Buradasınız

Anasayfa » Content

Akut İskemik ve Akut Hemorajik İnmede Risk Faktörü Olarak Homosistein

Homocysteın As A Rısk Factor In Acute Ischemic and Acute Hemorrhagic Cerebral Stroke

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Objective : Elevated level of serum homocystein is accepted as a risk factor which is indefinite, changeable and independent for ischemic strokes. However such a relationship in the hemorrhagic strokes has not been vastly discussed. The goal of this study is to investigate whether the elevated serum homocystein level, as a risk factor for the acute ischemic and acute hemorrhagic strokes, shows a meaningful difference or not. Material and Methods : 32 patients who were hospitalized with diagnosis of acute ischemic stroke and 32 patients who were hospitalized with diagnosis of acute hemorrhagic stroke in the Neurology Department of Taksim Training and Research Hospital between February 2005 and June 2006 were included in the study group. None of these patients belonging to the two groups defined a stroke history. The results were evaluated by using the following statistical methods; Mann Whitney U, One-way Variance Analysis, Q square test, Pearson Correlation Analysis, Dunn’s Multiple Comparison Test. Results : The average of serum homocystein level in ischemic stroke group and in hemorrhagic stroke group were 15,9 +/- 5.4 μmol/l, 15,8 +/- 6.1 μmol/l respectively (normal adult serum homocystein level is 5-14 μmol/l). No meaningful difference with respect to homocystein level found between two groups. (P>0.05) Conclusion : This study supported that there is no meaningful difference with respect to the elevation of homocystein level between the studied two-groups.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç : Serum yüksek homosistein düzeyi, iskemik inmeler için bağımsız, değiştirilebilen, kesinleşmemiş bir risk faktörü olarak kabul edilmektedir. Hemorajik inmelerde ise, böyle bir ilişki çok tartışılmamıştır. Bu çalışmanın amacı, serum yüksek homosistein düzeyinin, akut iskemik inme ve akut hemorajik inmeli hastalarda risk faktörü olarak, anlamlı bir fark gösterip göstermeyeceğini değerlendirebilmekti. Gereç ve Yöntem: Taksim Eğitim ve Araştırma Hastanesi Nöroloji Kliniğine Şubat 2005 –Haziran 2006 tarihleri arasında yatırılan, daha önce herhangi bir inme geçirmemiş, akut hemorajik serebrovasküler hastalık tanısı alan 32 olgu ve yine akut iskemik serebrovasküler hastalık tanısı alan 32 olgu değerlendirildi. İstatistiksel olarak sonuçlar; Mann-Whitney-U testi, tek yönlü varyans analizi, ki kare testi, Pearson korelasyon analizi testi, Dunn’s çoklu karşılaştırma testi aracılığı ile değerlendirildi. Sonuçlar : İskemik serebrovasküler hastalık grubunda, serum homosistein düzeyi ort: 15.9± 5.4 μmol /L, hemorajik grupta bu düzey ort:15.8± 6.1μmol /L olarak elde edildi. (normal erişkin serum homosistein düzeyi: 5-14 μmol / L). İskemik serebrovasküler hastalık grubundaki serum homosistein düzeyi ile hemorajik serebrovasküler hastalık grubundaki serum homosistein düzeyi arasında anlamlı fark bulunmadı( p>0.05). Yorum : Sonuç olarak yaptığımız çalışma, risk faktörü olarak yüksek serum homosistein düzeylerinin akut iskemik ve akut hemorajik serebrovasküler hastalıklar arasında anlamlı bir fark göstermediğini desteklemektedir.
FULL TEXT (PDF): 
PDF icon arastirmax-akut-iskemik-akut-hemorajik-inmede-risk-faktoru-olarak-homosistein.pdf
  • 3
181-185
  • Turkish

REFERENCES

References: 

1. Cerebrovasculer Disorders . A clinical and research clasification. WHO ofset Publ. 1978 No:43.
2. Bonitta R: Epidemiology of stroke. Lancet.1992;339:342-4.
3. Zhaohui Li, et al. Elevated plasma homocystein was associated with hemorrhagic and ischemic stroke. STROKE 2003;34:2085-90
4. Bogusslavsky J, Van Mele G, Regli F: The Lausanne Stroke Registry: Analysis of 1000 consecutive patients with first stroke. Stroke.1998;19:1083-92.
5. Balkan S. Serebrovasküler hastalıklar, Güneş kitabevi Yayınları 2005
6. Boushey CJ, Shirley AA, Beresford SAA. A quantitative assesment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA. 1995;27: 1049- 57.
7. Ellen KB, Kostense PJ. Hyperhomocysteinemia increases risk of death. Circulation 2000,10 1: 1506- 11.
8. Tsai Michael Y, Garg Uttam, Key Nigel S, et al. Molecular and Biochemical approaches in the identification of heterozygotes for homocystinuria. Atherosclerosis, 1996; 122: 69-77.
9. Graeme J Hankey, et al, clinical usefulness of plazma homoeysteine in vascular dissease. MJA 2004; 181(6):314-8.
10. Stanfer MJ,Malino MR et al.A prospective Study of Plasma Homocystein and risk of myocardial infarctıon in US physicians.JAMA 1992;268:877-81
11. Abbot RD, Rodriguez BL, Burchfield CM, et aL. Physical activity in older middle aged men and reduced risk of stroke : The Honolulu Heart Program. Am J Epidemiol. 1994;139;881-93.
12. Adams J.r HP, Bendixen BR, Kapelle J. The TOAST inastigators. Classification of subtypes of acut ischemik stroke Definiation for use in multicenter clinical trial. Stroke.1993;24:35-41.
13. Ashok P, Radhakrishnan K, et al: Incidence and pattern of cerebrovascular disease in benghazi, Libya J Neurol, Neurosurgery psychiatry 1986;49: 519-53.
14. Charles G. C. Spencer, StevenC. et al: Relationship of homocysteine to markers of platelet and endothelial activation in 'high risk 'hypertensives. International Journal of Cardiology 94(2004) 293-300.
15. Velioglu Sibel K, Boz C, Arı N, Uydu Hüseyin A, Özmenoglu M. Skemik strokta akut ve subakut dönemde homosistein düzeyleri. Türk Serebrovasküler Hastalıklar Dergisi., 2003;9: 1-5.
16. Burchfield CM, Curb jD, Rodriguez BL et al. Glucose intolerance and 22 year stroke incidence, The Honolulu Heart program. Stroke.1994;25:951 -7.
17. Kang S, Wong PW, Malinow MR. Hyperhomocysteinemia as risk factor for occlusive vasculer disease. Ann Rev Nutr. 1992;12: 279-98.
18. Bushey CJ, Beresford Sa, Omenn GS, Motulsky AG. Aquantitative assesment of plasma homocysteine as a risk factor for vascular disease probable benefits of increasing folic acid intakes. JAMA. 1995; 274: 1049-57.
19. Bethany Van Guelpen et al, Folat, Vitamin B 12, and Risk of İschemic and Hemorrhagic Stroke: A Prospective, Nested Case-Referent Study of Plasma Concenration and Dietary Intake Stroke 2005 ;36; 1426-31.
20. Eliyahu H, Mizrahi MD, Shlomo Noy MD et al. Furter evidance of İnterrelation between homocysteine and hypertension in stroke patients. A cross sectional study. IMAJ. Volum 5 november, 2003; 791-4.
21. Lindgren A, Brattström l, Norrving B, et al.Plasma Homocysteine in Acute and Convalescent Phases After Stroke. Stroke,1995;26:795-8002.
22. Jun-Hyun Yoo, Chin-Sang Chung, Soo-Sang Kang. Relation of plasma Homocysteine to Cerebral Infarction and Cerebral Atherosclerosis. Stroke, 1998;29: 2478-83.
23. John C.Chambers, MD, et al. Improved Vascular Endothelial Function After Oral B Vitamins. Circulation 2000,102:2479-83.
24. Ka He, MD; Anwar Merchant, DMD; Eric B. Rimm, ScD; Bemard A. Rosner, PhD; Meir J. Stampfer, 110; Walter C. Willett, 110; Alberto Ascherio, MD Folate, Vitamin B6, and B12 Intakes in Relation to Risk of Stroke Among Men. Stroke Januar 2004:169-74.
25. Khamasta MA, Cuadreado MJ, Mujic F et al. The Management of tmonıbosis in the antiphospolipid-antibody sendrome. N Eng J. Med 1995;332:993- 7.
26. Kumral E,Kumral K:İnme risk faktörleri. Nöropsikiyatri arşivi. 1991;28: 55- 8.
27. Kumral E, Özkaya B, Sağduyu A, Şirin H, Vardarlı E, Pehlivan M, The stroke registry. A hospital based study in the Aegian Region, İzmir, Turkey. Analysis of 2000 patients.Cerebrovascular Dis.1998;8:278-88
28. L.Parnetti et al, mild hyperhomocysteinemia is a risk faktör in all etiological subtypes of stroke Neurol sci 2004;25: 13- 7.
29. Modi M, Prabhakar S,et aL. Hyperhomocysteinemia as a risk factor for ischemic stroke: An Indian scenario. Neurology India 2005;53: 297- 301.
30. Nygard O, Vollset SE, Refsum H, et al. Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA 1995;274:1526-33 .
31. Herman B, Leyten A, Van Lujik J et aL. Epiomiology of stroke in Tilburg; The Netherlands. Stroke.1982;13: 629- 34.
32. Hiroyasu Iso MD et al, serum total homosisteine consentrations and risk of strok and !ts subtypes in Japanese Cireulation. 2004; 109:2766.
33. P.j KELLY, j.P. Kistler, et al: Inflammation Homocysteine and Vitamin B6 Status After Ischemic Stroke. Stroke 2004;35;12- 5.
34. Özdemir G Ve ark. Türkiyede Beyin damar hastalıkları için major risk faktörleri; Türk çok merkezli strok çalışması. Türk BDH Derg. 2000;6;2: 31- 5
35. James F.Toole, md, M.Rene Malinov, MD, et al: Lowering Homocysteine in Patients With Ischemic Stroke to Prevent Reeurrent Stroke,Myocardial Infarction, and Deth. JAMA.2004;291:565- 75.
36. Gravanis J\1B, Histopathology of artheriosclerosis. Braunwald E (ed) atlas of He art Diseases volume 10, 1996.
37. Manson JE, Stampfer MJ, Willet WC et al, Physical activity and incidence of coronary heart disease and stroke in women. Circulation 1995;9 (supp) 5 Abstract
38. Nencini P, et al, mcidence of stroke in young adults in Florence, Italy stroke 1988;19: 977- 81.
39. Fakhrzadeh H, S Ghotbi, R Pourebrahim. Plasma homocysteine concentration and blood pressure in healthy Iranian adults: the Tehran Homocysteine Survey, Journal of Human Hypertension (2005) 19,869- 76.
40. Malgrem R,et al,Geographical and seculer trends in stroke incidence Lancet 1987;2: 1196-201.
41. Hofmann MA, Lalla E, Lu Y. Hyperhomocysteinemia enhances vascular infiammation and acelerates atherosclerosis in a murine model. J Clin Invest. 2001; 107: 675- 83.
42. Patrizia Nencin, Crstina Sarti, et al: Acute Inflammatory Events and Ischemic Stroke Subtypes. Cerebrovasc Dis 2003; 15: 215- 21
43. Homocysteine and blood pressure in the Third National Health and Nutrition Examinasion Survey, 1988- 1994 Am J Epidemiol 2002;156:1105- 13.
44. Bejot Y, Caillier M, Rouaud O. Epidemiology of strokes. Impact on the treatment decision. Presse Med. 2007 Jan;36(1 Pt 2):117- 27. Epub 2006 Dec 11
45. Sazci A, Ergul E, Tuncer N. Methylenetetrahydrofolate reductase gene polymorphisms are associated with ischemic and hemorrhagic stroke: Dual effect of MTHFR polymorphisms C677T and A1298C. Brain Res Bull. 2006 Dec 11;71(1- 3):45- 50. Epub 2006 Aug 15

Thank you for copying data from http://www.arastirmax.com