Relationship between homocysteine and thrombotic disease

Jacob Selhub, Armando D'Angelo

Research output: Contribution to journalArticle

Abstract

Hyperhomocysteinemia is a condition which, in the absence of kidney disease, indicates a disrupted sulfur amino acid metabolism, either because of vitamin deficiency (folate, B12 and B6) or a genetic defect. Epidemiologic evidence suggests that mild hyperhomocysteinemia is associated with increased risk of arteriosclerotic disease and stroke. The relationship between hyperhomocysteinemia and thrombosis has been investigated in 10 studies involving a total of 1200 patients and 1200 controls. Eight of these studies demonstrated positive association with odds ratios that ranged from two to 13. This association was enhanced by including a methionine loading test. There is some evidence which suggests that hyperhomocysteinemia and activated protein C resistance have synergistic effect on the onset of thrombotic disease. Recent studies with animal models for mild hyperhomocysteinemia provided encouraging results in the understanding of the mechanism that underlies this relationship between mild elevations of plasma homocysteine and vascular disease. These animal models pointed to the possibility that the effect of elevated homocysteine is multifactorial, affecting both the vascular wall structure and the blood coagulation system.

Original languageEnglish
Pages (from-to)129-141
Number of pages13
JournalAmerican Journal of the Medical Sciences
Volume316
Issue number2
DOIs
Publication statusPublished - Aug 1998

Keywords

  • Arteriosclerosis
  • Folate
  • Homocysteine
  • Thrombosis
  • Vitamins

ASJC Scopus subject areas

  • Medicine(all)

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