Cengiz TURGUT, M. Ufuk ALUÇLU, Ebru KALE, Dilek HAMDANOĞULLARI, Zeki AKKUŞ

Akut serebral infarkt olgularında serum homosistein düzeyi

Homosistein’in venöz trombozda belirgin risk faktörü olarak rol oynadığı belirlenmesine karşın iskemik serebrovasküler hastalıklardaki rolü üzerine olan etkisi tam olarak belirlenememiştir. Bu çalışma amacı bölgemizde meydana gelen akut iskemik serebrovasküler hastalıklardaki serum homosistein düzeyini ve rolünün belirlenmesidir. Dicle Üniversitesi Tıp Fakültesi Nöroloji kliniğine Mart – Aralık 2002 tarihleri arasında akut serebral infarkt ön tanısı ile yatırılan 38 hasta çalışma grubu olarak seçildi. Kontrol grubu olarak 32 kişilik sağlıklı hastane personeli seçildi. Sonuçlar istatistiksel olarak student-t testi ile değerlendirildi. İskemik serebrovasküler hastalık grubunda serum homosistein düzeyi 19.92 ± 8.69 $\mu$mol /L, kontrol grubunun ise 11.81 ± 3.47 $\mu$mol / L olup , serebral infarktlı hastalarda anlamlı olarak yüksek bulundu ( p

Anahtar Kelimeler:

Homosistein, Serum, Serebral enfarktüs, Risk faktörleri

Serum level of homocysteine in acute ischemic cerebrovascular disease

The role of homocysteine in ischemic cerebrovascular disease has been investigated in different studies. In this study, we wanted to determine the level and role of homocysteine in ischemic cerebrovascular disease. Thirty-eight patients who were hospitalized with diagnosis of cerebral infarctus in Department of Neurology between March and December 2002 were included to the study group . Control group were choosen from 32 healthy hospital staff. Resuts were evaluated with student-t test, statistically. While study group’s mean level of homocysteine was 19.92 ± 8.69 $\mu$mol /L, control group’s mean level was 11.81 ± 3.47 $\mu$mol / L. There was statistically significance between two groups (p<0.001). In conclusion, this study also supported that high serum level of homocysteine was a risk factor for ischemic cerebrovascular disease.

Keywords:

Homocysteine, Serum, Cerebral Infarction, Risk Factors,

PDF

___

1. Tsai Michael Y, Garg Uttam, Key Nigel S, et al. Molecular and Biochemical approaches in the identification of heterozygotes for homocystinuria. Atherosclerosis, 1996; 122: 69-77. 2. Lindgren A, Brattström l, Norrving B, et al.Plasma Homocysteine in Acute and Convalescent Phases After Stroke. Stroke,1995;26:795-8002. 3. Selhub J, Jacques P F, Wilson PWF, Rush D, Rosenberg IH. Vitamin status and intake as primary determinats of homocysteinemia in an elderly population. JAMA, 1993; 270: 2693-2698. 4. Jacques PF, Bostom AG, Williams RR, et al. Relation between folate status, a common mutation in methylentetrahydrofolate reductaseand plasma homocysteine metabolism. Circulation, 1996;93:7-9. 5. Tsai JC, Perrella MA, et al.Promotion of vasculer smooth muscle cell growth by homocysteine: a link to aterosclerosis. Proc Natl Acad Sci USA, 1994; 91:6369-73. 6. Tang L, Mamotte CD, et al. The effect of homocysteine on DNA synthesis in cultured human vasculer smooth muscle. Atherosclerosis, 1998; 136:169-73. 7. Stanler JS, Osborne JA, et al.Adverse vasuler effects of homocysteine are modulated by endothelium derived relaxing factor and related oxides of nitrogen. J Clin Invest, 1993;91:308-18. 8. McCully KS. Vascular pathology of homocysteinemia: İmplications for the pathogenesis of arteriosclerosis. Am J Pathol, 1969;56:111-128. 9. Kang S-S, Wong PWK, Malinow MR. Hyperhomocysteinemia as a risk factor for occlusive vascular disease. Annu Rev Nutr,1992;12: 279-298. 10. Kang S-S, Wong PWK, Norusis M, MesserJV.Protein – bound homocysteine: A possible risk factor for coronary artery disease. J Clin Invest, 1986; 77: 1482- 1486. 11. Stampfer MJ, Malinow MR, WilletWC, Newcomer LM, Upson B, Ullman D, Tishler PV, Hennekens Ch.A Prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. JAMA, 1992; 268: 877-881. 12. Kang S-S, Passen EL, Ruggie N, Wong PWK, Sora H. Thermolabil defect of methylenetetrahydrofolate reductase in coronary arter disease. Circulation,1993; 88: 1463-1469. 13. Ueland Per M, Refsum H, Stabler SP, Malinow M R, Anderson A, Allen R H. Total homocysteine in plama or serum.Methods and clinical applications. Clin Chem. 1993;39: 1764- 1779. 14. Perry IJ, Refsum H, Morris RW, Ebrahim SB, Ueland PM, Shaper AG. Prospective study of serum total homocysteine concentration and risk of stroke in middle – age Brithish men. Lancet 1995; 346:1395-1398. 15. Evers S, Koch H-G, Grotemeyer K-H, Lange B, Deufel T, Ringelstein E-B. Features,symptoms, and neurophysiological findings in stroke associated with hyperhomocysteinemia. Arch Neurol. 1997; 54: 1276-1282. 16. Jun-Hyun Yoo, Chin-Sang Chung, Soo-Sang Kang. Relation of plasma Homocysteine to Cerebral Infarction and Cerebral Atherosclerosis. Stroke, 1998;29: 2478-2483.
17. Kang S, Wong PW, Malinow MR. Hyperhomocysteinemia as risk factor for occlusive vasculer disease. Ann Rev Nutr. 1992;12: 279-298. 18. Bushey CJ, Beresford Sa, Omenn GS, Motulsky AG. Aquantitative assesment of plasma homocysteine as a risk factor for vascular disease probable benefits of increasing folic acid intakes. JAMA. 1995; 274: 1049-1057. 19. Velioglu Sibel K, Boz C, Arı N, Uydu Hüseyin A, Özmenoglu M. Skemik strokta akut ve subakut dönemde homosistein düzeyleri. Türk Serebrovasküler Hastalıklar Dergisi., 2003;9: 1-5.