Hyperhomocysteinemia as a Risk Factor for Intracranial Aneurysms: A Case–Control Study

Rosí, Jefferson; Morais, Bárbara Albuquerque; Pecorino, Lucas S.; Oliveira, Allan R.; Solla, Davi Jorge Fontoura; Teixeira, Manoel Jacobsen; Figueiredo, Eberval Gadelha

doi:10.1016/j.wneu.2018.07.132

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…Total Hcy level >15 µmol/L was associated with higher risk of CA development (adjusted OR 2.196; 95% CI 1.188-4.057; p=0.012) [36]. Nevertheless, in a study performed by Rosi et al [37] in Brazil, median homocysteine serum level was similar in group of patients with CA in comparison with controls ( Elevated Hcy levels may result from nutritional deficiencies of folate, vitamin B 6 and B 12 . Although the results of studies concerning the beneficial effects of reduction of serum Hcy on cardiovascular diseases and mortality are not conclusive, it appears that adequate vitamin B intake may possibly protect from intracranial aneurysm formation.…”

Section: Nomentioning

confidence: 95%

Role of diet-related factors in cerebral aneurysm formation and rupture

Czekajło

2019

Rocz Panstw Zakl Hig

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Cerebral aneurysms (CAs) are dilations of the wall of an artery in the brain filled with blood. The prevalence of unrupted CA in general population is estimated at approximately 3%. Ruptured aneurysms are the cause of 85% of spontaneous subarachnoid hemorrhage (SAH) cases. The formation of cerebral aneurysms results from various factors, including chronic inflammation, hemodynamic stress and vascular wall remodeling. Reactive oxygen species may induce the endothelial dysfunction possibly through the activation of Nuclear Factor Kappa-B, which is a key regulator of the proinflammatory genes. Hypertension may additionally increase the hemodynamic stress and activate the local renin-angiotensin system. The aim of this review was to assess the role of selected diet-related factors in the formation and rupture of cerebral aneurysms. It appears that inadequate intake of dietary antioxidants, hyperhomocysteinemia, hypertension (including incidental elevated blood pressure) and alcohol consumption may increase the risk of intracranial aneurysms. Individuals at high risk of CA formation and/or rupture should consume adequate amounts of antioxidant vitamins (vitamin C, vitamin E and carotenoids), B vitamins (vitamin B 6 , vitamin B 12 and folate), flavonoids and n-3 fatty acids, limit alcohol and caffeine consumption and regularly control their blood pressure. Vegetables, fruits, grains, pulses, nuts and fish, as well as herbs, spices and tea, should be the major components of the daily diet. Due to the synergistic effect of various dietary components on health, Mediterranean diet or Dietary Approach to Stop Hypertension (DASH) diet, as they meet abovementioned requirements and have high anti-inflammatory potential, are thus recommended for the prevention of cerebral aneurysm formation and rupture. STRESZCZENIETętniaki mózgu to ograniczone poszerzenia światła naczynia krwionośnego wypełnione krwią. Występowanie tętniaków mózgu w ogólnej populacji wynosi około 3%, a pęknięcie tętniaka jest przyczyną 85% przypadków krwotoku do przestrzeni podpajęczynówkowej. Na powstanie tętniaka mózgu wpływa wiele czynników, w tym przewlekły stan zapalny, stres hemodynamiczny i przebudowa ścian naczyń mózgowych. Reaktywne formy tlenu mogą nasilać dysfunkcję śródbłonka m.in. poprzez aktywację jądrowego czynnika transkrypcyjnego NF-κB, który jest głównym regulatorem genów związanych z przebiegiem procesu zapalnego. Ponadto wysokie ciśnienie tętnicze krwi może nasilać stres hemodynamiczny oraz aktywować lokalny układ renina-angiotensyna-aldosteron. Celem artykułu był przegląd piśmiennictwa dotyczącego roli wybranych czynników związanych z dietą i z ryzykiem powstania i pęknięcia tętniaków mózgu. Wydaje się, że niewystarczająca podaż składników o działaniu antyoksydacyjnym, hiperhomocysteinemia, nadciśnienie tętnicze (w tym nagłe skoki ciśnienia tętniczego krwi) oraz spożycie alkoholu mogą zwiększać ryzyko rozwoju tętniaków mózgu. Osoby o podwyższonym ryzyku powstania i/lub pęknięcia tętniaka mózgu powinny więc stosować dietę o odpowiedniej zaw...

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Section: Nomentioning

confidence: 95%

Role of diet-related factors in cerebral aneurysm formation and rupture

Czekajło

2019

Rocz Panstw Zakl Hig

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“…Homocysteine is an endogenous, nonstructural protein which contains sulphur [13]. Homocysteine is involved in the metabolism pathway of methionine and cysteine [13,14]. Homocysteine can be irreversibly degraded to cysteine via the trans-sulphuration pathway or remethylated back to methionine [15].…”

Section: Homocysteinementioning

confidence: 99%

“…However, in another study, there was no association between homocysteine and intracranial aneurysms. Notably, this study was conducted comparing a case group (patients with intracranial aneurysms) with a control group consisting of patients with arteriovenous malformation (AVM) as well as no aneurysms [14].…”

Section: Role Of Nitric Oxide In Homocysteine Metabolismmentioning

confidence: 99%

Serum Homocysteine and Intracranial Aneurysms

Tai¹,

Toh²,

Hussain³

et al. 2020

New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review

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Subarachnoid haemorrhage (SAH) occurs as a result of rupture of intracranial aneurysms. SAH causes significant morbidity and mortality. In addition, SAH leads to significant financial burden. In this chapter, we will look into the association between raised serum homocysteine and intracranial aneurysms. In a study on the Han Chinese patients with intracranial aneurysm who were admitted to the hospital, the mean serum total homocysteine level in the patient group with intracranial aneurysm was significantly higher than those in the control group. In the same study, the patients with raised serum homocysteine had 2.196 higher risk of developing intracranial aneurysms. Ren et al. proposed that homocysteine should be seen as an indicator of the risk of intracranial aneurysm and not a direct cause of intracranial aneurysm. In another study, homocysteine increases the development of intracranial aneurysms in rats. Endothelial damage is an early change in the walls of intracranial aneurysms. Polymorphisms of the genes coding for the various components of the vessel walls may be associated with the formation of intracranial aneurysms. In a previous animal study, the size of intracranial aneurysms is significantly smaller in the mice with inducible nitric oxide synthase (iNOS) compared with the mice without iNOS.

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“…In recent years, some studies found that Hcy was associated with the occurrence of abdominal aortic aneurysms (AAA) (Li et al, 2018;Miao et al, 2021). Observational studies also have found that Hcy is related to the development of IAs (Ren et al, 2017;Rosi et al, 2018;Wang et al, 2020). However, since the subjects of these studies include ruptured and unruptured aneurysms and the influence of SAH on Hcy levels cannot be completely excluded, it is still unknown whether Hcy increases the risk of IA rupture.…”

Section: Introductionmentioning

confidence: 99%

Homocysteine Levels Are Associated With the Rupture of Intracranial Aneurysms

Wei

Yuan

et al. 2022

Front. Neurosci.

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BackgroundHomocysteine (Hcy) levels may be associated with the development of intracranial aneurysms (IAs). However, whether it increases the risk of rupture of IAs is unknown. This study aimed to determine the association between homocysteine levels and IA rupture.MethodsWe retrospectively reviewed patients with IAs and subarachnoid hemorrhage (SAH) at our hospital between January 2019 and May 2021. Clinical data, including Hcy levels and IA images, were assessed. The association between Hcy level and IA rupture was investigated using multivariate logistic regression analyses in patients with IAs and SAH.ResultsA total of 589 patients were included. 546 patients with IAs, including 331 UIA (Unruptured IA) and 215 RIA (Ruptured IA). The average age was 57.43 ± 10.86 years old, and 67.03% were women. Among them, all 215 RIAs lead to SAH. In addition, we also enrolled 43 non-aneurysmal subarachnoid hemorrhage (Na-SAH) patients. The average age was 54.12 ± 10.55 years old, and 53.48% were female. After adjusting for confounders in the multivariate model, Hcy levels were correlated with the rupture of IA (odds ratio [OR] 1.069; 95% confidence interval [CI] 1.025–1.114, p = 0.002) and a-SAH (OR 1.083; 95% CI 1.002–1.170, p = 0.046).ConclusionHcy levels were associated with IA rupture. These findings provide novel insights into IAs rupture, and future studies are needed to confirm this relationship.

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Hyperhomocysteinemia as a Risk Factor for Intracranial Aneurysms: A Case–Control Study

Cited by 11 publications

References 14 publications

Role of diet-related factors in cerebral aneurysm formation and rupture

Role of diet-related factors in cerebral aneurysm formation and rupture

Serum Homocysteine and Intracranial Aneurysms

Homocysteine Levels Are Associated With the Rupture of Intracranial Aneurysms

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