Gürkan ÇIKIM, Solmaz SUSAM, Mustafa GÖKSU, Fatih ÜÇKARDEŞ, Muhittin ÖNDERCİ

Evaluation of Homocysteine, Trace Element, and Vitamin Levels in Male Individuals with Hemorrhoidal Disease

Objectives: Hemorrhoidal disease is a common and uncomfortable condition affecting people worldwide, primarily in the lower rectal region. This study explores the relationship between hemorrhoidal disease and the levels of homocysteine, folic acid, vitamin B12, zinc, and copper in men. Methods: A prospective study included 38 male patients with internal hemorrhoids (Group I) and 38 healthy male individuals (Group II). Venous blood samples were collected after a 12-hour fast and analyzed for homocysteine, folic acid, vitamin B12, zinc, and copper levels. Statistical analyses, including the Kolmogorov-Smirnov test, Mann-Whitney U or Two-Sample t-test, Receiver Operating Characteristic (ROC) analysis, and Multivariate Binary Logistic regression, were performed. Results: Group I and Group II had similar age and body mass index (BMI). Homocysteine and copper levels were significantly higher in Group I, while folic acid and vitamin B12 levels were significantly lower. High homocysteine levels (≥11.2 µmol/L) had a sensitivity of 92.11%, while low vitamin B12 (<114) and high copper (≥1004) levels exhibited high specificity (97.37% and 86.8%, respectively). An increase of one unit in vitamin B12 was associated with a 1.04% decrease in hemorrhoid occurrence. Conclusion: This study suggests that evaluating homocysteine, copper, folate, and vitamin B12 levels may be valuable in patients with or at risk of hemorrhoidal disease. Future research should include larger, more diverse samples to enhance the generalizability of these findings.

Keywords:

Hemorrhoidal disease, trace elements, folate, B12 vitamin, homocysteine,

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Sheikh P, Régnier C, Goron F, Salmat G. The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey. Journal of comparative effectiveness research. 2020;9(17):1219-32.
Sandler RS, Peery AF. Rethinking what we know about hemorrhoids. Clinical Gastroenterology and Hepatology. 2019;17(1):8-15.
Efthymakis K, Neri M. The role of Zinc L-Carnosine in the prevention and treatment of gastrointestinal mucosal disease in humans: a review. Clinics and Research in Hepatology and Gastroenterology. 2022;46(7):101954.
Lopez J, Ramchandani D, Vahdat L. Copper depletion as a therapeutic strategy in cancer. Met Ions Life Sci. 2019;19:303-30.
Członkowska A, Litwin T, Dusek P, Ferenci P, Lutsenko S, Medici V, et al. Wilson disease. Nature reviews Disease primers. 2018;4(1):21.
Hasan T, Arora R, Bansal AK, Bhattacharya R, Sharma GS, Singh LR. Disturbed homocysteine metabolism is associated with cancer. Experimental & molecular medicine. 2019;51(2):1-13.
Hermann A, Sitdikova G. Homocysteine: biochemistry, molecular biology and role in disease. MDPI; 2021. p. 737.
Kaplan P, Tatarkova Z, Sivonova MK, Racay P, Lehotsky J. Homocysteine and mitochondria in cardiovascular and cerebrovascular systems. International journal of molecular sciences. 2020;21(20):7698.
Langan RC, Goodbred AJ. Vitamin B12 deficiency: recognition and management. American family physician. 2017;96(6):384-9.
Shulpekova Y, Nechaev V, Kardasheva S, Sedova A, Kurbatova A, Bueverova E, et al. The concept of folic acid in health and disease. Molecules. 2021;26(12):3731.
Murray LK, Smith MJ, Jadavji NM. Maternal oversupplementation with folic acid and its impact on neurodevelopment of offspring. Nutrition reviews. 2018;76(9):708-21.
Cikim G, Hatipoglu HS, Susam S. Evaluation of homocysteine, vitamin, and trace element levels in women with gallstones. Journal of Trace Elements in Medicine and Biology. 2023;78:127177.
Kumar T, Sharma GS, Singh LR. Homocystinuria: therapeutic approach. Clinica Chimica Acta. 2016;458:55-62.
Liu Z, Cui C, Wang X, Fernandez-Escobar A, Wu Q, Xu K, et al. Plasma levels of homocysteine and the occurrence and progression of rectal cancer. Medical science monitor: international medical journal of experimental and clinical research. 2018;24:1776.
Çıkım G, Veranyurt Ü. Evaluation of homocysteine and vitamin d levels in osteoarthritis patients. Medical Sciences. 2021;16(2):68-73.
Çıkım G, Abdullah T. Habituel Abortus Olan Gebelerde Homosistein Folik Asid ve Vit B12 Seviyelerinin Değerlendirilmesi. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi. 2021;16(3):417-20.
Gaetke LM, Chow-Johnson HS, Chow CK. Copper: toxicological relevance and mechanisms. Archives of toxicology. 2014;88:1929-38.
Prasad S, Gupta SC, Tyagi AK. Reactive oxygen species (ROS) and cancer: Role of antioxidative nutraceuticals. Cancer letters. 2017;387:95-105.
Khoshdel Z, Naghibalhossaini F, Abdollahi K, Shojaei S, Moradi M, Malekzadeh M. Serum copper and zinc levels among Iranian colorectal cancer patients. Biological trace element research. 2016;170:294-9.
MA, Dixon SJ. Copper-induced cell death. Science. 2022;375(6586):1231-2.