Effects of hyperhomocysteinemia on peripheral neuropathy

Jiang Jiwen; Feng Liqun; Zhang Shuping; Bi Qi

doi:10.3760/cma.j.issn.1673-4777.2014.05.014

Abstract：Objective To investigate the relationship between plasma homocysteine(Hcy) and peripheral neuropathy.Methods The 146 patients diagnosed as hyperhomocysteinemia were divided into two groups:hyperhomocysteinemia with peripheral neuropathy (case group)and hyperhomocysteinemia without peripheral neuropathy (control group).Patients with peripheral neuropathy caused by other etiologies were excluded.Sympathetic skin response,sensory and motor nerve conduction velocity were selected as electrophysiological examination methods.The differences in physiological data electric of non PND and PND group were compared.The patients in case group were treated with folic acid and vitamin B12 and followed for 6 months and than the differences of before and after treatment were observed.Results Totally 146 patients with hyperhomocysteinemia were included in this study.The case group (n =39,26.7％) with peripheral neuropathy mainly had axonal lesion.Hcy concentration in the study group was 26-81 μmol/L with an average of (51 ± 13)μmol/L.Hey concentration of control group was 21-44 μmol/L with an average of (30± 5)μmol/L.The difference between the two groups was significant (P ＜0.05).The total effective rate of three months was 48.7％ (19 cases) and the total effective rate of three months was 82.0％ (32 cases).The incubation period of double upper limb before treatment was (1 596 ± 143)ms and amplitude was (1.01 ±0.32)mV.The incubation period of lower limbs was (2 796 ±381)ms and amplitude was (0.28 ± 0.14)mV.3 months after treatment,incubation period of double upper limb was (1 438 ± 126)ms and amplitude was (2 610 ± 273) mV.The incubation period of lower limbs ws (1.58 ± 0.31) ms and amplitude was (0.37 ± 0.13)mY.6 months after treatment,incubation period of double upper limb was (1 326 ± 102)ms and amplitude was (2 090 ± 122) mV.The incubation period of lower limbs was(1.78 ± 0.37) ms and amplitude was (0.70 ± 0.11) mV.3 months and 6 months after treatment,the incubation period of double upper limb and double lower limbs and amplitude had statistical significant differences compared with those before treatment (all P ＜ 0.05).Conclusions Hyperhomocysteinemia may be implicated by peripheral nerve damage and meet the criteria of metabolic peripheral neuropathy.Lesions may be dose-dependent of serum Hcy concentrations.