Association between hyperhomocysteinemia and stroke with atherosclerosis and small artery occlusion depends on homocysteine metabolism-related vitamin levels in Chinese patients with normal renal function

• Published in: Metabolic brain disease 2017-06, Vol.32 (3), p.859-865
• Main Authors: Wu, Guan-Hui, Kong, Fan-Zhen, Dong, Xiao-Feng, Wu, De-Feng, Guo, Qian-Zhu, Shen, Ai-Rong, Cheng, Qing-Zhang, Luo, Wei-Feng
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arteriosclerosis; Asian Continental Ancestry Group; Atherosclerosis; Biochemistry; Biomedical and Life Sciences; Biomedicine; Case-Control Studies; Cerebrovascular Disorders - blood; Cerebrovascular Disorders - diagnostic imaging; Cerebrovascular Disorders - epidemiology; China - epidemiology; Correlation analysis; Cyanocobalamin; Disease; Female; Folic acid; Folic Acid - blood; Health risk assessment; Health risks; Homocysteine; Homocysteine - blood; Humans; Hyperhomocysteinemia; Hyperhomocysteinemia - blood; Hyperhomocysteinemia - diagnostic imaging; Hyperhomocysteinemia - epidemiology; Incidence; Intracranial Arteriosclerosis - blood; Intracranial Arteriosclerosis - diagnostic imaging; Intracranial Arteriosclerosis - epidemiology; Ischemia; Kidney - physiology; Male; Metabolic Diseases; Metabolism; Middle Aged; Morbidity; Neurology; Neurosciences; Occlusion; Oncology; Original Article; Patients; Renal function; Retrospective Studies; Risk analysis; Risk factors; Rural areas; Stroke; Stroke - blood; Stroke - diagnostic imaging; Stroke - epidemiology; Subgroups; Supplements; Vitamin B 12 - blood; Vitamin B12; Vitamin B6
• ISSN: 0885-7490; 1573-7365
• DOI: 10.1007/s11011-017-9978-3

This study was conducted to investigate the role of different homocysteine metabolism-related vitamin (HMRV) levels in the correlation between hyperhomocysteinemia (HHCY) and ischemic stroke (IS) subtypes. Three hundred and forty-eight IS patients manifesting different vascular subtypes were subclassified on the basis of HMRV deficiencies. Correlation between HHCY and IS subtypes was investigated in all the subgroups. In this study, HHCY was significantly correlated with the IS subtypes in large artery atherosclerosis (OR 1.126, 95%CI: 1.051 ~ 1.206, P  = 0.001) and small artery occlusion (OR 1.105, 95%CI: 1.023 ~ 1.193, P  = 0.012). Subgroup analysis revealed a correlation between HHCY and IS subgroup (OR 1.201, 1.178, 95%CI: 1.081 ~ 1.334, 1.058 ~ 1.313, P  = 0.001, P  = 0.003, respectively) in HMRV deficiency, but not significantly with the IS subgroup in normal HMRV levels. Serum vitamin B12 concentrations are inversely correlated with both IS subtypes in HMRV deficiency subgroups (OR 0.992, 0.995, 95%CI: 0.987 ~ 0.996, 0.991 ~ 0.999, P