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Homocysteine and stroke

Cheng-Jin You, Dan Liu, Li-Li Liu, Guo-Zhong Li
The present study was to examine the relationship between white matter lesions (WMLs) and insulin resistance (IR) in patients with acute stroke and evaluate clinical prognosis.Around 200 patients with initial onset of acute stroke including 146 patients (73.0%) with WMLs and 54 patients (27%) without WMLs were analyzed by neuropsychological scales. Fasting blood glucose (FBG), fasting insulin, blood lipid, homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), creatinine, and uric acid, diabetes mellitus (DM), prediabetes (PD), and normal glucose (NG) were determined according to HbA1c levels...
March 2018: Medicine (Baltimore)
Luke Mugge, Tarek R Mansour, Brianna Krafcik, Travis Mazur, Tonya Floyd-Bradstock, Azedine Medhkour
Stroke is one of the leading causes of mortality and morbidity worldwide and requires rapid and intensive treatment to prevent adverse outcomes. Decompressive hemicraniectomy stands as the gold standard for surgical resolution of the intracranial swelling which accompanies cerebral infarction; however, the benefits of this procedure are not as well achieved in the elderly (age >65 yoa) compared to the younger population. This is a critical review performed on all available literature relating to middle cerebral artery (MCA) stroke in the elderly with emphasis on articles examining causality of adverse outcomes in this group over younger populations...
March 8, 2018: Journal of Neurosurgical Sciences
Alicia Mattia, M Reza Azarpazhooh, Claudio Munoz, Chrysi Bogiatzi, Mackenzie A Quantz, J David Spence
Objectives: Microembolic signals (MES) on transcranial Doppler (TCD) predict stroke and cognitive decline. Plasma levels of total homocysteine (tHcy), a prothrombotic factor, are higher in patients with microemboli in carotid stenosis and in patients with paradoxical embolism. In this study we assessed the association between the level of tHcy and the number of MES in patients with mechanical heart valves (MHVs). Methods: TCD monitoring was performed to detect MES before and after breathing 100% oxygen and repeated every 2-4 weeks up to six times...
December 2017: Stroke and Vascular Neurology
Hui Pang, Bing Han, Qiang Fu, Lin Hao, Zhenkun Zong
Previous studies have focused mostly on independent effects of the stroke risk factors, whereas little attention has been paid to interactions between individual factors which may be important for stroke prevention. We collected data related to the patients' demographic characteristics, history of chronic diseases and lifestyle factors in 2258 patients with primary hypertension. Logistic regression models based on odds ratio (OR) with their associated 95% confidence interval (CI) were used to estimate an independent effect of homocysteine (Hcy) on the risk of stroke but also include the interactions between Hcy and other risk factors...
March 1, 2018: Scientific Reports
A David Smith, Martin J Warren, Helga Refsum
The biosynthesis of B12 , involving up to 30 different enzyme-mediated steps, only occurs in bacteria. Thus, most eukaryotes require an external source of B12 , and yet the vitamin appears to have only two functions in eukaryotes: as a cofactor for the enzymes methionine synthase and methylmalonylCoA mutase. These two functions are crucial for normal health in humans, and in particular, the formation of methionine is essential for providing methyl groups for over 100 methylation processes. Interference with the methionine synthase reaction not only depletes the body of methyl groups but also leads to the accumulation of homocysteine, a risk factor for many diseases...
2018: Advances in Food and Nutrition Research
N Kotova, V Maichuk, O Fedorenko
Neural tube defects occupy second place in frequency after the defects of the cardiovascular system. The folate metabolism violation and hyperhomocysteinemia in women are proved to be the leading risk factors for the NTD of the fetus. Polymorphism of the 5,10-methylenetetrahydrofolate reductase gene (MTHFR) is a genetic determinant of folate metabolism violation. Admission of folic acid in a standard dose of 0.4 mg and / or the use of fortified foods does not allow reaching the protective level of folic acid if there is a mutation of the MTHFR gene or when several risk factors combine, which requires a higher dose of folic acid...
January 2018: Georgian Medical News
Xinye Liu, Lingxu Wang, Hao Chi, Jin Wang, Qian Zheng, Jingye Li, Yong Li, Dongwei Yang
BACKGROUND/AIMS: The association between the genetic polymorphisms located in either the exon or untranslated region of MTHFR and the risk of human atherosclerosis has been well-documented. This study analyzed MTHFR polymorphisms at the 3'-untranslated region for association with risk and outcome of atherosclerosis in a Chinese Han population. METHODS: The hospital based case-control study was conducted with 500 patients and 600 healthy volunteers as control enrolled...
2018: Cellular Physiology and Biochemistry
Gábor Holló
Both exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) are associated with systemic vascular diseases and abnormalities. Though no uniform relationship between XFS/XFG and clinical systemic vascular diseases has been established across various populations, vascular dysfunction with or without clinically significant consequences has been repeatedly detected with both epidemiological and pathophysiological methods. Elevated plasma homocysteine, reduced cutaneous capillary flow reactions, damaged conduit artery dysfunction, impaired baroreflex sensitivity, parasympathetic cardiovascular neuropathy, and pathological heart rate variability indices have all been shown in XFS and XFG...
February 6, 2018: Journal of Glaucoma
Zhike Zhou, Yifan Liang, Huiling Qu, Mei Zhao, Feng Guo, Chuansheng Zhao, Weiyu Teng
Intracerebral hemorrhage (ICH) has the highest mortality rate in all strokes. However, controversy still exists concerning the association between plasma homocysteine (Hcy) and ICH. A systematic review and meta-analysis was conducted using Pubmed, Embase, and Web of Science up to April 18, 2017. Standard mean difference (SMD) for mean differences of plasma Hcy levels with 95% confidence intervals (CI) was calculated. Seven studies including 667 ICH patients and 1821 ischemic stroke patients were identified for meta-analysis...
February 7, 2018: Scientific Reports
Beata Sarecka-Hujar, Ilona Kopyta, Michal Skrzypek
An elevated level of homocysteine is a risk factor for vascular diseases, brain atrophy and several other disorders. The 1298A>C polymorphism (rs1801131) leads to mildly decreased MTHFR activity. Previously, it was observed that the MTHFR 1298A>C polymorphism in combined analysis with the MTHFR 677C>T polymorphism increases homocysteine levels. However, conflicting results on its relation to ischaemic stroke in children can be found. We conducted a meta-analysis to analyse possible connections between the MTHFR 1298A>C polymorphism and ischaemic stroke in paediatric patients...
February 2, 2018: Clinical and Experimental Medicine
Aifan Li, Yunshu Shi, Liyan Xu, Yuchao Zhang, Huiling Zhao, Qiangmin Li, Xingjuan Zhao, Xinhui Cao, Hong Zheng, Ying He
BACKGROUND: Homocysteine (Hcy) plays an important role in vascular function and Hcy level contributes to pathogenesis of ischemic stroke (IS). MTHFR gene polymorphism may have effects on IS risks by influencing the Hcy metabolic pathway. In the present study, a case-control study was designed to evaluate the relationship among MTHFR C677Tpolymorphism, plasma Hcy level, and susceptibility of IS in Chinese population. METHODS: A total of 300 patients with IS and 261 matched control subjects were recruited...
December 2017: Medicine (Baltimore)
He-Hong Geng, Qiang Wang, Bo Li, Bin-Bin Cui, Yong-Ping Jin, Rong-Li Fu, Qing Zhang, Jing-Jie Wang, Pei-Xi Wang
Early neurological deterioration (END) is associated with increased risk of functional disability and mortality. However, data are limited regarding the long-term risk of poor functional outcomes. Thus we explored the association between END and long-term outcomes in patients with acute ischemic stroke.A total of 1064 patients were enrolled with acute ischemic stroke who were consecutively admitted to the 3 stroke units of Huai-He Hospital, Kaifeng, China. END was defined as an increment change of at least one point in motor power or total National Institute of Health Stroke Scale (NIHSS) score deterioration ≥2 points within the first week after admission...
December 2017: Medicine (Baltimore)
Xiao Huang, Xianhui Qin, Wenbin Yang, Lishun Liu, Chongfei Jiang, Xianglin Zhang, Shanqun Jiang, Huihui Bao, Hai Su, Ping Li, Mingli He, Yun Song, Min Zhao, Delu Yin, Yu Wang, Yan Zhang, Jianping Li, Renqang Yang, Yanqing Wu, Kui Hong, Qinhua Wu, Yundai Chen, Ningling Sun, Xiaoying Li, Genfu Tang, Binyan Wang, Yefeng Cai, Fan Fan Hou, Yong Huo, Hong Wang, Xiaobin Wang, Xiaoshu Cheng
OBJECTIVE: This post hoc analysis of the CSPPT (China Stroke Primary Prevention Trial) assessed the individual variation in total homocysteine (tHcy)-lowering response after an average 4.5 years of 0.8 mg daily folic acid therapy in Chinese hypertensive adults and evaluated effect modification by methylenetetrahydrofolate reductase ( MTHFR ) C677T genotypes and serum folate levels. APPROACH AND RESULTS: This analysis included 16 413 participants from the CSPPT, who were randomly assigned to 2 double-blind treatment groups: either 10-mg enalapril+0...
March 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Jia Zhang, Yanfang Liu, Anxin Wang, Dandan Wang, Ruixuan Jiang, Jiaokun Jia, Shengyun Chen, Xingquan Zhao
Asymptomatic extracranial artery stenosis (ECAS) is a well-known risk factor for stroke and H-type hypertension, which is defined as hypertension with hyperhomocysteinemia, is associated with cardio-cerebrovascular diseases. However, the impact of H-type hypertension on ECAS is mostly unknown. We designed this study to investigate the association between H-type hypertension and prevalence of ECAS. We included 2330 participants in this study and classified them into four groups: the control group without hypertension or hyperhomocysteinemia, isolated hypertension group, isolated hyperhomocysteinemia group and H-type hypertension group...
January 22, 2018: Scientific Reports
Jing Shang, Wen Wang, Jun Feng, Guo-Gang Luo, Ying Dang, Jian Sun, Yan-Qiu Yang, Li-Tao Ruan
Objective: To ascertain the feasibility of using shear wave velocity (SWV) in assessing the stiffness of carotid plaque by supersonic shear imaging (SSI) and explore preliminary clinical value for such evaluation. Materials and Methods: Supersonic shear imaging was performed in 142 patients with ischemic stroke, including 76 males and 66 females with mean age of 66 years (range, 45-80 years). The maximum, minimum, and mean values of SWV were measured for 129 carotid plaques...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Yan Li, Pingjin Gao, Dingliang Zhu
Elevated plasma homocysteine (Hcy) is suggested as an independent risk factor for stroke. We aimed to investigate the association of Hcy concentration with intracranial atherosclerosis (ICAS) and extracranial AS (ECAS) in hypertensive patients without stroke in Chinese population and to explore modified effect of methylenetetrahydrofolate reductase (MTHFR) C677T on their relationship. The stenosis of intracranial and extracranial arteries were evaluated in a total of 929 subjects through computerized tomographic angiography (CTA) from aortic arch to the skull base...
January 12, 2018: Scientific Reports
Jieyun Yin, Chongke Zhong, Zhengbao Zhu, Xiaoqing Bu, Tan Xu, Libing Guo, Xuemei Wang, Jintao Zhang, Yong Cui, Dong Li, Jianhui Zhang, Zhong Ju, Chung-Shiuan Chen, Jing Chen, Yonghong Zhang, Jiang He
BACKGROUND: Homocysteine (HCY) and high sensitivity C reactive protein (hs-CRP) were suggested to be involved in post-stroke depression (PSD), which is a frequent mood disorder after stroke. However, the combined effect of HCY and hs-CRP on PSD remains unclear. METHODS: A total of 598 acute ischemic stroke patients from 7 of 26 centers participating in the China Antihypertensive Trial in Acute Ischemic Stroke with HCY or hs-CRP measurements were included in this analysis...
January 8, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Laura M Raffield, Jaclyn Ellis, Nels C Olson, Qing Duan, Jin Li, Peter Durda, Nathan Pankratz, Brendan J Keating, Christina L Wassel, Mary Cushman, James G Wilson, Myron D Gross, Russell P Tracy, Stephen S Rich, Alex P Reiner, Yun Li, Monte S Willis, Ethan M Lange, Leslie A Lange
Homocysteine (Hcy) is a heritable biomarker for CVD, peripheral artery disease, stroke, and dementia. Little is known about genetic associations with Hcy in individuals of African ancestry. We performed a genome-wide association study for Hcy in 4927 AAs from the Jackson Heart Study (JHS), the Multi-Ethnic Study of Atherosclerosis (MESA), and the Coronary Artery Risk in Young Adults (CARDIA) study. Analyses were stratified by sex and results were meta-analyzed within and across sex. In the sex-combined meta-analysis, we observed genome-wide significant evidence (p < 5...
January 10, 2018: Journal of Human Genetics
Ali Mazaheri, Neda Mostofizadeh, Mahin Hashemipour
Homocystinuria is the second most common treatable aminoacidopathy. Clinically, affected patients present with eye, skeleton, central nervous system, and most importantly, vascular system abnormalities. This autosomal recessive disorder leads to accumulation of homocysteine and its metabolites in the blood and urine. In this report, we present a case with clinical and biochemical findings of homocystinuria with stroke and a positive familial history of the disease in her brother. A 4-year-old girl was admitted to pediatric emergency ward because of acute onset of right hemiparesis and subsequent generalized tonic-clonic seizures...
2017: Advanced Biomedical Research
Lian Duan, Ling Wei, Yanghua Tian, Zhengshan Zhang, Panpan Hu, Qiang Wei, Sugang Liu, Jun Zhang, Yuyang Wang, Desheng Li, Weizhong Yang, Rui Zong, Peng Xian, Cong Han, Xiangyang Bao, Feng Zhao, Jie Feng, Wei Liu, Wuchun Cao, Guoping Zhou, Chunyan Zhu, Fengqiong Yu, Weimin Yang, Yu Meng, Jingye Wang, Xianwen Chen, Yu Wang, Bing Shen, Bing Zhao, Jinghai Wan, Fengyu Zhang, Gang Zhao, Aimin Xu, Xuejun Zhang, Jianjun Liu, Xianbo Zuo, Kai Wang
BACKGROUND AND PURPOSE: Moyamoya disease (MMD) is a rare cerebral vasculopathy characterized by bilateral internal carotid artery stenosis and often leads to stroke in children or young adults. Although familial inheritance is well recognized, the genetic basis of MMD remains poorly understood. METHODS: A 2-stage genome-wide association study was conducted involving 1492 cases and 5084 controls. In the discovery stage, logistic regression was used to test associations, and imputation was conducted based on genotyped single-nucleotide polymorphisms (SNPs)...
January 2018: Stroke; a Journal of Cerebral Circulation
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