Hyperhomocysteinemia in health and disease: where we are now, and where do we go from here ?

نویسندگان

  • Giuseppe Lippi
  • Mario Plebani
چکیده

Homocysteine is a sulfur-containing amino acid, which is synthesized from the precursor methionine through a multi-step process, and then reconverted to methionine or catabolyzed into cysteine. The presence of vitamin B9 (folic acid), vitamin B6 (pyridoxine) and vitamin B12 (cobalamin) is essential in homocysteine metabolism, wherein deficiency of one or more of these nutrients is associated with various degree of hyperhomocysteinemia. There is little doubt that hyperhomocysteinemia is associated with several human disorders, such as cardiovascular disease, neurodegenerative disorders, pregnancy complications and fractures, so that its measurement might be useful for risk assessment. Nevertheless, several randomized homocysteine-lowering therapy trials have failed to show that supplementation with vitamins B substantially modifies (and – more importantly – improves) the end points and the related outcomes. According to the current state of scientific knowledge, it seems thus reasonable to conclude that lowering homocysteine alone is probably insufficient to mitigate the risk of thromboembolic, cardiovascular and neurodegenerative disorders inasmuch as this bizarre amino acid acts in strict synergy with other probably more powerful risk factors. Several lines of evidence suggest, however, that its measurement may be helpful for identifying subjects at greater risk of disease, who may thus benefit from a more aggressive treatment of other modifiable risk factors, as recently shown by result of the 5-year Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Association of hyperhomocysteinemia with coronary artery disease in southern Iran

Dear Editor, In response to the criticisms regarding the article entitled; “association of hyperhomocysteinemia with coronary artery disease in Southern Iran”, published in Iran J Med Sci,1 we still believe the methodology used in this study was a case control design as the cases where chosen on the basis of outcome (coronary artery disease) and the controls were individuals without the disease...

متن کامل

Reflection for the undergraduate on writing in the portfolio: where are we now and where are we going?

Introduction: The portfolio can be seen as a tool for assessmentof a variety of learning activities that differ in content, usage, andassessment. The portfolio not only meets the learner’s educationalneeds but also the political and public reassurance demand thatthe health professional has achieved the required competency ofthe curriculum that allows him or her to practice safely with orwithout...

متن کامل

Adhesive small bowel obstruction: where do we stand now?

Adhesive small bowel obstruction (ASBO) is one of the most frequently encountered disorders in Emergency Surgery Departments worldwide without negligible hospital admission rates and social costs (1,2). Notwithstanding significant improvements in techniques and materials, intra-abdominal adhesions following abdominal surgery still represent a major unsolved and debated issue harbouring challeng...

متن کامل

Reconceptualising Religion : A Philosophical Critique of Religious Studies as Cultural Studies

The aim of my argument (1) is to reconceptualise what is now called religious studies as the study of institutionalised values, and the relation between values and the legitimation of power in a specific society. Though I do not talk much about power here, it is always a fundamental issue in the study of specific social groups.The first assumption which I make in this paper is that the way anal...

متن کامل

I-36: Preimplantation Genetic Diagnosis - Where Have We Been and Where Are We Going

Preimplantation genetic diagnosis (PGD) is now considered routine in IVF laboratories with micromanipulation capability and access to genetic diagnostic services. The past two decades have witnessed a dramatic increase in the use of PGD, the number of cycles performed, and the indications for which PGD has been used. This increase has been mirrored by a slow, but steady, increase in the range o...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Clinical chemistry and laboratory medicine

دوره 50 12  شماره 

صفحات  -

تاریخ انتشار 2012