Renal function exerts only a minor influence on high plasma homocysteine concentrations in patients with acute coronary syndromes

被引:8
作者
Jonasson, T [1 ]
Öhlin, H
Andersson, A
Arnadottir, M
Hultberg, B
机构
[1] Univ Lund Hosp, Dept Med, S-22185 Lund, Sweden
[2] Univ Lund Hosp, Dept Lab Med, Div Clin Chem, S-22185 Lund, Sweden
[3] Landspitali Univ Hosp, Dept Med, Reykjavik, Iceland
关键词
acute coronary syndromes; cobalamin; creatinine; cystatin C; folate; homocysteine; pyridoxine; renal function;
D O I
10.1515/CCLM.2002.024
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
It has been suggested that hyperhomocysteinemia observed in patients with occlusive vascular disease is caused by reduced renal function secondary to renovascular disease. We have therefore used serum cystatin C, a new sensitive marker for glomerular filtration, in 59 patients with acute coronary syndromes and high plasma homocysteine (tHcy) concentration to measure renal function. Samples were also obtained from 34 patients with low-normal plasma tHcy and 50 control subjects. The patients with low-normal plasma tHcy concentration showed decreased concentrations of serum cystatin C and serum creatinine and increased concentrations of blood folate and serum cobalamin compared to the controls and to the patients with high plasma tHcy. There was a large overlap in cystatin C concentrations between patients with high and low-normal plasma tHcy. None of the parameters investigated except plasma tHcy were significantly different in the group of patients with high plasma tHcy concentration compared to the control group. In order to further demonstrate the importance of renal impairment, a subgroup of the patients with high plasma tHcy was supplemented daily with folic acid 5 mg, pyridoxine 40 mg and cyancobalamin 1 mg for 3 months. Vitamin therapy reduced plasma tHcy from 18.3+/-4.6 mumol/l to 9.6+/-2.2 mumol/l (p<0.0001). However, vitamin treatment did not strengthen the correlation between cystatin C and plasma tHcy concentrations. These findings do not support the hypothesis that subtle renal dysfunction is an important cause of high plasma tHcy concentration in patients with acute coronary syndromes.
引用
收藏
页码:137 / 142
页数:6
相关论文
共 28 条
[1]  
ANDERSSON A, 1993, CLIN CHEM, V39, P1590
[2]   The effect of reduced glomerular filtration rate on plasma total homocysteine concentration [J].
Arnadottir, M ;
Hultberg, B ;
NilssonEhle, P ;
Thysell, H .
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, 1996, 56 (01) :41-46
[3]  
Bostom AG, 1999, J AM SOC NEPHROL, V10, P164
[4]   Cystatin C as a determinant of fasting plasma total homocysteine levels in coronary artery disease patients with normal serum creatinine [J].
Bostom, AG ;
Bausserman, L ;
Jacques, PF ;
Liaugaudas, G ;
Selhub, J ;
Rosenberg, IH .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 1999, 19 (09) :2241-2244
[5]  
Brattström L, 2000, AM J CLIN NUTR, V72, P315
[6]   Common methylenetetrahydrofolate reductase gene mutation leads to hyperhomocysteinemia but not to vascular disease -: The result of a meta-analysis [J].
Brattström, L ;
Wilcken, DEL ;
Öhrvik, J ;
Brudin, L .
CIRCULATION, 1998, 98 (23) :2520-2526
[7]   HOMOCYSTEINE AND CYSTEINE - DETERMINANTS OF PLASMA-LEVELS IN MIDDLE-AGED AND ELDERLY SUBJECTS [J].
BRATTSTROM, L ;
LINDGREN, A ;
ISRAELSSON, B ;
ANDERSSON, A ;
HULTBERG, B .
JOURNAL OF INTERNAL MEDICINE, 1994, 236 (06) :633-641
[8]   FOLIC-ACID - AN INNOCUOUS MEANS TO REDUCE PLASMA HOMOCYSTEINE [J].
BRATTSTROM, LE ;
ISRAELSSON, B ;
JEPPSSON, JO ;
HULTBERG, BL .
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, 1988, 48 (03) :215-221
[9]   Blood levels off homocysteine and increased risks of cardiovascular disease -: Causal of casual? [J].
Christen, WG ;
Ajani, UA ;
Glynn, RJ ;
Hennekens, CH .
ARCHIVES OF INTERNAL MEDICINE, 2000, 160 (04) :422-434
[10]   Plasma homocysteine as a risk factor for vascular disease - The European concerted action project [J].
Graham, IM ;
Daly, LE ;
Refsum, HM ;
Robinson, K ;
Brattstrom, LE ;
Ueland, PM ;
PalmaReis, RJ ;
Boers, GHJ ;
Sheahan, RG ;
Israelsson, B ;
Uiterwaal, CS ;
Meleady, R ;
McMaster, D ;
Verhoef, P ;
Witteman, J ;
Rubba, P ;
Bellet, H ;
Wautrecht, JC ;
deValk, HW ;
Luis, ACS ;
ParrotRoulaud, FM ;
Tan, KS ;
Higgins, I ;
Garcon, D ;
Medrano, MJ ;
Candito, M ;
Evans, AE ;
Andria, G .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (22) :1775-1781