Plasma Homocysteine: Independent Risk Factor for Occlusive Vascular Disease

pp 571-581

Abstract

Determination of total homocysteine in plasma is becoming an important procedure in clinical chemistry, since high homocysteine levels maydamage blood vessels, causing atherosclerosis, or clogging of the heart arteries. Numerous studies established that moderate hyperhomocysteinemia is a major independent risk factor for the development and progression of occlusive vascular disease. Several conditions are known to elevate homocysteine in plasma above normal levels, including in born errors of metabolism, nutritional status and treatment with drugs. Possible mechanisms bywhich elevated homocysteine levels lead to vascular disease include effects on platelets, clotting factors and endothelium. Low serum vitamins B6and B12 and folate levels are often associated with high homocysteine in plasma concentration and can be reduced by vitamin supplementation. Thus, aterosclerotic lesions and thrombosis related to hyperhomocysteinemia might be prevented with a higher vitamin intake. However, no clinical trials have been conducted.