scholarly journals Association of Elevated Plasma Total Homocysteine With Dementia With Lewy Bodies: A Case-Control Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Guili Zhang ◽  
Shuai Liu ◽  
Zhichao Chen ◽  
Zhihong Shi ◽  
Wenzheng Hu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Dementia With Lewy Bodies ◽  
Case Control Study ◽  
Lewy Bodies ◽  
Case Control ◽  
Elevated Plasma ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Plasma Total Homocysteine ◽  
Control Study

Background: Elevated plasma total homocysteine (tHcy) level, a known risk factor for vascular disease, is reported to be an independent risk factor for cognitive impairment and Alzheimer’s disease (AD) in most studies. tHcy may also be associated with dementia with Lewy bodies (DLB).Objective: To investigate the association between plasma tHcy levels and DLB or AD.Methods: This is a case-control study including 132 DLB patients, 264 AD patients, and 295 age-matched healthy controls. We used multivariate logistic regression model to analyze the data with adjustments for confounding variables.Results: The highest tHcy tertile (>13.9 μmol/L) was significantly independently associated with DLB [adjusted odds ratio (OR): 4.65, 95% confidence interval (CI): 1.95–11.10, P = 0.001] and AD (adjusted OR: 1.82, 95% CI: 1.02–3.23, P = 0.041) compared to the lowest tertile (<10.7 μmol/L). The cumulative frequency plots showed a shift in the distribution of the tHcy concentrations to higher values in patients with DLB compared to AD. The mean tHcy levels were stable and not altered by the duration of cognitive impairment prior to the collection of blood samples from DLB patients.Conclusion: Elevated plasma tHcy levels were independently associated with DLB, and the association was stronger for DLB than for AD. The lack of a relationship between tHcy levels and symptom duration may refute these observed associations being a consequence of DLB, and future longitudinal studies will be required to confirm whether tHcy plays a causative role in DLB.

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.

Investigating Lipoprotein(A) as a Risk Factor for Ischemic Arterial Stroke in U.S. Children. New Understanding from a Case-Control Study with Gold-Standard Laboratory Assessment.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2627-2627
Author(s):  
Neil A. Goldenberg ◽  
R. Knapp-Clevenger ◽  
Linda Jacobson ◽  
Taru Hays ◽  
Santica M. Marcovina ◽  
...  
Keyword(s):  
Risk Factor ◽  
Gold Standard ◽  
Case Control Study ◽  
Case Control ◽  
Diabetes Research ◽  
Healthy Children ◽  
Standard Laboratory ◽  
Elevated Plasma ◽  
Lipoprotein A ◽  
Control Study

Abstract Background: Lipoprotein(a) [Lp(a)] is a plasma lipoprotein that has been implicated in both atherogenesis and thrombophilia. A few reports in recent years, principally in European populations, have suggested that elevated plasma Lp(a) level may constitute a risk factor for ischemic arterial stroke (IAS) in children. However, the ELISA assays used in these studies are technically limited by their ability to provide accurate Lp(a) values independently of apo(a) size. Objective: To determine the prevalence of elevated plasma Lp(a) concentration among children with non-neonatal IAS and healthy children in a U.S. population using the current gold-standard laboratory methodology, toward the evaluation of Lp(a) as a risk factor for pediatric IAS. Methods: In a case-control study, children from 1 month to 21 years of age with a history of radiologically-confirmed IAS (case group, n=22) and healthy children (contemporaneous control group, n=41) were consecutively recruited from The Children’s Hospital, Denver, and the Mountain States Regional Hemophilia and Thrombosis Center (Aurora, CO). Children with IAS who were receiving drugs that affect Lp(a) level, such as niacin or statins, were excluded. Fasting plasma samples were obtained by peripheral venipuncture into EDTA with susequent centrifugation to yield platelet-poor plasma. Lp(a) assay was performed in the Northwest Lipid Metabolism and Diabetes Research Laboratories at the University of Washington, Seattle, using a double monoclonal antibody-based ELISA validated to be sensitive to apo(a) size heterogeneity. Results were expressed in nmol/L of Lp(a) protein, with corresponding race-appropriate percentiles. In accordance with NHLBI recommendations, values above the 75th percentile were considered to indicate increased risk, and were hence designated as elevated. Results: Median Lp(a) concentration did not significantly differ between the two groups (cases: 16.9 nmol/L, controls: 24.7 nmol/L; P=0.96). While the prevalence of elevated Lp(a) levels was increased among children with IAS (cases: 36%, controls: 24%), this difference did not reach statistical significance (P=0.32). The odds of having elevated Lp(a) were nearly two times that of healthy controls (OR=1.8, 95% CI=0.50–6.3); however, this also was not statistically significant. Conclusions: The present study demonstrates a qualitatively increased prevalence of elevated plasma Lp(a) concentration among children with non-neonatal IAS when compared to healthy children, using the gold-standard methodology for Lp(a) assessment. Expansion of the study to a larger population via multicenter collaboration will be necessary to definitively determine whether Lp(a) is a risk factor for IAS in children. Furthermore, given that genetic variation in the apo(a) gene is the major determinant of plasma Lp(a) concentration, apo(a) phenotyping may be useful to better define risk strata. These efforts are an important precursor to interventional studies evaluating Lp(a) management strategies in the secondary prevention of IAS in children.

scholarly journals Catechol-O-methyltransferase genotype is associated with plasma total homocysteine levels and may increase venous thrombosis risk

2007 ◽  
Vol 98 (12) ◽  
pp. 1226-1231 ◽  
Author(s):  
Sita Vermeulen ◽  
Ad Hermus ◽  
Henk Blom ◽  
Henkjan Gellekink ◽  
Jan-Willem Muntjewerff ◽  
...  
Keyword(s):  
Risk Factor ◽  
Venous Thrombosis ◽  
Haplotype Analysis ◽  
Case Control Study ◽  
Primary Objective ◽  
Thrombosis Risk ◽  
Total Homocysteine ◽  
Recurrent Venous Thrombosis ◽  
Plasma Total Homocysteine ◽  
Control Study

SummaryA disturbed methylation has been proposed as a mechanism via which homocysteine is associated with diseases like vascular disease, neural tube defects and mental disorders. Catechol- O-methyltransferase (COMT) is involved in the S-adenosylmethionine- dependent methylation of catecholamines and catecholestrogens and in this way contributes to homocysteine synthesis. COMT dysfunction has been related to schizophrenia and breast cancer. We hypothesized that COMT dysfunction by virtue of functional genetic polymorphisms may affect plasma total homocysteine (tHcy). Our primary objective was to study the association between common COMT polymorphisms and tHcy. Secondly, we evaluated these polymorphisms as a risk factor for recurrent venous thrombosis. We obtained genotype data from four polymorphisms in the COMT gene (rs2097603, rs4633, rs4680 [324G>A] and rs174699) from 401 populationbased controls. We performed haplotype analysis to investigate the association between common haplotypes and tHcy. In addition, we assessed the rs4680 variant as a genetic risk factor in a case-control study on recurrent venous thrombosis (n= 169). We identified a common haplotype that was significantly associated with tHcy levels. This effect was largely explained by the rs4680 variant, resulting in an increase in tHcy of 10.4% (95% CI 0.01 to 0.21, p=0.03) for 324AA compared with 324GG subjects. Interestingly, we found that the 324AA genotype was more common in venous thrombosis patients (OR 1.61 [95% CI 0.97 to 2.65], p=0.06) compared to control subjects. We show that the COMT rs4680 variant modulates tHcy, and might be associated with venous thrombosis risk as well.

Frontotemporal dementia and dementia with Lewy bodies in a case-control study of Alzheimer's disease

2009 ◽  
Vol 21 (4) ◽  
pp. 688-695 ◽  
Author(s):  
Olivier Piguet ◽  
Glenda M. Halliday ◽  
Helen Creasey ◽  
G. Anthony Broe ◽  
Jillian J. Kril
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Clinical Diagnosis ◽  
Dementia With Lewy Bodies ◽  
Case Control Study ◽  
Lewy Bodies ◽  
Case Control ◽  
Dementia Syndrome ◽  
Control Study

ABSTRACTBackground: The clinical presentations in dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD) overlap considerably with that of Alzheimer's disease (AD) despite different pathological processes. Autopsy studies have also shown that multiple brain pathology occurs frequently, even in cases with a single clinical diagnosis. We aimed to determine the frequency of clinical diagnosis of FTD and DLB and the underlying pathology in a well-characterized cohort of patients with a clinical diagnosis of probable or possible AD.Methods: We conducted a retrospective analysis of 170 AD patients (probable AD = 83; possible AD = 87) originally enrolled in a case-control study, 27 with postmortem examination, to establish the number of cases meeting probable diagnosis for FTD and DLB, using a checklist of features compiled from their consensus criteria.Results: 23/83 probable AD cases and 32/87 possible AD cases met probable criteria for another dementia, more commonly DLB than FTD. AD pathology was present in 8/15 probable AD and 8/12 possible AD cases coming to autopsy. DLB pathology was seen in four cases and FTD pathology in eight cases. In the AD cases reaching clinical diagnosis for a second dementia syndrome and coming to autopsy, a minority showed non-AD pathology only.Conclusions: Presence of core clinical features of non-AD dementia syndromes is common in AD. Concordance between clinical and pathological diagnoses of dementia remains variable. We propose that repeat clinical examinations and structural neuroimaging will improve diagnostic accuracy. In addition, clinical diagnostic criteria for the main dementia syndromes require refinement.

scholarly journals Risk factors for dementia with Lewy bodies: A case-control study

Neurology ◽  
2013 ◽  
Vol 81 (9) ◽  
pp. 833-840 ◽  
Author(s):  
B. P. Boot ◽  
C. F. Orr ◽  
J. E. Ahlskog ◽  
T. J. Ferman ◽  
R. Roberts ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dementia With Lewy Bodies ◽  
Case Control Study ◽  
Lewy Bodies ◽  
Case Control ◽  
Control Study
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