The total homocysteine concentration in the patients with ischemic stroke or carotid atherosclerosis disease, and intervention study

Abstract：Aim To investigate total homocysteine(tHcy) concentration in ischemic stroke patients and in carotid atherosclerosis patients in comparison with normal control elders and to evaluate whether providing foliate and vitamin B12 could decrease serum homocysteine concentration.Methods The sample in this study was obtained from the inpatients and outpatients of geriatric department, HuaShan hospital.160 patients were recruited and were divided into two groups with smoking controlled.Thyroid gland abnormality and renal failure were excluded.One group consisted of 71 male and 9 female ischemic stroke patients aged 73 years on average.There were 71 males,9 females carotid atherosclerosis disease patients,aged 72 years on average in the second group.Hypertension and mellitus diabetes were controlled to avoid the influence of the conditions on these patients.The third group consisted of 72 males and 8 females normal control elders,aged 71 years on average.Besides fast serum total homocysteine,every patient took laboratory and physical examinations,including plasma folate, vitamin B12,free plasma glucose,creatinine,cholesterol,triglyceride,blood pressure and blood mass index.Each group was randomly divided further into two subgroups in which one subgroup was provided with folic acid 1.25 mg once every other day and vitamin B12 8 μ g once per day while the other was not.These patients were reexamined after 10 months.Results The serum tHcy concentration was (16± 5) μ mol/L in ischemic stroke group and (14± 5) μ mol/L in carotid atherosclerosis group compared with (12± 3) μ mol/L in normal control elders(P=0.0001).The plasma folate level was lower in ischemic stroke and carotid atherosclerosis patients,and there were no significant differences in other laboratory examination results.Correlation analysis showed that tHcy was negatively correlated with folate and vitamin B12 level,r=- 0.392, - 0.36 respectively in ischemic stroke group, r=- 0.287, - 0.339 respectively in carotid atherosclerosis group, and r=- 0.338, - 0.227 in normal control group.The tHcy concentration was lower in the groups provided with folate and vitamin B12 than that in the groups without folate and vitamin B12 (P=0.0001),even in the normal elders.Conclusion The tHcy concentration is higher in the patients with ischemic stroke and carotid atherosclerosis.Folate supplement could moderately lower serum tHcy level.