Study of relationship between hyperhomocysteinemia and intracranial and extracranial vascular stenosis

Objective To study the relationship between hyperhomocysteinemia and intracranial and extracranial vascular stenosis in patients with ischemic cerebrovascular disease.Methods 405 patients with ischemic cerebrovascular disease were chosen to detect their serum homocysteine(Hcy) concentrations using automatic biochemical analyzer by enzymatic cycle detection,and the levels of serum folate and Vitamin B12 were detected .The intracranial vascular were detected by Transcranial Doppler, and the extracranial vascular were detected by Color Doppler. The internal carotid arteries(ICA) were classified as normal, mild stenosis(50%), moderate stenosis (50%～69%), severe stenosis (70%~99%) and occlusion.The middle cerebral arteries (MCA) were classified as normal, mild stenosis (50%~69%), severe stenosis(70%~95%),extreme stenosis (95%). Results Mean serum Hcy concentrations were significantly higher in patients with stenosis of intracranial or (and) extracranial vascular than that in the patients with no arterial stenosis (P0.01).The serum folate concentrations were significantly lower in patients with stenosis of intracranial or (and) extracranial artery than that in the patients with no vascular stenosis (P0.05).There was no significant difference in the concentrations of serum VitaminB12 between the two groups(P0.05). The serum Hcy concentrations were different significantly in patients with different severities of the ICA stenosis and the MCA stenosis (all P0.01). The serum folate concentrations were different significantly in patients with different severities of the ICA stenosis and the MCA stenosis (all P0.05).But the serum Vitamin B12 concentrations was no significant difference in patients with different severities of vasculare stenosis(all P0.05). The serum Hcy concentrations were positive correlation with severities of the ICA stenosis and the MCA stenosis(r=0.356, P0.01, r=0.345 , P0.01),while the serum folate was negative correlation with degree of the ICA stenosis and the MCA stenosis(r=-0.272 , P0.05, r= -0.265 , P0.05). Conclusion Hyperhomocysteinemia is closely correlative with degree of the intracranial and extracranial vascular stenosis and hyperhomocysteinemia may be a new risk factor for ischemic cerebrovascular disease.