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Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection.

Abstract

BACKGROUND AND PURPOSE

Elevated homocysteine (Hcy) plasma levels are associated with an increased risk of spontaneous cervical artery dissection (sCAD). We examined the potential association between Hcy, folate, vitamin B(12) levels and 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphisms in patients with cerebral infarct caused by sCAD.

PATIENTS AND METHODS

39 patients who survived a cerebral infarct caused by sCAD [20 (51%) women; 24 (61.5%) vertebral and 15 (38.5%) internal carotid arteries], and 76 healthy control subjects were included. Hcy plasma levels (fasting and after methionine load), folate and vitamin B(12) levels were measured. We also performed polymorphisms of MTHFR. Hcy, vitamin B(12), folates and polymorphisms of MTHFR were assessed and any associations were analyzed using multivariate statistics.

RESULTS

Mean plasma fasting Hcy level was 9.81 mumol/l for cases and 6.38 for controls (p = 0.001). The occurrence of sCAD was associated with elevated fasting Hcy levels (>95th percentile over the control group) with an adjusted odds ratio of 7.9 (95% CI 1.66-35). The association between low plasma folate values (<5th percentile) and the presence of CAD was 7.9 (95% CI 1.6-31) after adjusting for confounding variables. The distribution of the MTHFR genotype showed a higher TT mutant frequency among CAD patients (p = 0.034).

CONCLUSIONS

High plasma concentrations of Hcy and low plasma levels of folate were associated with an increased risk of sCAD in the sample studied. We conclude that deficiencies in nutritional status may contribute to the relatively high incidence of CAD in Mexico.

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  • Authors+Show Affiliations

    ,

    Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. arauzg@prodigy.net.mx

    , , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Carotid Artery, Internal, Dissection
    Case-Control Studies
    Cerebral Arteries
    Cerebral Infarction
    Fasting
    Female
    Folic Acid
    Gene Frequency
    Genetic Predisposition to Disease
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Male
    Methylenetetrahydrofolate Reductase (NADPH2)
    Mexico
    Middle Aged
    Nutritional Status
    Odds Ratio
    Polymorphism, Genetic
    Prospective Studies
    Risk Assessment
    Risk Factors
    Severity of Illness Index
    Vertebral Artery Dissection
    Vitamin B 12

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    17596690

    Citation

    Arauz, Antonio, et al. "Mild Hyperhomocysteinemia and Low Folate Concentrations as Risk Factors for Cervical Arterial Dissection." Cerebrovascular Diseases (Basel, Switzerland), vol. 24, no. 2-3, 2007, pp. 210-4.
    Arauz A, Hoyos L, Cantú C, et al. Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection. Cerebrovasc Dis. 2007;24(2-3):210-4.
    Arauz, A., Hoyos, L., Cantú, C., Jara, A., Martínez, L., García, I., ... Alonso, E. (2007). Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection. Cerebrovascular Diseases (Basel, Switzerland), 24(2-3), pp. 210-4.
    Arauz A, et al. Mild Hyperhomocysteinemia and Low Folate Concentrations as Risk Factors for Cervical Arterial Dissection. Cerebrovasc Dis. 2007;24(2-3):210-4. PubMed PMID: 17596690.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection. AU - Arauz,Antonio, AU - Hoyos,Leticia, AU - Cantú,Carlos, AU - Jara,Aurelio, AU - Martínez,Leticia, AU - García,Irma, AU - Fernández,María de Los Angeles, AU - Alonso,Elisa, Y1 - 2007/06/27/ PY - 2006/10/23/received PY - 2007/02/22/accepted PY - 2007/6/29/pubmed PY - 2007/10/12/medline PY - 2007/6/29/entrez SP - 210 EP - 4 JF - Cerebrovascular diseases (Basel, Switzerland) JO - Cerebrovasc. Dis. VL - 24 IS - 2-3 N2 - BACKGROUND AND PURPOSE: Elevated homocysteine (Hcy) plasma levels are associated with an increased risk of spontaneous cervical artery dissection (sCAD). We examined the potential association between Hcy, folate, vitamin B(12) levels and 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphisms in patients with cerebral infarct caused by sCAD. PATIENTS AND METHODS: 39 patients who survived a cerebral infarct caused by sCAD [20 (51%) women; 24 (61.5%) vertebral and 15 (38.5%) internal carotid arteries], and 76 healthy control subjects were included. Hcy plasma levels (fasting and after methionine load), folate and vitamin B(12) levels were measured. We also performed polymorphisms of MTHFR. Hcy, vitamin B(12), folates and polymorphisms of MTHFR were assessed and any associations were analyzed using multivariate statistics. RESULTS: Mean plasma fasting Hcy level was 9.81 mumol/l for cases and 6.38 for controls (p = 0.001). The occurrence of sCAD was associated with elevated fasting Hcy levels (>95th percentile over the control group) with an adjusted odds ratio of 7.9 (95% CI 1.66-35). The association between low plasma folate values (<5th percentile) and the presence of CAD was 7.9 (95% CI 1.6-31) after adjusting for confounding variables. The distribution of the MTHFR genotype showed a higher TT mutant frequency among CAD patients (p = 0.034). CONCLUSIONS: High plasma concentrations of Hcy and low plasma levels of folate were associated with an increased risk of sCAD in the sample studied. We conclude that deficiencies in nutritional status may contribute to the relatively high incidence of CAD in Mexico. SN - 1015-9770 UR - https://www.unboundmedicine.com/medline/citation/17596690/Mild_hyperhomocysteinemia_and_low_folate_concentrations_as_risk_factors_for_cervical_arterial_dissection_ L2 - https://www.karger.com?DOI=10.1159/000104479 DB - PRIME DP - Unbound Medicine ER -