370 research outputs found
Cerebral Venous Thrombosis and Livedo Reticularis in a Case with MTHFR 677TT Homozygote
Hyperhomocysteinemia associated with methylene terahydrofolate reductase (MTHFR) mutation can be a risk factor for idiopathic cerebral venous thrombosis. We describe the first case of MTHFR 677TT homozygote with cerebral venous thrombosis and livedo reticularis. A 45-year-old man presented with seizures and mottled-like skin lesions, that were aggravated by cold temperature. Hemorrhagic infarct in the right frontoparietal area with superior sagittal sinus thrombosis was observed. He had hyperhomocysteinemia, low plasma folate level, and MTHFR 677TT homozygote genotype, which might be associated with livedo reticularis and increase the risk for cerebral venous thrombosis
Effects of Metformin With or Without Supplementation With Folate on Homocysteine Levels and Vascular Endothelium of Women With Polycystic Ovary Syndrome
OBJECTIVE: To evaluate whether the administration of metformin exerts any effects
on serum homocysteine (Hcy) levels in patients with polycystic ovary syndrome
(PCOS) and whether supplementation with folate enhances the positive effects of
metformin on the structure and function of the vascular endothelium.
RESEARCH DESIGN AND METHODS: A total of 50 patients affected by PCOS, without
additional metabolic or cardiovascular diseases, were enrolled in a prospective
nonrandomized placebo-controlled double-blind clinical study. They were grouped
into two treatment arms that were matched for age and BMI. Patients were treated
with a 6-month course of metformin (1,700 mg daily) plus folic acid (400 microg
daily; experimental group, n = 25) or placebo (control group, n = 25). Complete
hormonal and metabolic patterns, serum Hcy, folate, vitamin B12, endothelin-1
levels, brachial artery diameter at the baseline (BAD-B) and after reactive
hyperemia (BAD-RH), flow-mediated dilation, and intima-media thickness in both
common carotid arteries were evaluated.
RESULTS: After treatment, a significant increase in serum Hcy levels was observed
in the control group compared with the baseline values and the experimental
group. A beneficial effect was observed in the concentrations of BAD-B, BAD-RH,
flow-mediated dilation, intima-media thickness, and serum endothelin-1 in both
groups. However, the results were improved more significantly in the experimental
group than in the control subjects.
CONCLUSIONS: Metformin exerts a slight but significant deleterious effect on
serum Hcy levels in patients with PCOS, and supplementation with folate is useful
to increase the beneficial effect of metformin on the vascular endothelium
Association of cardiovascular emerging risk factors with acute coronary syndrome and stroke: A case-control study
"This is the pre-peer reviewed version of the following article: "Martínez Linares, J.M.; et al. Association of cardiovascular emerging risk factors with acute coronary syndrome and stroke: A case control study. Nursing and Health Sciences, 18(4): 488-495 (2016)", which has been published in final form at http://dx.doi.org/10.1111/nhs.12299 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."In this study, we estimated the risk of acute coronary syndrome and stroke associated with several emerging
cardiovascular risk factors. This was a case-control study, where an age - and sex-matched acute coronary
syndrome group and stroke group were compared with controls. Demographic and clinical data were collected
through patient interviews, and blood samples were taken for analysis. In the bivariate analysis, all cardiovascular
risk factors analyzed showed as predictors of acute coronary syndrome and stroke, except total cholesterol and
smoking. In the multivariate logistic regression model for acute coronary syndrome, hypertension and body mass
index, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-Awere independent
predictors. For stroke, the predictors were hypertension, diabetes mellitus, body mass index, and N-terminal
section brain natriuretic peptide. Controlling for age, sex, and classical cardiovascular risk factors, N-terminal
section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent emerging
cardiovascular risk factors for acute coronary syndrome, but pregnancy-associated plasma protein-A was not
for stroke. High levels of cardiovascular risk factors in individuals with no episodes of cardiovascular disease
requires the implementation of prevention programs, given that at least half of them are modifiable.Health Agency of Health South of Granada.Project from "Ministerio de Economía y Competitividad. Dirección General de Investigación Científica y Técnica". Grant Number: MTM2013-47929-
Hyperhomocysteinaemia is associated with coronary events in type 2 diabetes
Objectives. Amongst nondiabetic individuals, a high serum homocysteine concentration is an independent but relatively weak risk factor for coronary events. However, it is not known whether homocysteine increases risk of coronary events in type 2 diabetes. Therefore, we examined the combined effect of homocysteine and type 2 diabetes on risk of fatal and nonfatal coronary events. Subjects. We assessed the 10-year risk of coronary events associated with homocysteine amongst diabetic (n = 140) and nondiabetic (n = 361) individuals. Design. We did this in the Hoorn Study, a population-based study of glucose tolerance and related complications in Caucasian men and women aged 50-75 years. Results. The incidence rate for coronary events was 2.63 (29 of 140) per 100 person-years amongst diabetic and 1.29 (42 of 361) amongst nondiabetic individuals. Amongst diabetic individuals, risk of coronary events increased 28% for each 5-μmol
Recommended from our members
Optimizing nutrition in older people
Older adults are at increased risk of malnutrition, for a variety of physiological and psychological reasons. This has implications for health, quality of life, independence and economic circumstances. Improvements in nutrition are known to bring tangible benefits to older people and many age-related diseases and conditions can be prevented, modulated or ameliorated by good nutrition. However, practical and realistic approaches are required to optimize diet and food intake in older adults. One area where improvements can be made relates to appetite. Encouraging older adults to prepare meals can increase appetite and food intake, and providing opportunities for older adults to eat a wide variety of foods, in company, is a simple strategy to increase food intake. The protein requirement of older adults is subject to controversy and although considered the most satiating macronutrient, it appears that protein does not elicit as great a satiating effect in older adults as it does in younger individuals. This indicates that there is potential to increase protein intake without impacting on overall energy intake. Other areas where simple practical improvements can be made include both packaging of foods that are easy to prepare and the education of older adults on the safe storage and preparation of food. Research into improving the diets and nutritional status of older adults has indicated that many of the strategies can be easily and cost-effectively undertaken
The Conselice Study of Brain Ageing
Among the age-related diseases, the development of cognitive impairments, in particular dementia, is the most devastating for the individual and has great social and healthcare costs. Accurate information is needed about the prevalence and incidence of cognitive disorders and the physiology of the ageing brain. In particular, only scant data are available about the relationship between ageing, cognitive status and nutritional factors. In order to address these issues we planned the Conselice Study of Brain Ageing, a longitudinal study of physiologic and pathologic brain ageing. The center involved in the study was the municipality of Conselice, Ravenna province, in the Northern Italian region Emilia-Romagna. A total of 1016 subjects aged 65 and over was enrolled at baseline. Information about cognitive status at 4-years of follow-up was collected for 940 of them. These data have been used to estimate prevalence and incidence of dementia in the elderly Italian population and to investigate the possible role of baseline blood homocysteine as risk factors for dementia
Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study
The aim of the present study was to investigate the relationship between homocysteine and homocysteine metabolism components and retinal microvascular disorders in subjects with and without Type 2 diabetes. In this population-based study of 256 participants, aged 60-85 years, we determined total plasma homocysteine, SAM (S-adenosylmethionine) and SAH (S-adenosylhomocysteine) in plasma and erythrocytes, total folate in serum and erythrocytes, 5-MTHF (5-methyltetrahydrofolate), and vitamins B12 and B6. Participants were examined ophthalmologically by means of indirect funduscopy and two-field 45° fundus photography, and were graded for retinopathy and retinal sclerotic vessel abnormalities. A computer-assisted method was used to measure retinal vessel diameters. Total plasma homocysteine was inversely associated with retinal arteriolar diameters {standardized β, -0.20 [95% CI (confidence interval), -0.33 to - 0.07]} or a decrease of 3.78 μm CRAEs (central retinal arteriolar equivalents) per 1 S.D. increase in homocysteine level (= 4.6 μmol/l). In addition, the SAM/SAH ratio in plasma was inversely associated with retinal sclerotic vessel abnormalities and retinopathy [odds ratios, 0.61 (95% CI, 0.39-0.96) and 0.50 (95% CI, 0.30-0.83) per 1 S.D. respectively]. The associations were independent of age, sex, glucose tolerance status, other homocysteine metabolism components and cardiovascular risk factors. In conclusion, the results of the present study support the concept that total plasma homocysteine and a low SAM/SAH ratio in plasma, which may reflect reduced transmethylation reactions, may contribute to the pathogenesis of (retinal) microangiopathy. © The Authors
MTHFR C677T and MTR A2756G polymorphisms and the homocysteine lowering efficacy of different doses of folic acid in hypertensive Chinese adults
<p>Abstract</p> <p>Background</p> <p>This study aimed to investigate if the homocysteine-lowering efficacy of two commonly used physiological doses (0.4 mg/d and 0.8 mg/d) of folic acid (FA) can be modified by individual methylenetetrahydrofolate reductase (MTHFR) C677T and/or methionine synthase (MTR) A2756G polymorphisms in hypertensive Chinese adults.</p> <p>Methods</p> <p>A total of 480 subjects with mild or moderate essential hypertension were randomly assigned to three treatment groups: 1) enalapril only (10 mg, control group); 2) enalapril-FA tablet [10:0.4 mg (10 mg enalapril combined with 0.4 mg of FA), low FA group]; and 3) enalapril-FA tablet (10:0.8 mg, high FA group), once daily for 8 weeks.</p> <p>Results</p> <p>After 4 or 8 weeks of treatment, homocysteine concentrations were reduced across all genotypes and FA dosage groups, except in subjects with MTR 2756AG /GG genotype in the low FA group at week 4. However, compared to subjects with MTHFR 677CC genotype, homocysteine concentrations remained higher in subjects with CT or TT genotype in the low FA group (<it>P </it>< 0.05 for either of these genotypes) and TT genotype in the high FA group (<it>P </it>< 0.05). Furthermore, subjects with TT genotype showed a greater homocysteine-lowering response than did subjects with CC genotype in the high FA group (mean percent reduction of homocysteine at week 8: CC 10.8% vs. TT: 22.0%, <it>P </it>= 0.005), but not in the low FA group (CC 9.9% vs. TT 11.2%, <it>P </it>= 0.989).</p> <p>Conclusions</p> <p>This study demonstrated that MTHFR C677T polymorphism can not only affect homocysteine concentration at baseline and post-FA treatment, but also can modify therapeutic responses to various dosages of FA supplementation.</p
Homocysteine Levels in Chronic Gastritis and Other Conditions: Relations to Incident Cardiovascular Disease and Dementia
Background Homocysteine levels in circulation are determined by several factors and hyperhomocysteinemia is reportedly associated with cardiovascular diseases and dementia. The aim of this study is to determine the relation of chronic gastritis and other conditions to homocysteine levels and their relation to incident cardiovascular diseases and dementia. Methods An adult population-based cohort (N = 488) was screened for H. pylori infection, gastro-duodenitis (endoscopic biopsies), disease history, and lifestyle factors. Blood samples were analyzed for pepsinogen I and II (gastric function), vitamin B12, folate, homocysteine, and cystatin C (renal function). The methylenetetrahydrofolate reductase C677T polymorphism reportedly associated with hyperhomocysteinemia was analyzed by pyrosequencing. Incident cardiovascular diseases and dementia were monitored during a median follow-up interval of 10 years. Results At baseline, there was a positive relation of S-homocysteine to male gender, age, S-cystatin C, methylenetetrahydrofolate reductase 677TT genotype and atrophic gastritis. During follow-up, cardiovascular diseases occurred in 101/438 and dementia in 25/488 participants, respectively. Logistic regression analysis (adjusting for gender, age at baseline, follow-up interval, BMI, smoking, alcohol consumption, NSAID use, P-cholesterol, and P-triglycerides) showed an association of S-homocysteine higher than 14.5 μmol/l to cardiovascular diseases (OR 2.05 [95% c.i. 1.14–3.70]), but not to dementia overall. Conclusions Gender, age, vitamin B12, folate, renal function, atrophic gastritis and the methylenetetrahydrofolate 677TT genotype were significant determinants of homocysteine levels, which were positively related to incident cardiovascular diseases
- …