Relationship Between Hyperhomocysteinemia and Arteriosclerosis in Renal Transplant Recipient
Trauma Monthly: 11 (2); 183-190 Article Type: Research Article
J, et al. Relationship Between Hyperhomocysteinemia and Arteriosclerosis in Renal Transplant Recipient,
Online ahead of Print
Aims. This study were to determine the total homocysteine (tHcy) level, and to evaluate its role as a risk factor of atherosclerosis in renal transplant recipients (RTRs). Methods. Clinical data and blood chemistries, fasting total homocysteine (tHcy), folic acid, vitamin B12, blood urea nitrogen, creatinine, fasting blood sugar and total cholesterol were assessed in 60 RTRs (26 woman and 34 men). Atherosclerosis was defined by clinical presentations of CAD or carotid intima-media thickness (IMT) by ultrasound. Results. Plasma tHcy level in RTRs was significantly higher than that in controls (18 . 48±6.8 µmol/lit vs. 9.02±0.7 μmol/lit, p<0.0001) . Plasma folate concentration in trial group was significantly lower than that in controls (6.01±4.5 ng/ml vs. 9.5±2.9 ng/ml, p<0.0001) and mean IMT in trial group was significantly higher than that in controls (0.84±0.17 mm vs. 0.55±0.05 mm, p<0.0001). By univariate analysis, was observed that aging (p<0.001), longer hemodialysis duration (p<0.005) and higher plasma tHcy level (p<0.01) correlated with atherosclerosis. There was also correlation between plasma tHcy level and IMT and atherosclerosis in RTRs. Conclusion. IMT is a useful marker of atherosclerosis in RTRs and given the results of this investigation, it seems that folate deficiency was a major cause of high tHcy plasma level in these patients and aging and hemodialysis duration before kidney transplant play a major role in increased IMT in these patients. It seems that h yperhomocysteinemia besides the other mentioned factors, can increase and facilitate the atherosclerosis process in the RTRs.
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