Editorial Hyperhomocysteinemia in health and disease : where we are now , and where do we go from here ?
نویسندگان
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 defi ciency 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 modifi es (and – more importantly – improves) the end points and the related outcomes. According to the current state of scientifi c knowledge, it seems thus reasonable to conclude that lowering homocysteine alone is probably insuffi cient 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 benefi t from a more aggressive treatment of other modifi able risk factors, as recently shown by result of the 5-year Fenofi brate Intervention and Event Lowering in Diabetes (FIELD) trial.
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 کاملReflection 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 کاملAdhesive 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 کاملThe Elephants in the Room: Sex, HIV, and LGBT Populations in MENA. Intersectionality in Lebanon; Comment on “Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward”
In response to this insightful editorial, we wish to provide commentary that seeks to highlight recent successes and illuminate the often unspoken hurdles at the intersections of culture, politics, and taboo. We focus on sexual transmission and draw examples from Lebanon, where the pursuit of data in quality and quantity is teaching us lessons about the way forward and where we are experiencing...
متن کامل