Abstract WP367: Factors Related To High Plasma Homocysteine Level At One Year Post-stroke In Korean Patients With Ischemic Stroke
Background : Despite reports of correlation between homocysteine(Hcy) and 2ndary stroke incidence, many stroke patients still have elevated plasma Hcy post-stroke. This study investigates the changes of Hcy over one year and the related factors to high Hcy including nutrient intakes in stroke patients.
Methods: A total of 203 patients with ischemic stroke admitted to the Asan Medical Center were enrolled. Blood samples were collected for Hcy and other biochemical measurements at admission and 1 year post stroke. Personal interview was performed to obtain socio-demographic data. Nutritional status was determined by mini nutritional assessment (MNA). Dietary intakes of the subjects were obtained by 24 hour dietary recall method and were analyzed with CAN pro (3.0 version).
Results: The patients with high Hcy (> 15μmol/L) at admission and one year post-stroke were 47(23.2%) and 59(29.1%), respectively. Among the patients with normal Hcy at admission, 36 (23.1%) patients had high Hcy one year post-stroke. The factors related to high plasma Hcy level at admission were male (p=0.048). The factors related to high Hcy one year post-stroke were low plasma folate level (p=0.002), and Vit B12 level (p=0.011), old age (p=0.025), male (p=0.006), and poor nutritional status (p=0.045). Administration of Vitamin and folate (1mg per day) were not related to Hcy level. The patients with elevated Hcy as compared to the patients with normal Hcy one year post- stroke although they all had normal Hcy at admission had low plasma Vit B12 (p=0.009), folate level(p=0.003), and poor nutritional status(p=0.031). And old age (p=0.049), male (p=0.021), and dietary Vit B6 intake (p=.032) were also significantly related to high Hcy one year post-stroke. However, administration of folate (1mg per day), smoking, and exercise were not related to high Hcy.
Conclusions: Hyperhomocysteinemia is common in Korean stroke patients 1 year after stroke. Many patients with high Hcy at admission still have elevated Hcy regardless of folate administration. The strategies to decrease Hcy after stroke should include nutritional modifications, particularly so in the male patients with old age.
- © 2012 by American Heart Association, Inc.