McIlroy Stephen P, Dynan Kevin B, Lawson John T, Patterson Christopher C, Passmore A Peter
Department of Geriatric Medicine, Queen's University Belfast, Belfast, Northern Ireland.
Stroke. 2002 Oct;33(10):2351-6. doi: 10.1161/01.str.0000032550.90046.38.
Elevated plasma homocysteine level has been associated with increased risk for cardiovascular and cerebrovascular disease. Variation in the levels of this amino acid has been shown to be due to nutritional status and methylenetetrahydrofolate reductase (MTHFR) genotype.
Under a case-control design we compared fasting levels of homocysteine and MTHFR genotypes in groups of subjects consisting of stroke, vascular dementia (VaD), and Alzheimer disease patients and normal controls from Northern Ireland.
A significant increase in plasma homocysteine was observed in all 3 disease groups compared with controls. This remained significant after allowance for confounding factors (age, sex, hypertension, cholesterol, smoking, creatinine, and nutritional measures). MTHFR genotype was not found to influence homocysteine levels, although the T allele was found to increase risk for VaD and perhaps dementia after stroke.
We report that moderately high plasma levels of homocysteine are associated with stroke, VaD, and Alzheimer disease. This is not due to vascular risk factors, nutritional status, or MTHFR genotype.
血浆同型半胱氨酸水平升高与心血管疾病和脑血管疾病风险增加相关。已表明这种氨基酸水平的变化归因于营养状况和亚甲基四氢叶酸还原酶（MTHFR）基因型。
在病例对照设计下，我们比较了来自北爱尔兰的中风患者、血管性痴呆（VaD）患者、阿尔茨海默病患者以及正常对照人群组中同型半胱氨酸的空腹水平和MTHFR基因型。
与对照组相比，所有3个疾病组的血浆同型半胱氨酸均显著升高。在考虑混杂因素（年龄、性别、高血压、胆固醇、吸烟、肌酐和营养指标）后，这一差异仍具有显著性。尽管发现T等位基因会增加VaD风险以及中风后发生痴呆的风险，但未发现MTHFR基因型会影响同型半胱氨酸水平。
我们报告血浆同型半胱氨酸中度高水平与中风、VaD和阿尔茨海默病相关。这并非由血管危险因素、营养状况或MTHFR基因型所致。
