Dhamija Rajinder K, Gaba P, Arora S, Kaintura A, Kumar M, Bhattacharjee J
Department of Medicine, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
J Neurol Sci. 2009 Jun 15;281(1-2):64-8. doi: 10.1016/j.jns.2009.02.341. Epub 2009 Mar 13.
Homocysteine and Lipoprotein (a) have been recognized as risk factors for coronary heart disease. However, their role in ischemic stroke is still not defined. Therefore the present study was undertaken to evaluate their levels and relationship in patients of ischemic stroke.
The study was conducted in consecutive patients admitted with a diagnosis of acute ischaemic stroke and age and sex matched healthy controls. Plasma homocysteine and serum l lipoprotein (a) levels were determined in the fasting venous blood samples using ELISA and immunoturbidimetric assay respectively.
66 patients with ischaemic stroke (30 males, 36 females) of mean age 54.43+/-1.97 years and 72 controls (39 males, 33 females) of mean age 53.86+/-1.88 years were studied. Mean plasma homocysteine levels in the stroke patients and control groups were 28.40+/-2.08 micromol/L and 11.16+/-1.09 micromol/L respectively (p<0.001). Odds ratio for raised homocysteine levels in stroke cases was 15.7. Plasma homocysteine levels showed a positive correlation with smoking (Pearson's correlation coefficient=0.324 and p-value of 0.008), (Odds ratio=5.71). Serum Lipoprotein (a) levels in stroke cases and control group were 57.33+/-4.40 mg/dl and 23.46+/-1.09 mg/dl respectively, (p<0.001), (Odds Ratio=8.62). A positive correlation was also observed between Homocysteine and Lipoprotein (a) levels with Pearson's correlation coefficient of 0.75 and p-value<0.001.
Raised homocysteine and serum lipoprotein (a) levels were found to be independently associated with ischemic stroke with a significant positive correlation between the two parameters. Elevated homocysteine levels may modulate the toxicity of lipoprotein (a) in ischemic stroke.
同型半胱氨酸和脂蛋白（a）已被确认为冠心病的危险因素。然而，它们在缺血性卒中中的作用仍不明确。因此，本研究旨在评估缺血性卒中患者中它们的水平及相关性。
本研究纳入连续收治的急性缺血性卒中患者以及年龄和性别匹配的健康对照者。分别采用酶联免疫吸附测定法（ELISA）和免疫比浊法测定空腹静脉血样本中的血浆同型半胱氨酸和血清脂蛋白（a）水平。
研究了66例缺血性卒中患者（男性30例，女性36例），平均年龄54.43±1.97岁，以及72例对照者（男性39例，女性33例），平均年龄53.86±1.88岁。卒中患者组和对照组的平均血浆同型半胱氨酸水平分别为28.40±2.08微摩尔/升和11.16±1.09微摩尔/升（p<0.001）。卒中病例中同型半胱氨酸水平升高的比值比为15.7。血浆同型半胱氨酸水平与吸烟呈正相关（Pearson相关系数=0.324，p值=0.008），（比值比=5.71）。卒中病例组和对照组的血清脂蛋白（a）水平分别为57.33±4.40毫克/分升和23.46±1.09毫克/分升，（p<0.001），（比值比=8.62）。同型半胱氨酸和脂蛋白（a）水平之间也观察到正相关，Pearson相关系数为0.75，p值<0.001。
发现同型半胱氨酸和血清脂蛋白（a）水平升高与缺血性卒中独立相关，且这两个参数之间存在显著正相关。同型半胱氨酸水平升高可能会调节脂蛋白（a）在缺血性卒中中的毒性。
