Drzewoski Józef, Gasiorowska Anita, Małecka-Panas Ewa, Bald Edward, Czupryniak Leszek
Department of Gastroenterology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland.
J Gastroenterol Hepatol. 2006 Apr;21(4):739-43. doi: 10.1111/j.1440-1746.2006.04255.x.
Homocysteine, an independent risk factor for thromboembolism, has been recently shown to be elevated in ulcerative colitis (UC). However, its relation to the activity of the disease remain unclear.
Two groups were studied: group consisted of 1-30 patients with UC (17 men, 13 women, mean age 50.3 +/- 14.7 years), including 15 patients with active disease. Group 2 (controls) consisted of 21 age-, sex-, bodyweight-matched healthy persons (12 men, nine women, mean age 53.1 +/- 12.8 years). Total plasma homocysteine (tHcy) and serum folate and vitamin B12 as well as selected coagulation parameters were assessed.
Mean tHcy in UC patients was significantly higher than in healthy controls: 10.8 +/- 3.1 mmol/L versus 6.8 +/- 2.5 mmol/L (P < 0.001). Patients with active disease had higher tHcy than patients in remission: 11.2 +/- 3.5 mmol/L versus 9.0 +/- 2.3 mmol/L (P = 0.048). Patients with > or =4 recurrences of the disease had also higher tHcy than the others: 11.5 +/- 3.6 mmol/L versus 9.0 +/- 2.1 mmol/L (P = 0.035). The tHcy correlated with duration of disease: r = 0.6632 (P < 0.05). Folate and B12 levels were within their reference ranges in all subjects. However, in the patients with active disease the platelet count, fibrinogen and D-dimer were significantly higher than in the patients in remission and the controls.
Ulcerative colitis is associated with elevated tHcy concentration, particularly in the active stage, and in more recurrent types of the disease; this elevation does not seem to be prevented by a normal folate status and might have an enhancing effect on the procoagulation blood profile.
同型半胱氨酸是血栓栓塞的一个独立危险因素，最近研究显示其在溃疡性结肠炎（UC）患者中升高。然而，其与疾病活动度的关系仍不清楚。
研究分为两组：第1组由1至30例UC患者组成（17例男性，13例女性，平均年龄50.3±14.7岁），其中15例为疾病活动期患者。第2组（对照组）由21例年龄、性别、体重匹配的健康人组成（12例男性，9例女性，平均年龄53.1±12.8岁）。评估了血浆总同型半胱氨酸（tHcy）、血清叶酸和维生素B12以及选定的凝血参数。
UC患者的平均tHcy显著高于健康对照组：分别为10.8±3.1 mmol/L和6.8±2.5 mmol/L（P<0.001）。疾病活动期患者的tHcy高于缓解期患者：分别为11.2±3.5 mmol/L和9.0±2.3 mmol/L（P = 0.048）。疾病复发≥4次的患者tHcy也高于其他患者：分别为11.5±3.6 mmol/L和9.0±2.1 mmol/L（P = 0.035）。tHcy与病程相关：r = 0.6632（P<0.05）。所有受试者的叶酸和维生素B12水平均在参考范围内。然而，疾病活动期患者的血小板计数、纤维蛋白原和D - 二聚体显著高于缓解期患者和对照组。
溃疡性结肠炎与tHcy浓度升高有关，尤其是在疾病活动期以及复发次数较多的类型中；这种升高似乎不受正常叶酸状态的影响，并且可能对促凝血血液指标有增强作用。
