International Journal of Medical Sciences

23 September 2014

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Int J Med Sci 2013; 10(4):408-412. doi:10.7150/ijms.5272

Research Paper

Hyperhomocysteinemia Associates with Small Vessel Disease More Closely Than Large Vessel Disease

Chao Feng1, Xue Bai1, Yu Xu2, Ting Hua2, Jing Huang1✉, Xue-Yuan Liu1✉

1. Department of Neurology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, China;
2. Department of Radiology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, China.

Abstract

Background: Hyperhomocysteinemia was believed to be an independent risk factor for stroke and associate with small vessel disease (SVD) related stroke and large vessel disease (LVD) related stroke differently. However it's still unclear which type of stroke associated with homocysteine (HCY) more strongly because the conclusions of previous studies were contradictory. In this study we focused on the subclinical angiopathies of stroke, i.e., SVD and LVD instead of stroke subtypes and sought to compare the associations between HCY level and different angiopathies. Methods: 324 non-stroke patients were enrolled. Sex, age, HCY level and other vascular risk factors were collected. MRI and angiographies were used to determine the type of angiopathies and their severity, i.e., the scores of leukoaraiosis (LA), plaques and numbers of silent brain infarctions (SBI). LVD was defined as the presence of atherosclerotic plaques of cerebral arteries. SVD was defined as the presence of either LA or SBI. 230 patients were deemed to have LVD; 180 patients were deemed to have SVD. Spearman's correlation test and logistic regression were used to analyze the association between HCY level and different angiopathies. Results: The correlation between HCY level and scores of plaques was weaker than that of the scores of LA and numbers of SBI. Hyperhomocysteinemia was an independent risk factor for SVD (OR = 1.315, P <0.001), whereas the association between HCY level and LVD was not that significant (OR = 1.058, P = 0.075). Conclusion: HCY level associated with SVD more strongly than LVD.

Keywords: Hyperhomocysteinemia, small vessel disease, large vessel disease, homocysteine.

How to cite this article:
Feng C, Bai X, Xu Y, Hua T, Huang J, Liu XY. Hyperhomocysteinemia Associates with Small Vessel Disease More Closely Than Large Vessel Disease. Int J Med Sci 2013; 10(4):408-412. doi:10.7150/ijms.5272. Available from http://www.medsci.org/v10p0408.htm