Neurology Clinic, Department of Neuroscience, Sant'Anna Hospital, Como, Italy.
Epilepsy Res. 2012 Nov;102(1-2):1-7. doi: 10.1016/j.eplepsyres.2012.07.003. Epub 2012 Jul 21.
Homocysteine (Hcy) is a sulfur-containing, nonprotein amino acid reversibly formed and secreted during metabolism of methionine. Elevated total Hcy levels (hyper-tHcy) have been associated with cardiovascular disease in multiple large-scale epidemiologic studies and, in particular, patients with epilepsy exhibit elevated plasma tHcy levels more frequently than the general population caused by polymorphisms in the MTHFR gene and chronic treatment with older antiepileptic drugs. Folic acid alone or folic acid combined with other B-vitamins have all been shown to reduce tHcy concentration in patients on chronic treatment with antiepileptic drugs, however, which is the most appropriate supplementation scheme of folic acid and/or B-vitamins in patients with epilepsy still remains matter of debate. We review the latest findings on the role of supra-physiological tHcy concentrations as vascular risk factor in patients with epilepsy and discuss the possible role played by folate and other B-vitamins supplementation in epileptic patient with hyper-tHcy.
同型半胱氨酸（Hcy）是一种含硫的非蛋白质氨基酸，在蛋氨酸代谢过程中可被可逆地合成和分泌。多项大规模的流行病学研究表明，总同型半胱氨酸水平升高（高 Hcy）与心血管疾病有关，特别是癫痫患者由于 MTHFR 基因的多态性和长期使用旧的抗癫痫药物，更频繁地出现血浆 tHcy 水平升高。单独使用叶酸或叶酸联合其他 B 族维生素均可降低接受抗癫痫药物长期治疗患者的 tHcy 浓度，然而，在癫痫患者中，最适合补充叶酸和/或 B 族维生素的方案仍然存在争议。我们综述了超生理 tHcy 浓度作为癫痫患者血管危险因素的最新研究结果，并讨论了叶酸和其他 B 族维生素补充在高 Hcy 癫痫患者中的可能作用。
