Is Hyperhomocysteinemia a Risk Factor for Ischemic Stroke?A Case Control Study

Objective: The results of the previous studies on the correlation between plasma levels of Homocysteine (Hcy) and ischemic stroke have been controversial. The aim of the present study is to investigate this correlation meticulously observing risk factors for the ischemic stroke as well as factors affecting the plasma levels of Hcy. Method: A case-control study was conducted between 2005-2006 with cases (55-84 years of age) who had never had a Transient Ischemic Attack (TIA) all within one week of their first-ever ischemic stroke. The 30 control subjects who had never had a stroke or TIA episode were selected from the orthopedics ward of the same hospital. The cases and controls were paired based on age, sex, cardiac disease, hypertension and smoking status and were adjusted for other risk factors. Their total non-fasting plasma Hcy level was determined using the High-Performance Liquid Chromatography (HPLC) method. Results: The mean plasma levels of Hcy was significantly higher in cases than controls (mean= 20.79 11.938 versus 14.45 8.028 mol/L; P<0.017). After using the multivariate logistic regression model, a significant correlation was found between plasma levels of Hcy and stroke (OR=1.149 with 95% of 1.032-1.280 for each 1 mol/L increment). Conclusion: The results indicate that there is a correlation betweenincreasing plasma Hcy level and ischemic stroke ; however, future research is needed to prove the causal relationship between the two.