Advance Search
Volume 37 Issue 12
Dec.  2021
Turn off MathJax
Article Contents
ZHANG Ou, LIU Yang, MENG Hang-juan, CONG Shu-yan. Progress in researches on plasma homocysteine level and stroke: a review[J]. Chinese Journal of Public Health, 2021, 37(12): 1840-1844. doi: 10.11847/zgggws1127767
Citation: ZHANG Ou, LIU Yang, MENG Hang-juan, CONG Shu-yan. Progress in researches on plasma homocysteine level and stroke: a review[J]. Chinese Journal of Public Health, 2021, 37(12): 1840-1844. doi: 10.11847/zgggws1127767

Progress in researches on plasma homocysteine level and stroke: a review

doi: 10.11847/zgggws1127767
  • Received Date: 2020-01-05
    Available Online: 2021-08-12
  • Publish Date: 2021-12-13
  • Homocysteine, as an independent risk factor for stroke, is closely related to the incidence, recurrence rate and prognosis of stroke. Homocysteine level varies in different stroke subtypes, and the pathogenesis mainly involves vascular endothelial injury, hyperplasia of smooth muscle cells, coagulopathy, and abnormal fat metabolism. Homocysteine level is affected by genotype, metabolism, age, gender, drugs and other factors. Supplementation with B vitamins and folic acid can significantly reduce homocysteine level, which is important for secondary prevention of cerebrovascular disease. In this study, the correlation between homocysteine level and stroke, subtype and severity, and the role of homocysteine in the pathogenesis of stroke, and the treatment status were reviewed to provide references for clinical prevention and treatment.
  • loading
  • [1]
    王莉, 沈娟, 陈从新, 等. 血液同型半胱氨酸水平与不同亚型脑卒中相关性的Meta分析[J]. 中国老年学杂志, 2018, 38(09): 2052 – 2055. doi: 10.3969/j.issn.1005-9202.2018.09.002
    Zhou Z, Liang Y, Qu H, et al. Plasma homocysteine concentrations and risk of intracerebral hemorrhage: a systematic review and meta-analysis[J]. Sci Rep, 2018, 8(1): 2568. doi: 10.1038/s41598-018-21019-3
    Li J, Jiang S, Zhang Y, et al. H-type hypertension and risk of stroke in Chinese adults: a prospective, nested case-control study[J]. J Transl Int Med, 2015, 3(4): 171 – 178. doi: 10.1515/jtim-2015-0027
    Pang H, Han B, Fu Q, et al. Association between homocysteine and conventional predisposing factors on risk of stroke in patients with hypertension[J]. Sci Rep, 2018, 8(1): 3900. doi: 10.1038/s41598-018-22260-6
    Kim JM, Park KY, Shin DW, et al. Relation of serum homocy-steine levels to cerebral artery calcification and atherosclerosis[J]. Atherosclerosis, 2016, 254: 200 – 204. doi: 10.1016/j.atherosclerosis.2016.10.023
    Tseng YL, Chang YY, Liu JS, et al. Association of plasma homocysteine concentration with cerebral white matter hyperintensity on magnetic resonance images in stroke patients[J]. J Neurol Sci, 2009, 284(1-2): 36 – 39. doi: 10.1016/j.jns.2009.03.030
    Omrani HQ, Shandiz EE, Qabai M, et al. Hyperhomocysteinemia, folateo and B12 vitamin in Iranian patients with acute ischemic stroke[J]. ARYA Atheroscler, 2011, 7(3): 97 – 101.
    Unal E, Mungan S, Bilen S, et al. The effects of lipoprotein(a) and homocysteine on prognosis and risk factors in acute ischemic stroke[J]. Int J Neurosci, 2013, 123(8): 532 – 536. doi: 10.3109/00207454.2013.772609
    Mao X, Han L. The Relationship of methylenetetrahydrofolate reductase gene C677T polymorphism and ischemic stroke in Chinese Han population[J]. Ann Clin Lab Sci, 2018, 48(2): 242 – 247.
    Piao X, Wu G, Yang P, et al. Association between homocysteine and cerebral small vessel disease: a meta-analysis[J]. J Stroke Cerebrovasc Dis, 2018, 27(9): 2423 – 2430. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.035
    He W, Lu MZ, Li GQ, at al. Methylene tetrahydrofolate reductase (MTHFR) rs868014 polymorphism regulated by miR-1203 associates with risk and short term outcome of ischemic stroke[J]. Cell Physiol Biochem, 2017, 41(2): 701 – 710. doi: 10.1159/000458429
    Ashjazadeh N, Fathi M, Shariat A. Evaluation of homocysteine level as a risk factor among patients with ischemic stroke and its subtypes[J]. Iran J Med Sci, 2013, 38(3): 233 – 239.
    Yang X, Zhou Y, Liu C, et al. Homocysteine and carotid plaque stability: a cross-sectional study in Chinese adults[J]. Plos One, 2014, 9(4): e94935. doi: 10.1371/journal.pone.0094935
    Shang J, Wang W, Feng J, et al. Carotid plaque stiffness measured with supersonic shear imaging and its correlation with serum homocysteine level in ischemic stroke patients[J]. Korean J Radiol, 2018, 19(1): 15 – 22. doi: 10.3348/kjr.2018.19.1.15
    Okubadejo NU, Oladipo OO, Adeyomoye AA, et al. Exploratory study of plasma total homocysteine and its relationship to short-term outcome in acute ischaemic stroke in Nigerians[J]. BMC Neurol, 2008, 8: 26. doi: 10.1186/1471-2377-8-26
    Zhou F, Chen B, Chen C, et al. Elevated homocysteine levels contribute to larger hematoma volume in patients with intracerebral hemorrhage[J]. J Stroke Cerebrovasc Dis, 2015, 24(4): 784 – 788. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.005
    Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2014, 45(7): 2160 – 2236. doi: 10.1161/STR.0000000000000024
    Dobrynina LA, Kalashnikova LA, Shabalina AA, et al. Indicators of homeostasis, inflammation and homocysteine in ischemic stroke in the young age[J]. Zh Nevrol Psikhiatr Im S S Korsakova, 2017, 117(12): 25 – 33. doi: 10.17116/jnevro201711712225-33
    Zhang W, Zhang X. Correlation between the youth cerebral infarc-tion in different TOAST classifications and high homocysteine[J]. Cell Biochem Biophys, 2015, 71(1): 39 – 42. doi: 10.1007/s12013-014-0159-2
    Wu W, Guan Y, Xu K, et al. Plasma homocysteine levels predict the risk of acute cerebral infarction in patients with carotid artery lesions[J]. Mol Neurobiol, 2016, 53(4): 2510 – 2517. doi: 10.1007/s12035-015-9226-y
    Bos MJ, van Goor ML, Koudstaal PJ, et al. Plasma homocysteine is a risk factor for recurrent vascular events in young patients with an ischaemic stroke or TIA[J]. J Neurol, 2005, 252(3): 332 – 337. doi: 10.1007/s00415-005-0647-9
    李倩, 李东霞. 高血压合并高同型半胱氨酸血症的研究进展[J]. 心血管病学进展, 2018, 39(2): 187 – 190.
    Chen Z, Wang F, Zheng Y, et al. H-type hypertension is an important risk factor of carotid atherosclerotic plaques[J]. Clin Exp Hypertens, 2016, 38(5): 424 – 428. doi: 10.3109/10641963.2015.1116547
    Zhang Q, Qiu DX, Fu RL, et al. H-Type Hypertension and C reactive protein in recurrence of ischemic stroke[J]. Int J Environ Res Public Health, 2016, 13(5): 477. doi: 10.3390/ijerph13050477
    Gungor L, Polat M, Ozberk MB, et al. Which ischemic stroke subtype is associated with hyperhomocysteinemia[J]? J Stroke Cerebrovasc Dis, 2018, 27(7), 1921-1929.
    Lehmann MF, Kallaur AP, Oliveira SR1, et al. Inflammatory and metabolic markers and short-time outcome in patients with acute ischemic stroke in relation to TOAST subtypes[J]. Metab Brain Dis, 2015, 30(6): 1417 – 1428. doi: 10.1007/s11011-015-9731-8
    Ma Y, Zhao X, Zhang W, et al. Homocysteine and ischemic stroke subtype: a relationship study in Chinese patients[J]. Neurol Res, 2010, 32(6): 636 – 641. doi: 10.1179/016164109X12445616596445
    Larsson SC, Traylor M, Markus HS. Homocysteine and small vessel stroke: A mendelian randomization analysis[J]. Ann Neurol, 2019, 85(4): 495 – 501. doi: 10.1002/ana.25440
    Tay SY, Ampil ER, Chen CP, et al. The relationship between homocysteine, cognition and stroke subtypes in acute stroke[J]. J Neurol Sci, 2006, 250(1 – 2): 58 – 61. doi: 10.1016/j.jns.2006.06.028
    Kumral E, Saruhan G, Aktert D, et al. Association of hyperhomocysteinemia with stroke recurrence after initial stroke[J]. J Stroke Cerebrovasc Dis, 2016, 25(8): 2047 – 2054. doi: 10.1016/j.jstrokecerebrovasdis.2016.05.008
    Wu GH. Kong FZ, Dong XF, et al Association between hyperhomocysteinemia and stroke with atherosclerosis and small artery occlusion depends on homocysteine metabolism-related vitamin levels in Chinese patients with normal renal function[J]. Metab Brain Dis, 2017, 32(3): 859 – 865. doi: 10.1007/s11011-017-9978-3
    Song IU, Kim YD, Kim JS, et al. Can high-sensitivity C-reactive protein and plasma homocysteine levels independently predict the prognosis of patients with functional disability after first-ever ischemic stroke[J]? Eur Neurol, 2010, 64(5): 304 – 310.
    Wang WJ, Gao CL, Yu CS, et al. No association between elevated total homocysteine levels and functional outcome in elderly patients with acute cerebral infarction[J]. Front Aging Neurosci, 2017, 9: 70. doi: 10.3389/fnagi.2017.00070
    Ye Z, Zhang Z, Zhang H, et al. Prognostic value of C-reactive protein and homocysteine in large-artery atherosclerotic stroke: a prospective observational study[J]. J Stroke Cerebrovasc Dis, 2017, 26(3): 618 – 626.
    Zhang S, Zhang X, Ling Y, et al. Predicting recurrent hypertensive intracerebral hemorrhage: derivation and validation of a risk-scoring model based on clinical characteristics[J]. World Neurosurg, 2019, 127: e162 – e171. doi: 10.1016/j.wneu.2019.03.024
    Wu XQ, Ding J, Ge AY, et al. Acute phase homocysteine related to severity and outcome of atherothrombotic stroke[J]. Eur J Intern Med, 2013, 24(4): 362 – 367. doi: 10.1016/j.ejim.2013.01.015
    Markišic M, Pavlović AM, Pavlović DM. The impact of homocysteine, vitamin B12, and vitamin D levels on functional outcome after first-ever ischaemic stroke[J]. BioMed Res Int, 2017, 2017: 5489057. doi: 10.1155/2017/5489057
    Forti P, Maioli F, Arnone G, et al. Homocysteinemia and early outcome of acute ischemic stroke in elderly patients[J]. Brain Behav, 2016, 6(5): e00460.
    Staszewski J, Piusińska-Macoch R, Brodacki B, et al. IL-6, PF-4, sCD40 L, and homocysteine are associated with the radiological progression of cerebral small-vessel disease: a 2-year follow-up study[J]. Clin Interv Aging, 2018, 13: 1135 – 1141. doi: 10.2147/CIA.S166773
    Yao ES, Tang Y, Xie MJ, et al. Elevated homocysteine level related to poor outcome after thrombolysis in acute ischemic stroke[J]. Med Sci Monit, 2016, 22: 3268 – 3273. doi: 10.12659/MSM.900010
    Markaki I, Klironomos S, Kostulas K, et al. Elevated plasma homocysteine upon ischemic stroke is associated with increased long-term mortality in women[J]. PLoS One, 2017, 12(8): e0183571. doi: 10.1371/journal.pone.0183571
    Liang Y, Li Q, Chen P, et al. Comparative study of back propagation artificial neural networks and logistic regression model in predicting poor prognosis after acute ischemic stroke[J]. Open Med (Wars), 2019, 14: 324 – 330. doi: 10.1515/med-2019-0030
    Shi Z, Liu S, Guan Y, et al. Changes in total homocysteine levels after acute stroke and recurrence of stroke[J]. Sci Rep, 2018, 8(1): 6993. doi: 10.1038/s41598-018-25398-5
    Anniwaer J, Liu MZ, Xue KD, et al. Homocysteine might increase the risk of recurrence in patients presenting with primary cerebral infarction[J]. Int J Neurosci, 2019, 129(7): 654 – 659. doi: 10.1080/00207454.2018.1517762
    Fu HJ, Zhao LB, Xue JJ, et al. Elevated serum homocysteine (Hcy) levels may contribute to the pathogenesis of cerebral infarction[J]. J Mol Neurosci, 2015, 56(3): 553 – 561. doi: 10.1007/s12031-015-0497-6
    Els T, Bruckmann J, Rohn G, et al. Spermidine: a predictor for neurological outcome and infarct size in focal cerebral ischemia[J]? Stroke, 2001, 32(1): 43 – 46.
    Bernstein JE, Savla P, Dong F, et al. Inflammatory markers and severity of intracerebral hemorrhage[J]. Cureus, 2018, 10(10): e3529.
    Haapaniemia E, Helenius J, Soinne L, et al. Serial measurements of plasma homocysteine levels in early and late phases of ischemic stroke[J]. Eur J Neurol, 2007, 14(1): 12 – 17. doi: 10.1111/j.1468-1331.2006.01518.x
    Zhao J, Chen H, Liu N, et al. Role of hyperhomocysteinemia and hyperuricemia in pathogenesis of atherosclerosis[J]. J Stroke Cerebrovasc Dis, 2017, 26(12): 2695 – 2699. doi: 10.1016/j.jstrokecerebrovasdis.2016.10.012
    Djuric D, Jakovljevic V, Zivkovic V, et al. Homocysteine and homocysteine-related compounds: an overview of the roles in the pathology of the cardiovascular and nervous systems[J]. Can J Physiol Pharmacol, 2018, 96(10): 991 – 1003. doi: 10.1139/cjpp-2018-0112
    Huang A, Yang YM, Feher A, et al. Exacerbation of endothelial dysfunction during the progression of diabetes: role of oxidative stress[J]. Am J Physiol Regul Integr Comp Physiol, 2012, 302(6): 674 – 681. doi: 10.1152/ajpregu.00699.2011
    Liu X, Zhang W, Li C, et a1. Nanomolar detection of Hey, GSH and Cys in aqueous solution, test paper and living cells[J]. RSC Adv, 2015, 5(7): 4941 – 4946. doi: 10.1039/C4RA13262A
    Ganguly P, Fatima Alam SF. Role of homocysteine in the development of cardiovascular disease[J]. Nutr J, 2015, 14: 6. doi: 10.1186/1475-2891-14-6
    常广文. Hcy相关酶基因多态性及Vitamin B6与缺血性脑血管病的相关性研究[D]. 郑州: 郑州大学博士学位论文, 2017.
    McCully KS. Homocysteine and the pathogenesis of athero-sclerosis[J]. Expert Rev Clin Pharmaco, 2015, 8(2): 211 – 219. doi: 10.1586/17512433.2015.1010516
    Price RK, Keaveney EM, Hamill L L, et a1. Consumption of wheat-aleurone rich foods increases fasting plasma betaine and modestly decreases fasting homocysteine and LDL-cholesterol in adults[J]. J Nutr, 2010, 140(12): 2153 – 2157. doi: 10.3945/jn.110.126961
    Feng C, Bai X, Xu Y, et a1. Hyperhomocysteinemia associates with small vessel disease more closely than large vessel disease[J]. Int J Med Sci, 2013, 10(4): 408 – 412.
    张爱玲, 冯来会, 滕军放, 等. 中青年脑梗死患者蛋氨酸合成酶还原酶基因多态性研究[J]. 中华神经医学杂志, 2012, 11(1): 37 – 41. doi: 10.3760/cma.j.issn.1671-8925.2012.01.009
    岳平, 林宁, 官燮, 等. 同型半胱氨酸水平在不同人群中的差异[J]. 中国医药导报, 2017, 14(17): 32 – 34.
    陈芳. 女性绝经后雌激素水平与血脂、血糖和血同型半胱氨酸的关系研究[J]. 中国实验诊断学, 2016, 2(5): 758 – 760.
    张国领, 张林, 刘桂萍. 高同型半胱氨酸血症的临床研究进展[J]. 中国医药导报, 2018, 15(20): 29 – 32.
    Santilli F, Davì G, Patrono C. Homocysteine, ethylenetetrahydrofo-late reductase, folate status and atherothrombosis: a mechanistic and clinical perspective[J]. Vascul Pharmacol, 2016, 78: 1 – 9. doi: 10.1016/j.vph.2015.06.009
    Shenoy V, Mehendale V, Prabhu K, et a1. Correlation of se-rumhomocysteine levels with the severity of coronary artery disease[J]. Indian J Clin Biochem, 2014, 29(3): 339 – 344. doi: 10.1007/s12291-013-0373-5
    肖培, 程龙慧, 刘纪军, 等. 孕中、晚期血清同型半胱氨酸水平及其与妊娠高血压和妊娠糖尿病的关系[J]. 检验医学与临床, 2018, 15(20): 3008 – 3010. doi: 10.3969/j.issn.1672-9455.2018.20.002
    Peker E, Demir N, Tuncer O, et al. The levels ofvitamin B-12, folate and homocysteine in mothers and their babies with neural tube defects[J]. J Matern Fetal Neonatal Med, 2016, 29(18): 2944 – 2948.
    Tan T, Yang KQ, Cui JG, et al. Folic acid supplementation for stroke prevention in patients with cardiovascular disease[J]. Am J Med Sci, 2017, 354(4): 379 – 387. doi: 10.1016/j.amjms.2017.05.020
    Huo Y, Li J, Qin X, et al. Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China. The CSPPT randomized trial[J]. JAMA, 2015, 313(13): 1325 – 1335. doi: 10.1001/jama.2015.2274
    Hsu CY, Chiu SW, Hong KS, et al. Folic acid in stroke prevention in countries without mandatory folic acid food fortification: a meta analysis of randomized controlled trials[J]. J Stroke, 2018, 20(1): 99 – 109. doi: 10.5853/jos.2017.01522
    Toole JF, Malinow MR, Chambless LE, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death. The Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial[J]. JAMA, 2004, 291(5): 565 – 575. doi: 10.1001/jama.291.5.565
  • 加载中


    通讯作者: 陈斌,
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Article views (236) PDF downloads(17) Cited by()
    Proportional views


    DownLoad:  Full-Size Img  PowerPoint