Homocysteine and Cholesterol: interaction and impact on outcome of ischemic stroke
Avinash Chandra1 M.D.; Hui Yu2, M.D.,Ph. D; Song Tan1M.D. Ph. D; Bo Song1 M.D. Ph. D; Hui Fang1 M.D., Rui Zhang1 M.D., Ph. D; Yu Ming Xu1* M.D., Ph. D
1. Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
2. Department of Radiation Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
Abstract: Objective and Aim: To determine the functional outcome in a cohort of patients with ischemic stroke, focusing on homocysteine (hcy) as well as the components of lipid profile and also to elucidate the relationship between hcy with other biochemical parameters. Material and Method: From the patient database of the First Affiliated Hospital of Zhengzhou University, data of total 623 patients were collected. The reports of only ischemic stroke patients were taken into consideration. Multivariate analysis was performed by logistic regression model. The predictor variables were age, sex, vascular risk factors, and other variables associated with outcome (P<0.1) in univariate analyses. Results and Conclusion: Average age of patients was 59.35 ±12.90 years, 67.2% being male. Total of 468 (87.3%) patients were found to have hyperhomocysteinemia (hhcy). Average hcy level was found to be 19.2±11.2mmol/l. Similarly 158 (29.5%) were found to have hypercholesterolemia (hTC) while 336 (62.7%) were found to have hyperlipidemia. 105 (19.6%) patients had history of stroke. MRS <3 at 6 months was defined as good stroke outcome. The univariate analysis showed that hhcy, hTC, and hyperlipidemia were statistically significantly correlated with the outcome of stroke (P≤0.1). Low density lipids (Ldl) and Hcy were significantly associated with each other P≤0.05 (P= 0.039, C.I. 1.080～19.677). Similar was the case of TC and Hcy at 10 mmol/l.. Interestingly, we found the synergistic effect between hcy and ldl, as well as hcy and TC towards the prognosis of stroke. The relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) of hcy and ldl as 1.827, 39.62%, and 2.024 as well as 0.209,26.03%,1.092 respectively. Conclusion- Hhcy, hyperlipidemia, hTC, high blood glucose (diabetes) are significantly correlated with the outcome of stroke. There is a significant intercorrelation of hhcy, TC and hyperlipidemia and positive synergism is observed among hcy and TC as well as hcy and ldl.
[Avinash Chandra, Hui Yu, Song Tan, Bo Song, Hui Fang, Rui Zhang, Yu Ming Xu. Homocysteine and Cholesterol: interaction and impact on outcome of ischemic stroke. Life Sci J 2013:10(1):3113-3120]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 7
Keywords: Homocysteine, Cholesterol, Atherogenesis, Stroke, Ischemic, Outcome, Interaction.