteine were tested andrecorded. All the patients were classified by TOAST classification standard．We studythe relation between acute ischemic stroke subtypes and plasma homocysteinelevels．According to the different locations of atherosclerosis，LAA group was dividedinto: intracranial lesions, extracranial lesions, intracranial and extracranial lesions.Results: Mean plasma homocysteine level of the case group[(16.81±1.44)umol/L] was significantly higher than the control group [(14.39±1.38)umol/L，P﹤0.05]．Hyperhomocysteinemia was60.69%in the case group，42.86%in the controlgroup．The difference was statistically significant between the case group and thecontrol group(χ2=5.471， p=0.019；OR=2.059，95%CI1.118～3.792)．Statisticsanalysis showed that homocysteine level was significantly correlated with age (r=0.370，P﹤0.01) and gender (r=0.190，P﹤0.01), which was an independent risk factorfor acute ischaemic stroke after adjustment for age、gender、diabetes and othercardiovascular risk factors (OR=1.134，95%CI1.022～1.257，P=0.017)．Ischemicstroke risk increased1.134times if homocysteine levels rise1umol/L．The TOASTclassification result was: LAA group in61cases、SAO group63cases、CE group16cases、SOE group7cases、SUE group of26cases．The mean homocysteine levels of thegroups were that LAA group (21.19±7.99) umol/L、SAO group (16.96±7.41) umol/L、CE group (17.46±5.44) umol/L、 SOE group (15.91±3.21) umol/L、 SUE group (17.56±8.10)umol/L and the control group (14.39±1.38) umol/L. Mean plasmahomocysteine was significantly higher in the LAA group compared with other groups(P﹤0.05)．LAA group included37intracranial cases、14extracranial、10intracranial andextracranial，which mean homocysteine levels were (18.62±1.32)umol/L、(25.07±1.36)umol/L、(17.86±1.18) umol/L respectively. Mean plasma homocysteine in extracranialcases was significant higher than those in other groups （p﹤0.05)．Conclusions:1. Mean plasma homocysteine level of the case group was significantly higherthan that in the control group．Plasma homocysteine was an independent risk factor foracute ischemic stroke．2. LAA subtype of TOAST classification was closely related with Plasmahomocysteine level.Plasma homocysteine level elevated more significantly inextracranial locations than in other locations.