(Stroke. 2001;32:1116.)
© 2001 American Heart Association, Inc.
Original Contributions |
Elevated Plasma Homocysteine Levels and Risk of Silent Brain Infarction in Elderly People
From the Department of Geriatric Medicine (T.M., H.A., M. Morikawa, H.S.), Tohoku University School of Medicine, Sendai, Japan; the Center for Emotional and Behavioral Disorders (T.Y., H.Y.), Hizen National Hospital, Saga, Japan; the Second Department of Internal Medicine (H.Y.), Kyushu University, Fukuoka, Japan; Research and Development (M. Miura, S. Hashimoto), Mitsubishi Kagaku Bio-Clinical Laboratories Inc, Tokyo, Japan; the Department of Psychiatry (S. Higuchi, S.M.), Kurihama National Hospital, Kanagawa, Japan; and the Department of Cardiology (A.K.), Sendai City Medical Center, Sendai, Miyagi, Japan.
Correspondence to Dr Hiroyuki Arai, Department of Geriatric Medicine, Tohoku University School of Medicine, Sendai, Miyagi, 980-8574, Japan. E-mail h-ara{at}mail.cc.tohoku.ac.jp
Background and Purpose—Silent brain infarction (SBI) on MRI is common in elderly people, and recent studies have demonstrated that SBI increases the risk of progression to clinically apparent stroke and cognitive decline. Therefore, an early and accurate detection of SBI and a search for potential treatable risk factors may have a significant impact on public health.
Methods—Community-dwelling
elderly people aged 
66 years who participated in the present
study (n=153) underwent brain MRI and standardized physical and
neuropsychological examinations as well as blood biochemistry
determinations, including total plasma homocysteine (pHcy), renal
function, vitamin status, and polymorphisms of the
methylenetetrahydrofolate reductase
gene.
Results—SBI was
found in 24.8% of the participants. In the univariate
analysis, the pHcy levels in subjects with SBI (13.6±4.1
µmol/L) were significantly higher
(P=0.0004) than those in
subjects without SBI (11.0±3.3 µmol/L). When pHcy levels were
stratified into high (15.1 mmol/L), moderate (11.6 to 15.0
mmol/L), and low (
11.5 mmol/L) groups, age
(P<0.0001), male sex
(P<0.0001), the habits of
cigarette smoking (P<0.0001)
and of alcohol consumption
(P=0.0002), and folate levels
(P=0.01) were significantly
associated with an elevation of pHcy levels. The elevated pHcy levels
were significantly associated with SBI after individual adjustment for
age, sex, hypertension, renal function, and the habits of smoking and
alcohol consumption.
Conclusions—pHcy level is associated with age and nutritional and other lifestyle factors, and it contributes to a risk for SBI.
Key Words: homocyst(e)ine • lacunar infarction • magnetic resonance imaging • risk factors
This article has been cited by other articles:
 |
|
 |
|
  S. Seshadri, P. A. Wolf, A. S. Beiser, J. Selhub, R. Au, P. F. Jacques, M. Yoshita, I. H. Rosenberg, R. B. D'Agostino, and C. DeCarli Association of Plasma Total Homocysteine Levels With Subclinical Brain Injury: Cerebral Volumes, White Matter Hyperintensity, and Silent Brain Infarcts at Volumetric Magnetic Resonance Imaging in the Framingham Offspring Study Arch Neurol, May 1, 2008; 65(5): 642 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Folstein, T. Liu, I. Peter, J. Buel, L. Arsenault, T. Scott, and W. W. Qiu The Homocysteine Hypothesis of Depression Am J Psychiatry, June 1, 2007; 164(6): 861 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L.-K. Yang, K.-C. Wong, M.-Y. Wu, S.-L. Liao, C.-S. Kuo, and R.-F. S. Huang Correlations Between Folate, B12, Homocysteine Levels, and Radiological Markers of Neuropathology in Elderly Post-Stroke Patients J. Am. Coll. Nutr., June 1, 2007; 26(3): 272 - 278. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-M. Kwon, B. J. Kim, S.-H. Lee, S. H. Choi, B.-H. Oh, and B.-W. Yoon Metabolic Syndrome as an Independent Risk Factor of Silent Brain Infarction in Healthy People Stroke, February 1, 2006; 37(2): 466 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J-M Serot, F Barbe, E Arning, T Bottiglieri, P Franck, P Montagne, and J-P Nicolas Homocysteine and methylmalonic acid concentrations in cerebrospinal fluid: relation with age and Alzheimer's disease J. Neurol. Neurosurg. Psychiatry, November 1, 2005; 76(11): 1585 - 1587. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Elias, L. M. Sullivan, R. B. D'Agostino, P. K. Elias, P. F. Jacques, J. Selhub, S. Seshadri, R. Au, A. Beiser, and P. A. Wolf Homocysteine and Cognitive Performance in the Framingham Offspring Study: Age Is Important Am. J. Epidemiol., October 1, 2005; 162(7): 644 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. L Tucker, N. Qiao, T. Scott, I. Rosenberg, and A. Spiro III High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study Am. J. Clinical Nutrition, September 1, 2005; 82(3): 627 - 635. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-K. Kuo, F. A. Sorond, J.-H. Chen, A. Hashmi, W. P. Milberg, and L. A. Lipsitz The Role of Homocysteine in Multisystem Age-Related Problems: A Systematic Review J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2005; 60(9): 1190 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Hoshi, K. Kitagawa, H. Yamagami, S. Furukado, H. Hougaku, and M. Hori Relations of Serum High-Sensitivity C-Reactive Protein and Interleukin-6 Levels With Silent Brain Infarction Stroke, April 1, 2005; 36(4): 768 - 772. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Sato, Y. Honda, J. Iwamoto, T. Kanoko, and K. Satoh Effect of Folate and Mecobalamin on Hip Fractures in Patients With Stroke: A Randomized Controlled Trial JAMA, March 2, 2005; 293(9): 1082 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. M. Scott, K. L. Tucker, A. Bhadelia, B. Benjamin, S. Patz, R. Bhadelia, E. Liebson, L. L. Price, J. Griffith, I. Rosenberg, et al. Homocysteine and B Vitamins Relate to Brain Volume and White-Matter Changes in Geriatric Patients With Psychiatric Disorders Am J Geriatr Psychiatry, December 1, 2004; 12(6): 631 - 638. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Quadri, C. Fragiacomo, R. Pezzati, E. Zanda, G. Forloni, M. Tettamanti, and U. Lucca Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia Am. J. Clinical Nutrition, July 1, 2004; 80(1): 114 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Iso, Y. Moriyama, S. Sato, A. Kitamura, T. Tanigawa, K. Yamagishi, H. Imano, T. Ohira, T. Okamura, Y. Naito, et al. Serum Total Homocysteine Concentrations and Risk of Stroke and Its Subtypes in Japanese Circulation, June 8, 2004; 109(22): 2766 - 2772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Maruyama, T. Matsui, H. Tanji, M. Nemoto, N. Tomita, M. Ootsuki, H. Arai, and H. Sasaki Cerebrospinal Fluid Tau Protein and Periventricular White Matter Lesions in Patients With Mild Cognitive Impairment: Implications for 2 Major Pathways Arch Neurol, May 1, 2004; 61(5): 716 - 720. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L.P. Giele, T. D. Witkamp, W. P.T.M. Mali, Y. van der Graaf, and for the SMART Study Group Silent Brain Infarcts in Patients With Manifest Vascular Disease Stroke, March 1, 2004; 35(3): 742 - 746. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. T. Longstreth Jr, R. Katz, J. Olson, C. Bernick, J. J. Carr, M. R. Malinow, D. L. Hess, M. Cushman, and S. M. Schwartz Plasma Total Homocysteine Levels and Cranial Magnetic Resonance Imaging Findings in Elderly Persons: The Cardiovascular Health Study Arch Neurol, January 1, 2004; 61(1): 67 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hassan, B. J. Hunt, M. O'Sullivan, R. Bell, R. D'Souza, S. Jeffery, J. M. Bamford, and H. S. Markus Homocysteine is a risk factor for cerebral small vessel disease, acting via endothelial dysfunction Brain, January 1, 2004; 127(1): 212 - 219. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. K. Kim, B. O. Choi, W. S. Jung, Y. J. Choi, and K. G. Choi Hyperhomocysteinemia as an independent risk factor for silent brain infarction Neurology, December 9, 2003; 61(11): 1595 - 1599. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. M. Martinez-Taboada, M. J. Bartolome, M. D. Fernandez-Gonzalez, R. Blanco, V. Rodriguez-Valverde, and M. Lopez-Hoyos Homocysteine levels in polymyalgia rheumatica and giant cell arteritis: influence of corticosteroid therapy Rheumatology, September 1, 2003; 42(9): 1055 - 1061. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kohara, M. Fujisawa, F. Ando, Y. Tabara, N. Niino, T. Miki, and H. Shimokata MTHFR Gene Polymorphism as a Risk Factor for Silent Brain Infarcts and White Matter Lesions in the Japanese General Population: The NILS-LSA Study Stroke, May 1, 2003; 34(5): 1130 - 1135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.T. Longstreth Jr, C. Dulberg, T. A. Manolio, M. R. Lewis, N. J. Beauchamp Jr, D. O'Leary, J. Carr, and C. D. Furberg Incidence, Manifestations, and Predictors of Brain Infarcts Defined by Serial Cranial Magnetic Resonance Imaging in the Elderly: The Cardiovascular Health Study Stroke, October 1, 2002; 33(10): 2376 - 2382. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Gorelick Stroke Prevention Therapy Beyond Antithrombotics: Unifying Mechanisms in Ischemic Stroke Pathogenesis and Implications for Therapy: An Invited Review Stroke, March 1, 2002; 33(3): 862 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. M. Rieder, D. Fricke, H. X. Wang, A. Wahlin, H. Basun, J. Fastbom, B. Winblad, and L. Fratiglioni Vitamin B12 and folate in relation to the development of Alzheimer's disease Neurology, November 13, 2001; 57(9): 1742 - 1743. [Full Text] [PDF]
|
|