Peran Hiperhomosisteinemia dalam Atherosklerosis

Abstract

Hiperhomosistenemia adalah peningkatan kadar homosistein dalam darah di atas 15 μmol/L. Di dalam siklus daur homosistein terdapat beberapa enzim yang memerlukan vitamin B12 dan asam folat sebagai kofaktor. Hiperhomosisteinemia dapat disebabkan defek genetik bawaan seperti defisiensi enzim Metilentetrahidrofolat reduktase, Metionin sintase, dan Sistationin β sintase, atau oleh faktor didapat seperti gagal ginjal, kanker, psoriasis, diabetes, paparan asap rokok, alkohol, kopi, usia tua, menopause, serta obat-obatan. Berbagai studi menunjukkan hiperhomosisteinemia berhubungan dengan disfungsi endotel, aktivasi platelet, dan pembentukan thrombus yang dapat berujung pada aterosklerosis dan penyakit jantung koroner.Hyperhomocysteinemia is defined as plasma homocystein level above 15 μmol/L. Several enzymes involved in homocysteine metabolism require vitamin B and folic acid as cofactor. Hyperhomocysteinemia could be caused by inherited genetic disease such as deficiency of Methylentetrahydrofolate reductase and Methionin synthase, or by acquired factors such as kidney failure, cancer, psoriasis, diabetes, smoking, alcohol, caffeine, elderly, menopause, and drugs. Prospective studies has shown that hyperhomocysteinaemia is associated with endothelial injury and dysfunction, promoting platelet activation and thrombus formation, which could result in atherosclerosis and coronary artery disease