Purpose: Although hyperhomocysteinemia (Hhcy) is a risk factor for cerebral infarction, its effect on recurrent cerebral infarction is less-defined. We aimed to investigate the association of Hhcy and increased risk of recurrent cerebral infarct.
Materials and methods: From 2011 to 2013, we recruited 231 primary cerebral infarct patients that were divided to a Hhcy group (n?=?105) and a control group (n?=?126) according to plasma homocysteinemia (Hcy) levels exceeding 15?μmol/L. In this prospective study, risk factors such as gender, age, blood lipid and glucose levels, history of diabetes, high blood pressure, smoking habits and plasma Hhcy levels were determined. A three-year follow-up compared differences in cerebral infarction recurrence rates. Statistical analyses identified whether plasma Hhcy levels were an independent risk factor for recurrent cerebral infarction.
Results: Triglyceride and low-density lipoprotein (LDL) levels in the Hhcy group were significantly higher than controls, and cerebral infarct recurrence rates in the Hhcy group exceeded control subject rates through the three-year follow-up (p?=?.021, p?=?.036 and p?=?.025). Cox proportional hazards modeling showed that elevated Hhcy levels (hazard ratio [HR]?=?3.062, p?<?.001), increased age (HR?=?1.069, p?<?.01), circulating triglyceride levels (HR?=?1.686, p?=?.048), and relative National Institutes of Health Stroke (NIHSS) score (HR?=?1.068, p?=?.016) were risk factors for recurrent cerebral infarction.
Conclusions: Level of Hhcy was a risk factor for recurrent cerebral infarction. Further, particular demographic and clinical outcomes including age, relative NIHSS scores, and circulating triglyceride levels were markedly associated with the occurrence of cerebral infarction. 相似文献
AIM: To investigate the effects of different methylenetetrahydrofolate reductase(MTHFR) 677CT gene polymorphism and hyperhomocysteinemia for the development of renal failure and cardiovascular events, which are controversial.METHODS: We challenged the relationship, if any, of MTHFR 677CT and MTHFR 1298AC polymorphisms with renal and heart function. The present article is a reappraisal of these concepts, investigating within a larger population, and including a subgroup of dialysis patients, if the two most common MTHFR polymorphisms, C677 T and A1298 C, as homozygous, heterozygous or with a compound heterozygous state, show different association with chronic renal failure requiring hemodialysis. MTHFR polymorphism could be a favorable evolutionary factor, i.e., a protective factor for many ominous conditions, like cancer and renal failure. A similar finding was reported in fatty liver disease in which it is suggested that MTHFR polymorphisms could have maintained and maintain their persistence by an heterozygosis advantage mechanism. We studied a total of 630 Italian Caucasian subject aged 54.60 ± 16.35 years, addressing to the increased hazard of hemodialysis, if any, according to the studied MTHFR genetic polymorphisms. RESULTS: A favorable association with normal renal function of MTHFR polymorphisms, and notably of MTHFR C677 T is present independently of the negative effects of left ventricular hypertrophy, increased IntraRenal arterial Resistance and hyperparathyroidism. CONCLUSION: MTHFR gene polymorphisms could have a protective role on renal function as suggested by their lower frequency among our dialysis patients in end-stage renal failure; differently, the association with left ventricular hypertrophy and reduced left ventricular relaxation suggest some type of indirect, or concurrent mechanism. 相似文献