Abstract:

[Abstract] Objective To investigate the relationship between total homocysteine (tHcy) and carotid intima-media thickness (CIMT) in brain infarction patients. Methods Sixty patients with fasting plasma tHcy levels≤10μmol/L (nonHhcy group),60patients with fasting plasma tHcy levels >10μmol/L and≤15μmol/L (H1group), and60patients with fast? ing plasma tHcy levels >15μmol/L (H2group) were chosen in hospitalized patients with acute cerebral infarction. Values of CIMT were detected in three groups of patients. The clinical biochemical indicators including triglyceride (TG), total choles? terol (TC), high density lipoprotein cholesterol (HDL- C), low density lipoprotein cholesterol (LDL- C), fasting blood sugar (FBS), folic acid (FA), Vitamin B12 (VitB12) and glycated hemoglobin (HbA1c) were also detected.Results There was signifi? cant difference in CIMT between three groups (P<0.01). The value of CIMT increased in H2group [0.98(0.90, 1.05)mm] com? pared with that of non-Hhcy group [0.85(0.80, 0.95)mm]. The value of CIMT increased in H2group compared with H1group [0.98(0.90, 1.05)mm vs0.85(0.85, 0.95)mm], P<0.05). There were significant differences in tHcy, FA and VitB12 between three groups. Based on the log-transformed values of CIMT as the dependent variable, multiple stepwise linear regression showed significant associations of the following variables with increased CIMT: increasing age, the history of smoking, the history of diabetes, higher LDL-C and tHcy levels.Conclusion Brain infarction in patients with higher tHcy level often have lower levels of FA and VitB12, and increased CIMT. When the level of tHcy >15μmol/L, there is more significantly higher level of CIMT. The increased CIMT level was associated with some cerebrovascular risk factors in patients with brain infarction

Key words: hyperhomocysteinemia, brain infarction, carotid arteries, atherosclerosis, ultrasonography, doppler, folic acid, 维生素B12