Objective To investigate the relationship between vascular endothelial dysfunction and serum homocysteine (HCY) level in patients with coronary lesions. Methods Serum HCY, serum nitric oxide (NO), plasma endothelin-1 ...Objective To investigate the relationship between vascular endothelial dysfunction and serum homocysteine (HCY) level in patients with coronary lesions. Methods Serum HCY, serum nitric oxide (NO), plasma endothelin-1 (ET-1), and circulation endothelial cell (CEC) were measured in 76 patients who received coronary angiography. Fifty-four patients with a stenosis of 50% or more at least in one coronary atery were as coronary artery disease (CAD) group. Other 22 cases with no recognizable plaque and/or stenosis were as control group. HCY level was detected using an enzyme immunoassay kit. NO concentration was measured using a nitrate reductase kit. Radio-immunoassay was applied to analyse the ET-1 level, and CEC was measured by flow cytometry. Results The levels of HCY, ET-1, and CEC in patients with coronary lesions were significantly increased in comparison with control group (P < 0.01), while NO level in CAD group was significantly lower compared with that in control (P < 0.01). Using a multivariate stepwise regression analysis, HCY level had a positive correlation with ET-1 level (r = 0.420, P < 0.05) and CECs number (r = 0.423, P < 0.05); and had a negative correlation with NO/ET-1 (r = -0.403, P < 0.05). But there was no significant correlation between HCY and NO levels. Conclusions HCY might lead to endothelial cell injury, which would provide a plausible mechanism for the relationship between hyperhomocysteinemia and development of coronary artery disease. HCY can be considered as a predictor for preli-minary or active coronary lesion.展开更多
Cardiovascular diseases constitute approximately 50% of deaths among dialysis patients in the USA and Europe. The increase in traditional and nontraditional cardiovascular risk factors in determining the high mortalit...Cardiovascular diseases constitute approximately 50% of deaths among dialysis patients in the USA and Europe. The increase in traditional and nontraditional cardiovascular risk factors in determining the high mortality of patients with end-stage renal disease （ESRD） is complicated due to the high frequency of risk factors in these patients. Some laboratory markers like homocysteine, albumin, cholesterol, triglycerides, LDL-cholesterol, and creatinine could be efficient in marking the risk of cardiovascular disease in these patients. We use Roche assay tests, based on routinely principles to determine this laboratory parameters used in the clinical laboratory. All laboratory parameters we measured on a biochemistry auto analyser Cobas Integra 400 at the clinical laboratory of University Hospital--Pleven. Using a statistical program a research was done on the quantitative characteristics and prognostic capabilities of homocysteine and other biochemical parameters. We determined the diagnostic specificity and sensitivity of our lab performance against vascular disease （heart attack or stroke） by ROC curves. For each of the observed values of biochemical parameters we calculated the diagnostic sensitivity and specificity. The threshold values for which the parameters have the highest sensitivity and specificity have been concluded. Summary of diagnostic value of parameters to judge the coefficient AUC--area under the curve, for cholesterol, LDL, triglycerides, albumin, it was a significant （P 〈 0.05）. Homocysteine and the rest of the studied by us laboratory parameters can be regarded as laboratory markers of choice for assessing the risk of heart attack or stroke in patients on dialysis.展开更多
文摘Objective To investigate the relationship between vascular endothelial dysfunction and serum homocysteine (HCY) level in patients with coronary lesions. Methods Serum HCY, serum nitric oxide (NO), plasma endothelin-1 (ET-1), and circulation endothelial cell (CEC) were measured in 76 patients who received coronary angiography. Fifty-four patients with a stenosis of 50% or more at least in one coronary atery were as coronary artery disease (CAD) group. Other 22 cases with no recognizable plaque and/or stenosis were as control group. HCY level was detected using an enzyme immunoassay kit. NO concentration was measured using a nitrate reductase kit. Radio-immunoassay was applied to analyse the ET-1 level, and CEC was measured by flow cytometry. Results The levels of HCY, ET-1, and CEC in patients with coronary lesions were significantly increased in comparison with control group (P < 0.01), while NO level in CAD group was significantly lower compared with that in control (P < 0.01). Using a multivariate stepwise regression analysis, HCY level had a positive correlation with ET-1 level (r = 0.420, P < 0.05) and CECs number (r = 0.423, P < 0.05); and had a negative correlation with NO/ET-1 (r = -0.403, P < 0.05). But there was no significant correlation between HCY and NO levels. Conclusions HCY might lead to endothelial cell injury, which would provide a plausible mechanism for the relationship between hyperhomocysteinemia and development of coronary artery disease. HCY can be considered as a predictor for preli-minary or active coronary lesion.
文摘Cardiovascular diseases constitute approximately 50% of deaths among dialysis patients in the USA and Europe. The increase in traditional and nontraditional cardiovascular risk factors in determining the high mortality of patients with end-stage renal disease （ESRD） is complicated due to the high frequency of risk factors in these patients. Some laboratory markers like homocysteine, albumin, cholesterol, triglycerides, LDL-cholesterol, and creatinine could be efficient in marking the risk of cardiovascular disease in these patients. We use Roche assay tests, based on routinely principles to determine this laboratory parameters used in the clinical laboratory. All laboratory parameters we measured on a biochemistry auto analyser Cobas Integra 400 at the clinical laboratory of University Hospital--Pleven. Using a statistical program a research was done on the quantitative characteristics and prognostic capabilities of homocysteine and other biochemical parameters. We determined the diagnostic specificity and sensitivity of our lab performance against vascular disease （heart attack or stroke） by ROC curves. For each of the observed values of biochemical parameters we calculated the diagnostic sensitivity and specificity. The threshold values for which the parameters have the highest sensitivity and specificity have been concluded. Summary of diagnostic value of parameters to judge the coefficient AUC--area under the curve, for cholesterol, LDL, triglycerides, albumin, it was a significant （P 〈 0.05）. Homocysteine and the rest of the studied by us laboratory parameters can be regarded as laboratory markers of choice for assessing the risk of heart attack or stroke in patients on dialysis.
