Abstract
Hyperhomocyst(e)inemia is an established risk factor for atherosclerosis. We
performed this study to identify the correlating variables and risk factors for
atherosclerosis, as measured by the atherosclerotic score (AS), and to determine
the relative risk for cardiovascular disease in relation to plasma
homocyst(e)ine levels in patients on chronic hemodialysis. We evaluated and
measured 61 patients on chronic hemodialysis for clinical and biochemical
parameters including atherosclerotic score (AS) and plasma homocyst(e)ine. We
divided patients into high and low groups, first, by the mean AS, and second, by
the median value of plasma total homocyst(e)ine levels. Then we compared the
variables between the two groups. Out of the 61 patients, the median plasma
total homocyst(e)ine level was 24.4 micromol/L (mean±SD, 27.7±17.4; range,
9.8-127.4 micromol/L), and the median AS was 5 (mean±SD, 6.2±2.8; range,
3-13) out of a possible 20 points. AS was significantly correlated with plasma
total homocyst(e)ine levels (r=0.37) and age (r=0.67). Through multivariate
analysis, plasma total homocyst(e)ine level and age were determined as
significant risk factors for the high-AS group (p<0.05). However, plasma total
homocyst(e)ine level did not correlate with age (p>0.05). Eighteen of the 61
patients, presented with cardiovascular disease until the present study, had an
AS>6. Cardiovascular disease was found more often in the high-homocyst(e)ine
group (>24.4 micromol/L) than in the low-homocyst(e)ine group (odds ratio, 9.3;
95% confidence interval, 2.3-37.4). Regardless of age, hyperhomocyst(e)inemia
(especially homocyst(e)ine levels >24.4 micromol/L) is a risk factor that can be
modified for the development of cardiovascular disease in patients on chronic
hemodialysis.