The Clinical Study Of Hyperhomocysteinemia In Renal Transplant Recipients

Objective:Cardiovascular and cerebrovascular complications is one of important causes of death to renal transplant recipients (RTRs), recently confirmed that homocysteine (Hcy) is in relation with cerebral apoplexy. To research transplantation duration and the incidence of hyperhomocysteinemia(HHcy) in renal transplant recipients, and the correlation of Hcy and Sex, Age, fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDLC), low-density lipoprotein (LDLC), lipoprotein a (Lp (a)), uric acid (UA), serum creatinine (Scr), body mass index (BMI), C-reactive protein (CRP), alanine transaminase (ALT), aspartate aminotransferase (AST), albumin (ALB), concentration of tacrolimus, blood cyclosporin a (CsA) trough levels,2-hour postdose CsA, transplantation duration and to provide the evidences for early clinical diagnosis and positive prevention treatment, and reduce the complications such as cardiovascular disease after renal transplantation, improve renal transplant recipients quality of life and prolong its life.Methods:Collect blood time:collect all blood specimens in the morning after recipients with 12 hours of fasting. Methods:the cardiovascular and cerebrovascular complications risk factors of 120 cases renal transplant recipients were evaluated,82 males (68%) and 38females (32%), mean age (43.25±1.04)years. Hcy was detected with enzyme kinetic method, and the level of FBG, TC, TG, HDLC, LDLC, Lp (a), UA, Scr, CRP, ALT, AST and ALB were detected with enzyme-linked immunosorbent assay (ELISA), and the concentration of Tacrolimus, blood CsA trough levels and 2-hour postdose CsA were detected with enzyme-multiplied immunoassay technique (EMIT). At the same time, Sex, Age and cerebrovascular complications were analyzed between normal Hcy group and high Hcy group(normal Hcy group:Hcy< 12umol/L, a total of 6 people; HHcy grop:Hcy≥12umol/L, a total of 114 people), and are analyzed with Pearson correlation analysis. Take medicine progrem:Methylprednisolone (or prednisone)+Mycophenlate Mofetil (or Mizoribine)+Tacrolimus (or cyciosporin).Results:1.The overall incidence of hyperhomocysteinemia was 95%, and with 97.6% in males and 89.5 in females. There was no difference in males than in females P>0.05.The average levels of Hcy were (22.25±9.90) umol/L in males and (18.06±5.75) umol/L in females, P<0.05.2.The leves of Lp(a), UA, Scr and AST are significantly higher in the hyperhomocyteinemia group than normal Hcy group, P<0.05.3.Using Pearson correlation analysis, the results show that the leves of Hcy and after half a month of Scr (r=0.832, P=0.013), UA (r=0.263, P=0.005) and Lp(a) (r=0.754, P=0.003) were positively correlated; Hcy and TC (r=0.197, P=0.197), Sex (r=0.219, P=0.019), P=0.032),concentration of tacrolimus (r=0.244, P=0.013) show a negative correlation; Hcy and FBG (r=0.089, P =0.344), TG (r=0.074, P=0.074), HDLC (r=0.129, P=0.129) and LDLC (r=0.101, P=0.286), the Age (r=0.099, P=0.294), BMI (r=0.051, P=0.051), CRP (r=0.032,P-0.514), ALT (r=0.090,P=0.338), AST (r=0.086, P=0.365), ALB (r=0.112, P=0.236), blood CsA trough levels (r=0.209, P=0.515),2-hour postdose CsA (r=0.025, P=0.937), the transplantation duration in RTRs (r=-0.007, P=0.945) were no correlation.Conclusion:1.The incidences of hyperhomocysteinemia in renal transplant recipients are higher, the Hcy lelves of male RTRs is higher than female. It is existenced with influenceing tranplantation traditional risk factor of cardiovascular and cerebrovascular disease, may increase the risk of cardiovascular and cerebrovascular disease in RTRs, and the necessity of screening Hcy in RTRs, reducing the level of Hcy in HHcy patients.2.The primary causes of hyperhomocysteinemia in renal transplant recipients may be related with Sex, TC, Lp (a), Scr, UA, concentration of tacrolimusand. Hcy is irrelevant with Age, BMI, FBG, TG, HDLC, LDLC, CRP, ALT, AST, ALB, blood CsA trough levels,2-hour postdose CsA and transplantation duration.