Document Detail

Hyperhomocysteinemia and inflammatory bowel disease: prevalence and predictors in a cross-sectional study.
MedLine Citation:
PMID:  11467646     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Homocysteine is a sulfur-containing amino acid formed during the demethylation of methionine. Vitamin B12 and folate deficiency and therapy with antifolate drugs may predispose patients with inflammatory bowel disease (IBD) to hyperhomocysteinemia. The known associations between hyperhomocysteinemia and smoking, osteoporosis, and thrombosis make it an interesting candidate as a pathogenetic link in IBD. The aim of this study was to identify the prevalence and risk factors of hyperhomocysteinemia in patients with IBD. METHODS: Sixty-five consecutive IBD patients were recruited from a tertiary outpatient gastroenterology practice. Fasting plasma homocysteine levels were measured, along with vitamin B12 and folate. Data regarding medication use, multivitamin use, disease location and severity, and extraintestinal manifestations of IBD were gathered. Homocysteine levels in 138 healthy control subjects were compared with the IBD cohort, and adjustments for age and sex were made using logistic regression. Multivariate analysis was performed to seek predictors of homocysteine levels. RESULTS: The mean age in the IBD cohort was 42+/-13.4 yr (+/-SD), and 43% were male. The mean disease duration was 13.8+/-9.4 yr, and 32% had used steroids within the last 3 months. Immunomodulator therapy had been used in 32%, and 75% had had an intestinal resection. Osteoporosis was present in 33% of patients. Five patients had experienced venous thrombosis or stroke, but only one of these had hyperhomocysteinemia. Of the 10 IBD patients (15.4%) with hyperhomocysteinemia, only two had vitamin B12 deficiency. The homocysteine levels in the IBD cohort cases and controls were 8.7 and 6.6 micromol/L, respectively (p < 0.05). IBD significantly increased the risk of hyperhomocysteinemia (adjusted odds ratio = 5.9 [95% CI: 1.5-24]). Advanced age, male sex, vitamin B12 deficiency or lower vitamin B12 serum levels, and multivitamin therapy were independently associated with higher homocysteine levels in the multivariate analysis (R2 = 0.55; p = 0.001). CONCLUSIONS: Hyperhomocysteinemia is significantly more common in patients with IBD compared with healthy controls, and is associated with lower (but not necessarily deficient) vitamin B12 levels.
J Romagnuolo; R N Fedorak; V C Dias; F Bamforth; M Teltscher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  96     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-24     Completed Date:  2001-08-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2143-9     Citation Subset:  IM    
Division of Gastroenterology, McGill University Health Centre, Montreal, Canada.
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MeSH Terms
Cohort Studies
Cross-Sectional Studies
Homocysteine / blood
Hyperhomocysteinemia / blood,  epidemiology*,  etiology*
Inflammatory Bowel Diseases / complications*
Models, Chemical
Risk Factors
Vitamin B 12 / blood
Reg. No./Substance:
454-28-4/Homocysteine; 68-19-9/Vitamin B 12
Comment In:
Am J Gastroenterol. 2002 Feb;97(2):490-1   [PMID:  11866298 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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