scholarly journals Gonadotropin treatment increases homocysteine levels in idiopathic hypogonadotropic hypogonadism: an indirect effect mediated by changes in body composition

2003 ◽  
Vol 179 (1) ◽  
pp. 35-39 ◽  
Author(s):  
C Oktenli ◽  
Z Yesilova ◽  
M Ozata ◽  
H Yaman ◽  
A Tuzun ◽  
...  
Keyword(s):  
Folic Acid ◽  
Hypogonadotropic Hypogonadism ◽  
Free Testosterone ◽  
Multivariate Regression Analysis ◽  
Idiopathic Hypogonadotropic Hypogonadism ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Vitamin B 12 ◽  
Male Patients ◽  
Plasma Total Homocysteine

The main objective of the present study was to examine the alterations in plasma total homocysteine (tHcy) concentrations during a testosterone-deficient state and after gonadotropin treatment for 6 Months in patients with idiopathic hypogonadotropic hypogonadism (IHH). Thirty-five newly diagnosed male patients with IHH (mean age 21.34+/-1.53 years) and 29 age- and body mass index-matched healthy males (mean age 21.52+/-1.77 years) were recruited into the study. Pretreatment levels of free testosterone (1.51+/-0.66 pg/ml), estradiol (21.37+/- 4.37 pg/ml), FSH (0.91+/-0.24 IU/l) and LH (1.25+/- 0.53 IU/l) were lower than controls (25.17+/-3.06 pg/ml, 31.00+/-4.96 pg/ml, 3.14+/-1.62 IU/l and 4.83+/-1.65 IU/l respectively) (P<0.001). They increased significantly after treatment (18.18+/-1.59 pg/ml, 27.97+/- 4.25 pg/ml, 2.41+/-0.27 IU/l and 2.79+/-0.19 IU/l respectively) (P<0.001). Patients with IHH had lower tHcy levels than controls (10.14+/-1.34 and 12.58+/- 2.29 micro mol/l respectively) (P<0.001). Plasma tHcy concentrations increased significantly (12.63+/-1.44 micromol/l) after 6 months of treatment (P<0.001). As compared with the controls, pretreatment levels of serum creatinine (63.54+/-13.01 vs 82.84+/-16.69 micromol/l), hemoglobin (12.98+/-0.56 vs 13.83+/-0.71 g/dl) and hematocrit (39.29+/-2.01 vs 41.38+/-1.95%) were significantly lower (P<0.001), and they increased significantly following treatment (80.24+/-11.93 micromol/l, 13.75+/-0.49 g/dl and 41.26+/-1.78% respectively) (P<0.001). The pretreatment folic acid and vitamin B(12) levels were significantly higher in patients when compared with controls (14.87+/-5.68 vs 12.52+/-4.98 nmol/l, P=0.034 and 289.75+/-92.34 vs 237.59+/-108.17 pmol/l, P=0.002 respectively). They decreased significantly after treatment (11.29+/-3.31 nmol/l and 228.51+/-54.33 pmol/l respectively) (P<0.001). The univariate and multivariate regression analysis results showed that only changes in creatinine, creatinine clearance, vitamin B12 and folic acid were independently associated with changes in tHcy levels in patients with IHH. In conclusion, the increase in plasma tHcy concentrations following gonadotropin treatment seems to be largely independent of changes in androgen levels.

scholarly journals Polymorphisms in the Transcobalamin Gene: Association with Plasma Homocysteine in Healthy Individuals and Vascular Disease Patients

2002 ◽  
Vol 48 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
Karin JA Lievers ◽  
Lydia A Afman ◽  
Leo AJ Kluijtmans ◽  
Godfried HJ Boers ◽  
Petra Verhoef ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Vascular Disease ◽  
Vitamin B12 Deficiency ◽  
Potential Effect ◽  
Sequence Variants ◽  
Cvd Risk ◽  
Plasma Thcy ◽  
B12 Deficiency ◽  
Total Homocysteine ◽  
Plasma Total Homocysteine

Abstract Background: Hyperhomocysteinemia is an independent risk factor for cardiovascular disease (CVD). Intracellular vitamin B12 deficiency may lead to increased plasma total homocysteine (tHcy) concentrations and because transcobalamin (TC) is the plasma transporter that delivers vitamin B12 to cells, genetic variation in the TC gene may affect intracellular vitamin B12 availability and, consequently, tHcy concentrations. Methods: We examined five sequence variants, i.e., I23V, G94S, P259R, S348F, and R399Q, in the TC gene as possible determinants of tHcy and, concordantly, as possible risk factors for CVD in 190 vascular disease patients and 601 controls. We also studied potential effect-modification of vitamin B12 by genotype. Results: In individuals with high vitamin B12, 259PP individuals had lower tHcy concentrations than 259PR and 259RR individuals. Homozygous 23VV individuals had lower fasting tHcy concentrations than their 23IV and 23II peers. None of the genotypes defined by the three other sequence variants showed an association with tHcy concentrations, nor was any TC genotype associated with an increased CVD risk. Conclusions: In individuals in the highest quartile of the vitamin B12 distribution (&gt;299 pmol/L), tHcy concentrations are lower in 259PP homozygotes than in 259PR and 259RR individuals. Therefore, 259PP individuals, who represent &gt;25% of the general population, may be more susceptible to reduction of plasma tHcy concentrations by increasing the vitamin B12 status.

scholarly journals Association between plasma total homocysteine level within normal range and bone mineral density in adults

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zhongxin Zhu ◽  
Changhua Liu ◽  
Xiao’e Li ◽  
Xiaocong Yao
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Recursive Algorithm ◽  
Positive Trend ◽  
Mineral Density ◽  
Normal Range ◽  
Thcy Level ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Plasma Total Homocysteine

Abstract Background Growing evidence indicates that homocysteine is a noteworthy marker for general health status. However, research regarding plasma total homocysteine (tHcy) levels and bone mineral density (BMD) is sparse and controversial. Hence, we aimed to investigate the association between plasma tHcy level within normal range and lumbar BMD in adults. Methods In this cross-sectional study, using the National Health and Nutrition Examination Survey database, data on 10748 adults aged between 30 and 85 years were analyzed. The weighted multiple logistic regression analyses were conducted to evaluate the association between plasma tHcy level and lumbar BMD. The fitted smoothing curves were performed to explore potential non-linear relationships. When non-linearity was detected, we further calculated the inflection point using a recursive algorithm and constructed a weighted two-piecewise linear regression model. Results After adjusting for all the covariates, the association between plasma tHcy and lumbar BMD was different in various age groups (adults aged 30–49 years: β = −0.0004, 95% CI −0.0025, 0.0018; adults aged 50–69 years: β = 0.0001, 95% CI −0.0025, 0.0026; adults aged 70–85 years: β = 0.0050, 95% CI 0.0008, 0.0092). In the subgroup analysis stratified by gender, this association also differed based on gender. There was a negative trend in females (aged 30–49 years: β = −0.0022, 95% CI −0.0054, 0.0011; aged 50–69 years: β = −0.0028, 95% CI −0.0062, 0.0007), and a positive trend in males (aged 30–49 years: β = 0.0018, 95% CI −0.0012, 0.0048; aged 50–69 years: β = 0.0027, 95% CI −0.0009, 0.0063) in both 30–49 years group and 50–69 years group. In the 70–85 years group, this association was significantly positive in males (β = 0.0136, 95% CI 0.0068, 0.0204), but was not significantly different in females (β = 0.0007, 95% CI −0.0046, 0.0060). Conclusion The correlation between plasma tHcy level within the normal range and lumbar BMD differs by age and gender.

Assessing Plasma Total Homocysteine in Patients with End-Stage Renal Disease

2007 ◽  
Vol 27 (5) ◽  
pp. 476-488 ◽  
Author(s):  
Bradley L. Urquhart ◽  
Andrew A. House
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Elevated Plasma ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Stage Renal Disease ◽  
End Stage ◽  
Plasma Total Homocysteine

Elevated plasma total homocysteine (tHcy) is a risk factor for cardiovascular disease; however, in light of several recent randomized trials, the issue of causality has been cast into doubt. Patients with end-stage renal disease are particularly interesting as they consistently have elevated tHcy and their leading causes of morbidity and mortality are related to cardiovascular disease. In the present article, we review the early evidence for the homocysteine theory of atherosclerosis, homocysteine metabolism, mechanisms of toxicity, and pertinent available clinical investigations. Where appropriate, the sparse evidence of homocysteine in peritoneal dialysis is reviewed. We conclude by addressing the difficulties associated with lowering plasma tHcy in patients with end-stage renal disease and suggest some novel methods for lowering tHcy in this resistant population. Finally, to address the issue of causality, we recommend that clinicians and scientists await the results of the FAVORIT trial before abandoning homocysteine as a modifiable risk factor for cardiovascular disease, as this study has recruited patients from a population with consistently elevated plasma tHcy who are known to respond to vitamin therapy.

scholarly journals Plasma Total Homocysteine, Folate, and Vitamin B12 Status and Hospitalizations for Cardiovascular Disease

Pteridines ◽  
2007 ◽  
Vol 18 (1) ◽  
pp. 122-127
Author(s):  
Bakhouche Houcher ◽  
Mirande Candito ◽  
Pierre Gibelin
Keyword(s):  
Vitamin B12 ◽  
Serum Vitamin ◽  
Inverse Correlation ◽  
Serum Folate ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Group 2 ◽  
Folate And Vitamin B12 ◽  
Plasma Total Homocysteine ◽  
Group 1

Abstract Elevated plasma total homocysteine (tHcy) is an independent risk factor for cardiovascular disease (CVD). Also known is that plasma folate and vitamin B12 influence homocysteine metabolism as cosubstrate and cofactor, respectively. This population-based study was conducted to evaluate the plasma concentrations of tHcy, folate, and vitamin B12 in 54 older patients aged ≥51 years (40 males; 14 females) of Nice hospital cardiology service. After excluding cases with a serum creatinine >120 mmol/L, we established the test properties of a plasma tHcy concentration <15 μmol/L (Group 1) or ≥15 μmol/L (Group 2). In the population aged ≥51 years, plasma tHcy was higher in women (18.0 μmol/L) than in men (15.5 μmol/L; not significant), conversely, serum vitamin B12 was higher in men (376.9 pg/ml) than in women (340.7 pg/ml; not significant). Average plasma tHcy was 11.5 μmol/L in Group 1 and 21.6 μmol/L in Group 2. Vice versa, serum vitamin B12 was higher in Group 1 (419.5 pg/ml) than in Group 2 (307.2 pg/ml) (p <0.05). Correlation analysis (Pearson's r) in the total study population (20-84 years) indicated an inverse correlation between serum folate and age (r = -0.231, p <0.05). In the subjects, aged ≥51 years, there was a significant negative correlation between age and tHcy levels (r = -0.283, p <0.05) and serum vitamin B12 concentrations (r = -0.326, p <0.01) but not with serum folate. However, in subjects with tHcy <15 μmol/L, a significant inverse correlation existed between plasma tHcy and serum folate (r = -0.455; p <0.05). In conclusion, these results highlight the relevance of the vitamin status and particularly of folate levels in the modulation of fasting tHcy levels in the patients with clinical hyperhomocysteinemia, defined as plasma tHcy >15 μmol/L.

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