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Hyperhomocysteinemia and end-stage renal disease: determinants and association with cardiovascular disease in Tunisian patients.
Clin Chem Lab Med 2003; 41(5):675-80CC

Abstract

The study reports on plasma total homocysteine (tHcy) levels in Tunisian patients with chronic renal failure (CRF) and those treated with hemodialysis (HD) and renal transplant (RT). The aims of the study were to identify the determinants of tHcy concentration and to test the association between hyperhomocysteinemia and atherothrombotic disease in end-stage renal disease (ESRD). A total of 35 CRF patients on conservative treatment, 50 HD patients, and 30 RT recipients, and 31 age- and sex-matched healthy subjects were included. Plasma tHcy was assessed by a fluorescent-polarizing immunoassay method. Multivariate analysis was applied to identify the main determinants of tHcy concentration and to assess the relationship between hyperhomocysteinemia and cardiovascular disease. Plasma mean tHcy concentration was significantly increased (p < 0.001) in CRF patients (mean +/- SD) (28.9 +/- 9.8 micromol/l), in HD patients (29.4 +/- 11.1 micromol/l), and in RT (19.3 +/- 6.3 micromol/l) patients compared to controls (11.9 +/- 4.1 micromol/l). Multivariate analysis using GLM ANOVA modeling demonstrated that tHcy was significantly higher in males (p = 0.02), and was related to age (p = 0.008), albumin (p = 0.005), vitamin B12 (p = 0.002), folate (p = 0.00001), and creatinine clearance (p = 0.0008). However, tHcy was not associated with C-reactive protein and did not significantly differ between CRF, HD, or RT patients. The upper quartile of tHcy concentration was significantly associated with atherothrombotic cardiovascular disease (unadjusted odds ratio (OR) = 3.09; 95% CI, 1.11-8.61; p = 0.01). This association remained significant after adjusting for sex, age, hypertension, and smoking (multi-adjusted OR = 4.78; 95% CI, 1.92-11.9; p = 0.0008). The mean tHcy concentration was 2 to 3 times higher in ESRD patients than in subjects with normal renal function. This increase could be related to glomerular filtration rate reduction and functional B vitamins deficiency, but was not associated with inflammation. The upper quartile of tHcy concentrations confers 4.78-fold increased independent risk for atherothrombotic events in ESRD patients.

Authors+Show Affiliations

Laboratoire de Biochimie, Hôpital La Rabta, Tunis, Tunisia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12812266

Citation

Fellah, Hayet, et al. "Hyperhomocysteinemia and End-stage Renal Disease: Determinants and Association With Cardiovascular Disease in Tunisian Patients." Clinical Chemistry and Laboratory Medicine, vol. 41, no. 5, 2003, pp. 675-80.
Fellah H, Feki M, Hsairi M, et al. Hyperhomocysteinemia and end-stage renal disease: determinants and association with cardiovascular disease in Tunisian patients. Clin Chem Lab Med. 2003;41(5):675-80.
Fellah, H., Feki, M., Hsairi, M., Sanhaji, H., Kaabachi, N., Ben Abdallah, T., ... Mebazaa, A. (2003). Hyperhomocysteinemia and end-stage renal disease: determinants and association with cardiovascular disease in Tunisian patients. Clinical Chemistry and Laboratory Medicine, 41(5), pp. 675-80.
Fellah H, et al. Hyperhomocysteinemia and End-stage Renal Disease: Determinants and Association With Cardiovascular Disease in Tunisian Patients. Clin Chem Lab Med. 2003;41(5):675-80. PubMed PMID: 12812266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperhomocysteinemia and end-stage renal disease: determinants and association with cardiovascular disease in Tunisian patients. AU - Fellah,Hayet, AU - Feki,Moncef, AU - Hsairi,Mohamed, AU - Sanhaji,Haifa, AU - Kaabachi,Neziha, AU - Ben Abdallah,Taieb, AU - Massy,Ziad A, AU - Ben Maiz,Hedi, AU - Lacour,Bernard, AU - Mebazaa,Abderraouf, PY - 2003/6/19/pubmed PY - 2004/1/13/medline PY - 2003/6/19/entrez SP - 675 EP - 80 JF - Clinical chemistry and laboratory medicine JO - Clin. Chem. Lab. Med. VL - 41 IS - 5 N2 - The study reports on plasma total homocysteine (tHcy) levels in Tunisian patients with chronic renal failure (CRF) and those treated with hemodialysis (HD) and renal transplant (RT). The aims of the study were to identify the determinants of tHcy concentration and to test the association between hyperhomocysteinemia and atherothrombotic disease in end-stage renal disease (ESRD). A total of 35 CRF patients on conservative treatment, 50 HD patients, and 30 RT recipients, and 31 age- and sex-matched healthy subjects were included. Plasma tHcy was assessed by a fluorescent-polarizing immunoassay method. Multivariate analysis was applied to identify the main determinants of tHcy concentration and to assess the relationship between hyperhomocysteinemia and cardiovascular disease. Plasma mean tHcy concentration was significantly increased (p < 0.001) in CRF patients (mean +/- SD) (28.9 +/- 9.8 micromol/l), in HD patients (29.4 +/- 11.1 micromol/l), and in RT (19.3 +/- 6.3 micromol/l) patients compared to controls (11.9 +/- 4.1 micromol/l). Multivariate analysis using GLM ANOVA modeling demonstrated that tHcy was significantly higher in males (p = 0.02), and was related to age (p = 0.008), albumin (p = 0.005), vitamin B12 (p = 0.002), folate (p = 0.00001), and creatinine clearance (p = 0.0008). However, tHcy was not associated with C-reactive protein and did not significantly differ between CRF, HD, or RT patients. The upper quartile of tHcy concentration was significantly associated with atherothrombotic cardiovascular disease (unadjusted odds ratio (OR) = 3.09; 95% CI, 1.11-8.61; p = 0.01). This association remained significant after adjusting for sex, age, hypertension, and smoking (multi-adjusted OR = 4.78; 95% CI, 1.92-11.9; p = 0.0008). The mean tHcy concentration was 2 to 3 times higher in ESRD patients than in subjects with normal renal function. This increase could be related to glomerular filtration rate reduction and functional B vitamins deficiency, but was not associated with inflammation. The upper quartile of tHcy concentrations confers 4.78-fold increased independent risk for atherothrombotic events in ESRD patients. SN - 1434-6621 UR - https://www.unboundmedicine.com/medline/citation/12812266/Hyperhomocysteinemia_and_end_stage_renal_disease:_determinants_and_association_with_cardiovascular_disease_in_Tunisian_patients_ L2 - https://www.degruyter.com/doi/10.1515/CCLM.2003.102 DB - PRIME DP - Unbound Medicine ER -