A STUDY OF SEVERITY OF STROKE AND HOMOCYSTEINE LEVEL IN SOUTHERN PART OF RAJASTHAN, INDIA

Authors

  • VINOD KUMAR MEHTA Department of Neurology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
  • ABHIJIT BASU Department of Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
  • PRAHARSH H PATHAK Critical Care Physician at Phoenix Hospital, Ahmedabad, Gujarat, India.
  • AYUSHI JAIN Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India.
  • NEHA SHARMA Department of biochemistry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2021.v14i10.42674

Keywords:

Homocysteine, Stroke, Hemorrhage, Atherosclerosis

Abstract

Objective: Till date, a very few prospective studies have examined the association between serum homocysteine levels and the risk of stroke and stroke subtypes in Indian populations.

Methods: A prospective, case - control study of Indian subjects 10–90 years of age was conducted using frozen serum samples from 103 participants in cardiovascular risk surveys collected from December 2017 to November 2018. By the end of 103, we identified 55 incidents of severe strokes, one control subject per case was selected by matching for sex, age, community, year of serum storage, and fasting status. Serum total homocysteine levels were measured by Cobas c-311.

Results: Compared with control subjects, total (n_206), hemorrhagic (n_106), and ischemic (n_87) strokes had higher geometric mean values of total homocysteine and higher proportions of homocysteine −25.0 μ mol/L. Homocysteine was estimated after adjustment for body mass index, smoking, alcohol intake, hypertension, and other cardiovascular risk factors. The excess risk of total and ischemic strokes did not vary significantly according to sex, age, smoking status, or hypertensive status.

Conclusion: High total homocysteine concentrations were associated with the increased risk of total stroke, more specifically ischemic stroke) Capsuloganglionic and frontoparietal infarct (8 each)., among Indian men and women.

Downloads

Download data is not yet available.

Author Biographies

VINOD KUMAR MEHTA, Department of Neurology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

Associate professor, department of Neurology

ABHIJIT BASU, Department of Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

Medicine

, professor

PRAHARSH H PATHAK, Critical Care Physician at Phoenix Hospital, Ahmedabad, Gujarat, India.

CRITICAL CARE PHYSICIAN

References

Gorelick PB, Sacco RL, Smith DB, Alberts M, Mustone-Alexander L, Rader D, et al. Prevention of a first stroke: A review ofguidelines and a multidisciplinary consensus statement from the national stroke association. JAMA 1999;281:1112-20.

Wolfe CD. The impact of stroke. Br Med Bull 2000;56:275-86.

Reeves MJ, Bushnell CD, Howard G, Gargano JW, Duncan PW, Lynch G, et al. Sex differences in stroke, epidemiology, clinical presentation, medical care and outocmes. Lancel Neurol 2008;7:915- 26.

Appelros P, Stegmayr B, Terent A. Sex differences in stroke epidemiology: A systematic review. Stroke 2009;40:1082-90.

Wassertheil-Smoller S, Hendrix SL, Limacher M, Heiss G, Kooperberg C, Baird A, et al. Effect of estrogen plus progestin on stroke in postmenopausal women: The women’s health initiative: A randomized trial. JAMA 2003;289:2673-84.

Cox AM, McKevitt C, Rudd AG, Wolfe CD. Socioeconomic status and stroke. Lancet Neurol 2006;5:181-8.

Di Napoli M, Papa F. Inflammation, hemostatic markers, and antithrombotic agents in relation to long-term risk of new cardiovascular events in first-ever ischemic stroke patients. Stroke 2002;33:1763-71.

Lip GY. Fibrinogen and cardiovascular disorders. QJM 1995;88:155- 65.

Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet 1999;354:407-13.

Welch GN, Loscalzo J. Homocysteine and atherothrombosis. N Engl J Med 1999;338:1042-50.

Refsum H, Smith AD, Ueland PM, Nexo E, Clarke R, McPartlin J, et al. Facts and recommendations about total homocysteine determinants: An expert opinion. Clin Chem 2004;50:3-32.

Malinow MR, Bostom AG, Krauss RM. Homocysteine, diet, and cardiovascular diseases: A statement for health care professionals from the nutrition committee, American heart association. Circulation 1999;99:178-82.

Homocysteine Lowering Trialists’ Collaboration. Lowering blood homocysteine with folic acid based supplements: Meta-analysis of randomised trials. Homocysteine lowering trialists’ collaboration. BMJ 1998;316:894-8.

Ho GY, Eikelboom JW, Hankey GJ, Wong CR, Tan SL, Chan JB, et al. Methylenetetrahydrofolate reductase polymorphisms and homocysteine-lowering effect of vitamin therapy in Singaporean stroke patients. Stroke 2006;37:456-60.

Hankey GJ, Algra A, Chen C, Wong MC, Cheung R, Wong L, et al. Vitatops, the vitamins to prevent stroke trial: Rationale and design of a randomised trial of b-vitamin therapy in patients with recent transient ischaemic attack or stroke (nct00097669) (isrctn74743444). Int J Stroke 2007;2:144-50.

Kwon HM, Lee YS, Bae HJ, Kang DW. Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke. Stroke 2014;45:871-3.

Wang W, Gao C, Yu C, Liu S, Hou D, Wang Y, et al. No association between elevated total homocysteine levels and functional outcome in elderly patients with acute cerebral infarction. Front Aging Neurosci 2017;9:70.

Published

07-10-2021

How to Cite

MEHTA, V. K., A. BASU, P. H PATHAK, A. JAIN, and N. SHARMA. “A STUDY OF SEVERITY OF STROKE AND HOMOCYSTEINE LEVEL IN SOUTHERN PART OF RAJASTHAN, INDIA”. Asian Journal of Pharmaceutical and Clinical Research, vol. 14, no. 10, Oct. 2021, pp. 59-62, doi:10.22159/ajpcr.2021.v14i10.42674.

Issue

Section

Original Article(s)