Jain Vatsal Navin, Rana Priyanka, Bhoge Kshitij Arun, Ghanghurde Swati, Phad Mahesh B, Rojekar Mohit Vijay
Rajiv Gandhi Medical College & Chhatrapati Shivaji Maharaj Hospital, Kalwa, Thane, India.
Department of Biochemistry, Rajiv Gandhi Medical College & Chhatrapati Shivaji Maharaj Hospital, Kalwa, Thane, India.
Caspian J Intern Med. 2024 Spring;15(2):259-265. doi: 10.22088/cjim.15.2.259.
Stroke is one of the leading causes of mortality and morbidity worldwide accounting for 85% of global deaths from stroke. This study aimed to evaluate the role of homocysteine (HCY) in modulating various stroke parameters and it's with carotid intima-media thickness (IMT).
78 patients of radiology-confirmed acute ischemic stroke were recruited for this study and National Institutes of Health Stroke Scale (NIHSS) score was evaluated upon admission. Blood samples were tested for serum HCY, fasting blood glucose (FBG) and lipid profile. Ultrasonography of neck ascertained IMT of Common (CCA) and internal carotid artery (ICA).
Average age of male and female subjects was 57.88 ± 13.97 & 59.16 ± 13.62 years respectively. 71.93% of stroke patients were hyperhomocysteinemic (HHcyc) and 24.36% were hyperlipidemic. Patients with NIHSS ≥ 5 had higher low-density lipoprotein cholesterol (LDLC) than those with NIHSS < 5. HCY cutoff of ≥ 15 μmol/L had 91.7% sensitivity & 66.7% specificity for predicting. HHcyc state was associated with increased ICA IMT. HHcyc state was best predicted by ICA IMT with which it is positively correlated (P-Value = 0.012).
HHcyc state holds a good predictive value for severity of stroke. We also came to a conclusion that ICA IMT measurement may also reduce the need for a homocysteine test as it predicts higher HCY levels; this will reduce the burden on resources. We suggest that evaluating HCY and ICA IMT should be made part of the standard protocol for management of stroke.
中风是全球死亡和发病的主要原因之一，占全球中风死亡人数的85%。本研究旨在评估同型半胱氨酸（HCY）在调节各种中风参数及其与颈动脉内膜中层厚度（IMT）关系中的作用。
本研究招募了78例经放射学确诊的急性缺血性中风患者，并在入院时评估了美国国立卫生研究院中风量表（NIHSS）评分。检测血样中的血清HCY、空腹血糖（FBG）和血脂谱。颈部超声检查确定颈总动脉（CCA）和颈内动脉（ICA）的IMT。
男性和女性受试者的平均年龄分别为57.88±13.97岁和59.16±13.62岁。71.93%的中风患者为高同型半胱氨酸血症（HHcyc），24.36%为高脂血症。NIHSS≥5的患者低密度脂蛋白胆固醇（LDLC）高于NIHSS<5的患者。HCY临界值≥15μmol/L预测HHcyc状态的敏感性为91.7%，特异性为66.7%。HHcyc状态与ICA IMT增加有关。ICA IMT对HHcyc状态的预测最佳，二者呈正相关（P值=0.012）。
HHcyc状态对中风严重程度具有良好的预测价值。我们还得出结论，由于ICA IMT可预测较高的HCY水平，因此测量ICA IMT也可能减少同型半胱氨酸检测的需求；这将减轻资源负担。我们建议，评估HCY和ICA IMT应成为中风管理标准方案的一部分。
