Homocysteine Levels in Patients with Hemorragic Stroke: A Cross-sectional Study

Aim: Accumulating data have shown that increased homocysteine (Hcy) is a risk factor for ischemic stroke (IS). However, it remains controversial whether elevated plasma Hcy level is also a risk factor for hemorragic stroke (HS), which accounts for about one-fifth of stroke patients. We aimed to meas...

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Published in:Kırşehir Ahi Evran medical journal
Main Authors: YETİŞ, Aysu, ÇELİKBİLEK, Asuman, KAYA TEKEŞİN, Aysel, YAĞIZ, Orhan
Format: Journal Article
Language:English
Published: 10-10-2022
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Abstract Aim: Accumulating data have shown that increased homocysteine (Hcy) is a risk factor for ischemic stroke (IS). However, it remains controversial whether elevated plasma Hcy level is also a risk factor for hemorragic stroke (HS), which accounts for about one-fifth of stroke patients. We aimed to measure the plasma Hcy levels in patients with HS in order to investigate a possible link. Methods: The study included 30 patients with IS, 30 patients with HS, and 30 healthy subjects. Patients were evaluated for conventional risk factors and levels of Hcy, vitamin B12 and folic acid. Results: Hypertension was higher in both IS and HS patients than in healthy participants (p=0.029). Hcy levels were significantly higher in both IS and HS groups than in the control group (p=0.001), with no statistically difference between each other (p>0.05). Vitamin B12 levels were significantly lower in both IS and HS patients than in the controls (p=0.001), with no statistically difference between each other (p>0.05). Folic acid levels did not significantly differ between the three groups (p>0.05). There was no correlation between Hcy, vitamin B12 and folic acid levels (p>0.05). Conclusion: The present study indicated that the Hcy levels were found to be high in the stroke patients regardless of subgroups. As well, there was no correlation between Hcy, vitamin B12 and folate levels in these subgroups. Larger cohorts with better design, will be needed to validate our results. Amaç: Biriken veriler, artan homosisteinin (Hcy) iskemik inme (İS) için bir risk faktörü olduğunu göstermiştir. Ancak, yükselmiş plazma Hcy seviyesinin, inme hastalarının yaklaşık beşte birini oluşturan hemorajik inme (HS) için de bir risk faktörü olup olmadığı tartışmalıdır. Olası bir bağlantıyı araştırmak için HS'li hastalarda plazma Hcy düzeylerini ölçmeyi amaçladık. Araçlar ve Yöntem: Çalışmaya 30 IS'li hasta, 30 HS'li hasta ve 30 sağlıklı birey dahil edildi. Hastalar konvansiyonel risk faktörleri ve Hcy, vitamin B12 ve folik asit düzeyleri açısından değerlendirildi. Bulgular: Hipertansiyon hem IS hem de HS hastalarında sağlıklı katılımcılara göre daha yüksekti (p=0.029). Hcy düzeyleri, hem IS hem de HS gruplarında kontrol grubuna göre anlamlı olarak daha yüksekti (p=0.001) ve aralarında istatistiksel olarak fark yoktu (p>0.05). B12 vitamini düzeyleri hem IS hem de HS hastalarında kontrollere göre anlamlı olarak daha düşüktü (p=0.001) ve aralarında istatistiksel olarak fark yoktu (p>0.05). Folik asit seviyeleri üç grup arasında anlamlı farklılık göstermedi (p>0.05). Hcy, vitamin B12 ve folik asit düzeyleri arasında korelasyon yoktu (p>0.05). Sonuç: Bu çalışma, alt gruplardan bağımsız olarak inme hastalarında Hcy düzeylerinin yüksek olduğunu göstermiştir. Ayrıca bu alt gruplarda Hcy, vitamin B12 ve folat düzeyleri arasında da ilişki bulunmadı. Sonuçlarımızı doğrulamak için daha iyi tasarıma sahip daha büyük kohortlara ihtiyaç duyulacaktır.
AbstractList Aim: Accumulating data have shown that increased homocysteine (Hcy) is a risk factor for ischemic stroke (IS). However, it remains controversial whether elevated plasma Hcy level is also a risk factor for hemorragic stroke (HS), which accounts for about one-fifth of stroke patients. We aimed to measure the plasma Hcy levels in patients with HS in order to investigate a possible link. Methods: The study included 30 patients with IS, 30 patients with HS, and 30 healthy subjects. Patients were evaluated for conventional risk factors and levels of Hcy, vitamin B12 and folic acid. Results: Hypertension was higher in both IS and HS patients than in healthy participants (p=0.029). Hcy levels were significantly higher in both IS and HS groups than in the control group (p=0.001), with no statistically difference between each other (p>0.05). Vitamin B12 levels were significantly lower in both IS and HS patients than in the controls (p=0.001), with no statistically difference between each other (p>0.05). Folic acid levels did not significantly differ between the three groups (p>0.05). There was no correlation between Hcy, vitamin B12 and folic acid levels (p>0.05). Conclusion: The present study indicated that the Hcy levels were found to be high in the stroke patients regardless of subgroups. As well, there was no correlation between Hcy, vitamin B12 and folate levels in these subgroups. Larger cohorts with better design, will be needed to validate our results. Amaç: Biriken veriler, artan homosisteinin (Hcy) iskemik inme (İS) için bir risk faktörü olduğunu göstermiştir. Ancak, yükselmiş plazma Hcy seviyesinin, inme hastalarının yaklaşık beşte birini oluşturan hemorajik inme (HS) için de bir risk faktörü olup olmadığı tartışmalıdır. Olası bir bağlantıyı araştırmak için HS'li hastalarda plazma Hcy düzeylerini ölçmeyi amaçladık. Araçlar ve Yöntem: Çalışmaya 30 IS'li hasta, 30 HS'li hasta ve 30 sağlıklı birey dahil edildi. Hastalar konvansiyonel risk faktörleri ve Hcy, vitamin B12 ve folik asit düzeyleri açısından değerlendirildi. Bulgular: Hipertansiyon hem IS hem de HS hastalarında sağlıklı katılımcılara göre daha yüksekti (p=0.029). Hcy düzeyleri, hem IS hem de HS gruplarında kontrol grubuna göre anlamlı olarak daha yüksekti (p=0.001) ve aralarında istatistiksel olarak fark yoktu (p>0.05). B12 vitamini düzeyleri hem IS hem de HS hastalarında kontrollere göre anlamlı olarak daha düşüktü (p=0.001) ve aralarında istatistiksel olarak fark yoktu (p>0.05). Folik asit seviyeleri üç grup arasında anlamlı farklılık göstermedi (p>0.05). Hcy, vitamin B12 ve folik asit düzeyleri arasında korelasyon yoktu (p>0.05). Sonuç: Bu çalışma, alt gruplardan bağımsız olarak inme hastalarında Hcy düzeylerinin yüksek olduğunu göstermiştir. Ayrıca bu alt gruplarda Hcy, vitamin B12 ve folat düzeyleri arasında da ilişki bulunmadı. Sonuçlarımızı doğrulamak için daha iyi tasarıma sahip daha büyük kohortlara ihtiyaç duyulacaktır.
Author KAYA TEKEŞİN, Aysel
ÇELİKBİLEK, Asuman
YAĞIZ, Orhan
YETİŞ, Aysu
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