Relationship Of Serum Homocysteine And Vitamin B12 With Outcome Of Acute Ischemic Stroke In Nigeria

Abstract

Background: Stroke has been a global burden, with increasing morbidity and mortality especially in developing countries. Studies had reported elevated levels of serum homocysteine(hcy) and vitamin B12 (Vit B12) in patients with stroke. Objectives: To determine the relationship between hcy, and Vit B12 outcome in acute ischaemic stroke Materials and Methods: Hundred acute Ischaemic stroke patients were recruited into the study and were followed up for 2years. Serum homocysteine and vitamin B12 was done using ELISA. Patients outcome either dead or alive was recorded at 1 month and at 24 months. Results: Majority of the participants 62% were males with hcy of 1.62±0.37µmol/L and 38% were females with hcy of 1.62±0.31µmol/L. Vit B12 of males were 97.00 (181.30,80.00) pg/ml and females had a Vit B12 of 90.00(140.00,70.00) pg/ml. Thirty-four percent of patients had hyperhomocysteinaemia (>1.7µmol/L) while 64% had normal homocysteine levels. Also, 81% had hypovitaminosis B12 (<199.72pg/ml) and 19% had normal vit B12 on admission. There was no statistically significant difference (p value =0.932) between mean hcy levels of 25 dead patients (1.67 ±0.22µmol/L) and 58 patients that survived at one month (1.68±0.37µmol/L). Similarly, there is no statistically significant difference (p value =0.869) between mean Vit B12 levels of 25 dead patients (113.75±79.37pg/ml) and 58 patients that survived at one month (117.50±87.17pg/ml). After 24months of follow up, 31patients died. There is no statistically significant difference (p value=0.328). between mean homocysteine of 31 dead patients (1.62±0.30µmol/L) and the 47 patients that survived (71±0.36µmol/L). There was no statistically significant difference (p value= 0.214) between the Vitamin B12 concentration of the dead patients (131.29±104.01pg/ml) compared to those who survived (106.81±68.73pg/ml). Conclusion: There is no relationship between Homocysteine and vitamin B12 with outcome in patients admitted with an acute ischaemic stroke