Correlation between serum homocysteine level and ulcerative colitis: A meta-analysis

Abstract

Background: The aim of the present meta-analysis was to investigate the correlation of serum homocysteine (Hcy) concentration and ulcerative colitis (UC) through pooling all the relevant publications. Methods The electronic databases of PubMed, EMBase, Web of Science, Google Scholar, CBM, and CNKI were systematic searched with the text words of homocysteine/Hcy, ulcerative colitis/UC, and inflammatory bowel disease. The correlation between serum Hcy and UC were demonstrated by stand mean difference (SMD) and corresponding 95% confidence interval (95% CI). The publication bias was evaluated by Egger’s line regression test and Begg’s funnel plot. Results After systematic searching the related electronic databases of PubMed, EMBase, Web of Science, Google Scholar, CBM, and CNKI, eighteen publications relevant to serum Hcy and UC were included in the present meta-analysis. The serum Hcy leves were 14.01±2.76 and 10.31±1.59 μmol/L for UC groups and healthy controls respectively with statistical difference (p<0.05). Significant heterogeneity was found (I2=94.5%, p<0.001) among the included studies. Therefore, the SMD was pooled through the random effect model. The pooled SMD was 1.20 (95% CI: 0.89-1.51), indicating that serum Hcy levels were significant higher in UC groups compared to healthy controls with statistical difference (Z=7.52, P<0.001). Egger’s line regression test indicated no publications bias (t=1.45, p=0.17). Conclusion: Serum Hcy levels were usually elevated in UC patients, which indicates that Hcy may play an important role in UC development and may be used as a serological biomarker for UC diagnosis.

Evidence-based pathogenesis and treatment of ulcerative colitis: A causal role for colonic epithelial hydrogen peroxide

“…Several studies have reported significantly elevated levels of tissue and serum homocysteine in children and adults with UC[ 195 - 198 ]. A significant positive association between elevated homocysteine and UC was confirmed by two meta-analyses in 2011 and 2018[ 199 , 200 ]. Homocysteine inhibits GPx, the principal antioxidant enzyme system used by the cell to remove (neutralize) H 2 O 2 [ 201 , 202 ].…”

Hydrogen peroxide and disease: towards a unified system of pathogenesis and therapeutics

“…This allows increased ETC metabolism of reducing equivalents (NADH, FADH2) that generates additional H 2 O 2 . Finally, markedly elevated levels of tissue homocysteine have been reported in colonic mucosa of individuals with UC and a meta-analysis found that serum homocysteine levels were significantly higher in UC groups compared to healthy controls (P < 0.001) (Morgenstern et al 2003;Zhong et al 2019). Homocysteine is a potent oxidative stressor that increases H 2 O 2 in several ways.…”