Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Thromb Res. 2013 Jan;131(1):e12-6. doi: 10.1016/j.thromres.2012.11.011. Epub 2012 Dec 4.
Our aim was to investigate the impact of plasma total homocysteine (tHcyt) levels on cervico-cerebral atherosclerosis and cerebral small vessel ischemia in non-stroke individuals.
Demographic, laboratory, brain magnetic resonance imaging and magnetic resonance angiographic data were retrospectively analyzed in 682 non-stroke individuals. The association between plasma tHcyt and radiological indices of cervico-cerebral atherosclerosis (any presence of cervico-cerebral [aCC] atherosclerosis, extracranial [EC] atherosclerosis and intracranial [IC] atherosclerosis) and cerebral small vessel ischemia (silent brain infarct [SBI] and cerebral white matter hyperintensity [cWMH]) was analyzed after adjusting for cardiovascular risk factors.
There was no association between values for natural log-transformed tHcyt (log-Hcyt) and aCC atherosclerosis, EC atherosclerosis, or IC atherosclerosis. The log-Hcyt was independently associated with cWMH (OR: 3.07, 95% CI: 1.64-5.75) and SBI (OR: 2.91, 95% CI: 1.57-5.40) in multivariate analysis. Median plasma tHcyt level increased as the severity of cWMH increased.
Our results suggest that hyperhomocysteinemia plays a major role in the development of cerebral small vessel ischemia, but not in the development of atherosclerosis of major cerebral arteries.
本研究旨在探讨血浆总同型半胱氨酸（tHcyt）水平对非卒中个体颈脑动脉粥样硬化和脑小血管缺血的影响。
回顾性分析了 682 名非卒中个体的人口统计学、实验室、脑磁共振成像和磁共振血管造影数据。在校正心血管危险因素后，分析血浆 tHcyt 与颈脑动脉粥样硬化（颈脑 [aCC] 动脉粥样硬化、颅外 [EC] 动脉粥样硬化和颅内 [IC] 动脉粥样硬化任何存在）和脑小血管缺血（无症状性脑梗死 [SBI] 和脑白质高信号 [cWMH]）的放射学指标之间的相关性。
自然对数转换的 tHcyt（log-Hcyt）值与 aCC 动脉粥样硬化、EC 动脉粥样硬化或 IC 动脉粥样硬化之间均无相关性。log-Hcyt 与 cWMH（OR：3.07，95%CI：1.64-5.75）和 SBI（OR：2.91，95%CI：1.57-5.40）在多变量分析中独立相关。随着 cWMH 严重程度的增加，血浆 tHcyt 水平中位数增加。
我们的结果表明高同型半胱氨酸血症在脑小血管缺血的发展中起主要作用，但在大脑主要动脉粥样硬化的发展中不起作用。
