Relationship Between Hyperhomocysteinemia And Intracranial And Extracranial Artery Stenosis

Objective: To study the correlation between high level of homocysteine and intra andextracranial artery stenosis in patients with ischemic cerebrovascular disease.Method: Two hundreds patients with ischemic cerebrovascular disease werediagnosed by digital subtractiona angiography (DSA) system and confirmed by MRI(Feb.2011-Dec.2012). Based on the forth national cerebrovascular disease diagnosticguideline we ruled out patients with cardiac vascular disease, thyroid disease, cancer,liver and kidney function abnormality. Eighty healthy individuals were used as control.The plasma from fastened patients and control group was stored in4℃and wasmeasured the concentration of homocysteine by ELISA. These patients werecategorized high level of homocysteine group and normal level of homocysteine groupbased on the homocysteine level. Patients were categorized intracranial, extracranialand both intra and extracranial stenosis group by the location of stenosis. We measuredthe rate of stenosis based on North American Symptomatic Carotid EndarterectomyTrial (NASCET) guideline and divided into three groups mild, moderate and severe.In this study, we analyzed the association between homocysteine concentration and themorbidity, severity of disease and location of stenosis.Result:1) One hundred and thirty six out of two hundreds patients withischemic cerebrovascular disease had high hmocysteine concentration. The rateof high homocysteine was68%. However, this rate is30%in normal controlgroup (24out of80). The frequency of high homocysteine in artery stenosis group is significantly higher than normal control (χ~2=33.693，P<0.01).2) Theartery stenosis can be classified intracranial(107cases), extracranial(38cases)and both intra and extracranial(55cases) artery stenosis. The rates of highhomocysteine are68.2%(73/107)、68.4%/(26/38)and67.3%(37/55) respectively.There are no significant difference among these groups (χ~2=0.019，P>0.05);3)The rates of high homocysteine in patients with mild (78cases), moderate (84cases) and severe (38cases) artery stenosis are69.2%(54/78),64.3%(54/84)and73.6%(28/38) respectively. There are no significant differences amongthese three groups (χ~2=1.151，P>0.05);4) The level of homocysteine have nocorrelation with location of stenosis（rl=-0.006，P>0.05）, but the concentrationof homocysteine has positive correlation with the rate of cerebrovasculardisease（r=0.307，P<0.01）.Conclusion：High level of homocysteine is a risk factor of intra and extracerebrovascular stenosis. There were no significant difference between the grade ofhomocysteine levels and the location of stenosis. However the concentration ofhomocysteine associated with severity of cerebrovascular stenosis.