Serum level of homocysteine is correlated to carotid artery atherosclerosis in Chinese with ischemic stroke

Objectives: To investigate the relationship between serum level of homocysteine (Hcy) and carotid artery atheroscleosis (CAA). Methods: Both sides of the common carotid artery and internal carotid artery in 126 Chinese patients with ischemic stroke were measured by B-mode ultrasound. The patients were divided into groups: normal, A, B, C and D according to the severity of CAAs. With fasting serum, Hcy as well as folate, vitamin B-12 and lipids were detected. The mean +/- SD age was 64 +/- 13 years ( range 39 - 87 years). Results: In a logistic regression model, the Hcy concentrations were associated with an elevated risk of CAAs independent of all traditional risk factors, and when CAAs became severer, the serum Hcy was higher. The levels of the normal group and A, B, C, D groups were 13.22 +/- 6.15 mu mol/l, 16.29 +/- 9.81 mu mol/l, 19.49 +/- 11.16 mu mol/l, 27.21 +/- 17.47 mu mol/l, and 24.14 +/- 8.64 mu mol/l, respectively. Rank test showed a significant difference between normal and other groups (p < 0.05). The levels of folate and vitamin B-12 were negatively correlated with the Hcy concentrations. Spearman correlation coefficient were -0.23 and -0.42 (p < 0.05). Conclusions: Hyperhomocysteinaemia is an independent risk factor of CAAs and the degree of CAAs is highly correlated with the level of Hcy in serum. The causes of hyperhomocysteinemia may be the result from the decrease in folate and vitamin B-12. Clinical trials are now required to evaluate the effect of treatment with these vitamins on the primary and secondary prevention of cerebral vascular diseases.