Serum homocysteine levels of retinal vein occlusion patients with different ages and types_Chinese Journal of Ocular Fundus Diseases

Authors：

ZhouLongfang ,  YangHong

Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430074, China;

Corresponding author：

YangHong, Email: 1500475173@qq.com

Keywords：

Retinal vein occlusion/etiology; Homocysteine; Folic acid deficiency/complications; Vitamin B 6 deficiency/complications

DOI：

10.3760/cma.j.issn.1005-1015.2016.04.011

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Objective To observe serum homocysteine (Hcy) levels in retinal vein occlusion (RVO) patients with different ages and types. Methods A total of 79 patients (79 eyes) diagnosed with RVO were enrolled. There were 33 females and 46 males, the mean age was (57.00±9.29) years. Eighty-two age-and sex-matched patients (82 eyes) without retinal vascular disease were included as controls. There were 32 females and 50 males, the mean age was (60.00±10.15) years. Among RVO patients, there were 24 patients younger than 50 years old (young patients) and 55 patients older than 50 years old (elderly patients); 35 patients with central RVO (CRVO) and 44 patients with branch RVO (BRVO). Fasting plasma Hcy, serum vitamin (Vit) B6, B12 and folate levels were measured in all patients. The relationship of high Hcy, low VitB6, low folate and RVO with different age were analyzed. Results Hcy level was significantly higher in RVO patients than control subjects (t=2.946, P<0.01). Blood concentration of folate and VitB6 were significantly lower in RVO patients than control subjects (t=2.641, 2.889; P<0.01). Blood level of VitB12 was significantly different in RVO patients from control subjects (t=1.665, P>0.05). Concentrations of Hcy, folate, VitB12 and VitB6 were not different between patients with CRVO and BRVO (t=0.756,1.306,0.682,1.306;P>0.05). Hcy level was significantly higher in the young RVO patients than in the elderly RVO patients (t=2.394, P<0.05). Blood concentration of folate and VitB6 were lower in the young RVO patients than in the elderly RVO patients, but the difference were not significant(t=1.318, 1.694; P>0.05). The number of patients with high Hcy [χ²=13.67,odds ratio (OR)=3.327,95% confidence interval (CI)=1.742-6.354], low VitB6 (χ²=5.28,OR=2.068,95%CI=1.103-3.878) and low folate status (χ²=8.642,OR=2.546,95%CI=1.349-4.806) in RVO patients were more than control subjects (P=0.0001, 0.023, 0.004). Conclusions High Hcy, low folate and low VitB6 were risk factors for the onset of RVO. Hcy may play more important role in young patients with RVO. Hcy, folate and VitB6 levels were similar in CRVO and BRVO patients.

Citation： ZhouLongfang, YangHong. Serum homocysteine levels of retinal vein occlusion patients with different ages and types. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 391-394. doi: 10.3760/cma.j.issn.1005-1015.2016.04.011 Copy

1.	Glueck CJ, Wang P, Hutchins R, et al. Ocular vascular thrombotic events:central retinal vein and central retinal artery occlusions[J].Clin Appl Thromb Hemost, 2008,14(3):286-294.
2.	Rehak M, Rehak J, Muller M, et al. The prevalence of activated protein C (APC) resistance and factor V Leiden is significantly higher in patients with retinal vein occlusion without general risk factors. Case-control study and meta-analysis[J]. Thromb Haemost, 2008, 99(5):925-929. DOI:10.1160/TH07-11-0658.
3.	Janssen MC, Heijer M, Cruysberg JR, et al. Retinal vein occlusion:a form of venous thrombosis or a complication of atherosclerosis? A meta-analysis of thrombophilic factors[J]. Thromb Haemost,2005,93(6):1021-1206.
4.	Di Capua M, Coppola A, Albisinni R, et al. Cardiovascular risk factors and outcome in patients with retinal vein occlusion[J]. J Thromb Thrombolysis, 2010,30(1):16-22. DOI:10.1007/s11239-009-0388-1.
5.	胡晓颖, 张晓光.高同型半胱氨酸血症与疾病的关系[J]. 山东医药,2010,50(1):114-115. DOI:10.3969/j.issn.1002-266X.2010.01.070. Hu XY,Zhang XG. Relationship between high homocysteine and disease.[J]. Shandong Medical Journal,2010,50(1):114-115.DOI:10.3969/j.issn.1002-266X.2010.01.070.
6.	施殿雄.视网膜血管性疾病[M]//施殿雄.实用眼科诊断.上海:上海科学技术出版社,2005. Shi DX. Retinal vascular diseases[M]//Shi DX. Practical department of ophthalmology diagnosis.Shanghai:Shanghai Science and Technology Press,2005.
7.	Cattaneo M.Hyperhomocysteinemia, atherosclerosis and thrombosis[J].Thromb Haemost,1999,81(2):165-176.
8.	Cabezas-León MM,García-Montero MR,Morente-Matas P. Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient[J].Rev Neurol, 2003,37(5):441-443.
9.	Sofi F, Marcucci R, Bolli P, et al. Low vitamin B6 and folic acid levels are associated with retinal vein occlusion independently of homocysteine levels[J]. Atherosclerosis, 2008, 198(1):223-227. DOI:10.1016/j.atherosclerosis.2007.09.009.
10.	Lahiri KD,Dutta J, Datta H,et al.Hyperhomocysteinemia, as an independent risk factor for retinal venous occlusion in an Indian population[J]. Indian J Clin Biochem, 2013,28(1):61-64. DOI:10.1007/s12291-012-0238-3.
11.	Cahill MT, Stinnett SS, Fekrat S. Meta-analysis of plasma homocysteine, serum folate, serum vitamin B12, and thermolabile MTHFR genotype as risk factors for retinal vascular occlusive disease[J].Am J Ophthalmol,2003,136(6):1136-1150.
12.	王召军, 赵翠萍, 李晶洁, 等. 性别, 年龄因素对冠心病患者血同型半胱氨酸水平影响的研究[J]. 黑龙江医学, 2008, 32(8):561-562.DOI:10.3969/j.issn.1004-5775.2008.08.001. Wang ZJ,Zhao CP,Li JJ,et al.Effects of gender and age on blood homocysteine levels in the patients with coronary heart disease[J].Heilongjiang Medical Journal,2008, 32(8):561-562.DOI:10.3969/j.issn.1004-5775.2008.08.001.
13.	刘永珍, 尹静, 于逢春, 等. 脑卒中患者同型半胱氨酸水平及其影响因素研究[J]. 中国神经精神疾病杂志,2009,35(2):105-107.DOI:10.3969/j.issn.1002-0152.2009.02.011. Liu YZ,Yin J,Yu FC,et al.Study on the association between serum concentrations of homocysteine and relative factors in stroke patients[J].Chin J Nerv Ment Dis, 2009, 35(2):105-107. DOI:10.3969/j.issn.1002-0152.2009.02.011.
14.	Lahey JM, Tunç M, Kearney J, et al. Laboratory evaluation of hypercoagulable states in patients with central retinal vein occlusion who are less than 56 years of age[J]. Ophthalmology, 2002, 109(1):126-131.
15.	Chua B, Kifley A, Wong TY, et al. Homocysteine and retinal vein occlusion:a population-based study[J]. Am J Ophthalmol,2005,139(1):181-182.
16.	Cattaneo M, Lombardi R, Lecchi A,et al.Low plasma levels of vitamin B(6) are independently associated with a heightened risk of deep-vein thrombosis[J]. Circulation, 2001, 13,104(20):2442-2446.
17.	Gori AM, Sofi F, Corsi AM, et al. Predictors of vitamin B6 and folate concentrations in older persons:the InCHIANTI study[J]. Clin chem,2006,52(7):1318-1324.
18.	Ferrazzi P,Di Micco P, Quaglia I,et al.Homocysteine, MTHFR C677T gene polymorphism, folic acid and vitamin B12 in patients with retinal vein occlusion[J].Thromb J,2005,3:13.
19.	Gao W, Wang YS, Zhang P,et al.MTHFR C677T mutation in central retinal vein occlusion:a case-control study in Chinese population[J].Thromb Res, 2008, 121(5):699-703.
20.	Lattanzio R, Sampietro F, Ramoni A, et al. Moderate hyperhomocysteinemia and early-onset central retinal vein occlusion[J].Retina,2006,26(1):65-70.
21.	Cifkova R, Erdine S, Fagard R, et al.Practice guidelines for primary care physicians:2003 ESH/ESC hypertension guidelines[J]. J Hypertens, 2003, 21(10):1779-1786.
22.	Durga J,Verhoef P, Anteunis LJ,et al.Effects of folic acid supplementation on hearing in older adults:a randomized, controlled trial[J]. Ann Intern Med, 2007, 146(1):1-9.
23.	Vallelunga A, PegoraroV, Pilleri M, et al. The MTHFR C677T polymorphism modifies age at onset in Parkinson's disease[J]. Neurol Sci, 2014,35(1):73-77. DOI:0.1007/s10072-013-1545-z.

1. Glueck CJ, Wang P, Hutchins R, et al. Ocular vascular thrombotic events:central retinal vein and central retinal artery occlusions[J].Clin Appl Thromb Hemost, 2008,14(3):286-294.
2. Rehak M, Rehak J, Muller M, et al. The prevalence of activated protein C (APC) resistance and factor V Leiden is significantly higher in patients with retinal vein occlusion without general risk factors. Case-control study and meta-analysis[J]. Thromb Haemost, 2008, 99(5):925-929. DOI:10.1160/TH07-11-0658.
3. Janssen MC, Heijer M, Cruysberg JR, et al. Retinal vein occlusion:a form of venous thrombosis or a complication of atherosclerosis? A meta-analysis of thrombophilic factors[J]. Thromb Haemost,2005,93(6):1021-1206.
4. Di Capua M, Coppola A, Albisinni R, et al. Cardiovascular risk factors and outcome in patients with retinal vein occlusion[J]. J Thromb Thrombolysis, 2010,30(1):16-22. DOI:10.1007/s11239-009-0388-1.
5. 胡晓颖, 张晓光.高同型半胱氨酸血症与疾病的关系[J]. 山东医药,2010,50(1):114-115. DOI:10.3969/j.issn.1002-266X.2010.01.070. Hu XY,Zhang XG. Relationship between high homocysteine and disease.[J]. Shandong Medical Journal,2010,50(1):114-115.DOI:10.3969/j.issn.1002-266X.2010.01.070.
6. 施殿雄.视网膜血管性疾病[M]//施殿雄.实用眼科诊断.上海:上海科学技术出版社,2005. Shi DX. Retinal vascular diseases[M]//Shi DX. Practical department of ophthalmology diagnosis.Shanghai:Shanghai Science and Technology Press,2005.
7. Cattaneo M.Hyperhomocysteinemia, atherosclerosis and thrombosis[J].Thromb Haemost,1999,81(2):165-176.
8. Cabezas-León MM,García-Montero MR,Morente-Matas P. Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient[J].Rev Neurol, 2003,37(5):441-443.
9. Sofi F, Marcucci R, Bolli P, et al. Low vitamin B6 and folic acid levels are associated with retinal vein occlusion independently of homocysteine levels[J]. Atherosclerosis, 2008, 198(1):223-227. DOI:10.1016/j.atherosclerosis.2007.09.009.
10. Lahiri KD,Dutta J, Datta H,et al.Hyperhomocysteinemia, as an independent risk factor for retinal venous occlusion in an Indian population[J]. Indian J Clin Biochem, 2013,28(1):61-64. DOI:10.1007/s12291-012-0238-3.
11. Cahill MT, Stinnett SS, Fekrat S. Meta-analysis of plasma homocysteine, serum folate, serum vitamin B12, and thermolabile MTHFR genotype as risk factors for retinal vascular occlusive disease[J].Am J Ophthalmol,2003,136(6):1136-1150.
12. 王召军, 赵翠萍, 李晶洁, 等. 性别, 年龄因素对冠心病患者血同型半胱氨酸水平影响的研究[J]. 黑龙江医学, 2008, 32(8):561-562.DOI:10.3969/j.issn.1004-5775.2008.08.001. Wang ZJ,Zhao CP,Li JJ,et al.Effects of gender and age on blood homocysteine levels in the patients with coronary heart disease[J].Heilongjiang Medical Journal,2008, 32(8):561-562.DOI:10.3969/j.issn.1004-5775.2008.08.001.
13. 刘永珍, 尹静, 于逢春, 等. 脑卒中患者同型半胱氨酸水平及其影响因素研究[J]. 中国神经精神疾病杂志,2009,35(2):105-107.DOI:10.3969/j.issn.1002-0152.2009.02.011. Liu YZ,Yin J,Yu FC,et al.Study on the association between serum concentrations of homocysteine and relative factors in stroke patients[J].Chin J Nerv Ment Dis, 2009, 35(2):105-107. DOI:10.3969/j.issn.1002-0152.2009.02.011.
14. Lahey JM, Tunç M, Kearney J, et al. Laboratory evaluation of hypercoagulable states in patients with central retinal vein occlusion who are less than 56 years of age[J]. Ophthalmology, 2002, 109(1):126-131.
15. Chua B, Kifley A, Wong TY, et al. Homocysteine and retinal vein occlusion:a population-based study[J]. Am J Ophthalmol,2005,139(1):181-182.
16. Cattaneo M, Lombardi R, Lecchi A,et al.Low plasma levels of vitamin B(6) are independently associated with a heightened risk of deep-vein thrombosis[J]. Circulation, 2001, 13,104(20):2442-2446.
17. Gori AM, Sofi F, Corsi AM, et al. Predictors of vitamin B6 and folate concentrations in older persons:the InCHIANTI study[J]. Clin chem,2006,52(7):1318-1324.
18. Ferrazzi P,Di Micco P, Quaglia I,et al.Homocysteine, MTHFR C677T gene polymorphism, folic acid and vitamin B12 in patients with retinal vein occlusion[J].Thromb J,2005,3:13.
19. Gao W, Wang YS, Zhang P,et al.MTHFR C677T mutation in central retinal vein occlusion:a case-control study in Chinese population[J].Thromb Res, 2008, 121(5):699-703.
20. Lattanzio R, Sampietro F, Ramoni A, et al. Moderate hyperhomocysteinemia and early-onset central retinal vein occlusion[J].Retina,2006,26(1):65-70.
21. Cifkova R, Erdine S, Fagard R, et al.Practice guidelines for primary care physicians:2003 ESH/ESC hypertension guidelines[J]. J Hypertens, 2003, 21(10):1779-1786.
22. Durga J,Verhoef P, Anteunis LJ,et al.Effects of folic acid supplementation on hearing in older adults:a randomized, controlled trial[J]. Ann Intern Med, 2007, 146(1):1-9.
23. Vallelunga A, PegoraroV, Pilleri M, et al. The MTHFR C677T polymorphism modifies age at onset in Parkinson's disease[J]. Neurol Sci, 2014,35(1):73-77. DOI:0.1007/s10072-013-1545-z.

Chinese Journal of Ocular Fundus Diseases

Serum homocysteine levels of retinal vein occlusion patients with different ages and types

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