Hyperhomocysteinemia: Clinical Insights

Abstract

Homocysteine (Hcy) is a sulfhydryl-containing amino acid, and intermediate metabolite formed in metabolising methionine (Met) to cysteine (Cys); defective Met metabolism can increase Hcy. The effect of hyperhomocysteinemia (HHcy) on human health, is well described and associated with multiple clinical conditions. HHcy is considered to be an independent risk factor for common cardiovascular and central nervous disorders, where its role in folate metabolism and choline catabolism is fundamental in many metabolic pathways. HHcy induces inflammatory responses via increasing the pro-inflammatory cytokines and downregulation of anti-inflammatory cytokines which lead to Hcy-induced cell apoptosis. Conflicting evidence indicates that the development of the homocysteine-associated cerebrovascular disease may be prevented by the maintenance of normal Hcy levels. In this review, we discuss common conditions associated with HHcy and biochemical diagnostic workup that may help in reaching diagnosis at early stages. Furthermore, future systematic studies need to prove the exact pathophysiological mechanism of HHcy at the cellular level and the effect of Hcy lowering agents on disease courses.

Periodontal inflammation mediates the link between homocysteine and high blood pressure

“…Participants were mostly non-hispanic black participants (48.4%), higher education level (47.4%) and self-reported as never smoker (59.1%). Also, this sample had an average body mass index (BMI) of 27.9 (±7.1) kg/m 2 . A total of 734 participants were diagnosed as periodontitis cases (18.3%).…”

“…The sum of all individual PISA and PESA scores, in mm 2 , provides an overall area, respectively, for each participant.…”

“…Blood levels data included white blood cells (WBC) Count (10 9 /L), segmented neutrophils (10 9 /L), vitamin B12 (mg/dL), hemoglobin A1c (Hba1c) (%), CRP (mg/dL), Vitamin B12 (VB12) (pg/mL) and Folate (ng/mL). VB12 and Folate were considered given its link to the Hcy biosynthesis 1,2 .…”

“…Homocysteine (Hcy) is an amino acid synthesized as an intermediate metabolite from the methionine (Met) biosynthesis 1,2 . In plasma, 1% of Hcy circulates in its free form while the remaining 99% is bound to proteins 3 , and its concentration normally ranges between 5-15 µmol/L 2 . In cases of hyperhomocysteinemia (defined as total Hcy in plasma >15 µmol/L) 4,5 , the main causes may be impaired metabolism of Met or defective cofactors in the pathways of vitamins B6, B12 and folic acid 6 .…”

Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?

“…The main consequence of folate deficiency is megaloblastic anemia. Low folate levels can be associated with hyperhomocysteinemia, with an increased risk of thrombotic events [ 79 ].…”