Homocysteine and progression of generalized small-vessel disease: the SMART-MR Study.

Abstract:

OBJECTIVES:Assuming the involvement of homocysteine in a generalized small-vessel disease, we investigated the association of homocysteine levels with progression of white matter lesions, lacunar infarcts, and kidney disease. METHODS:Within the SMART-MR (Second Manifestations of ARTerial disease-Magnetic Resonance) Study, a prospective cohort study on brain aging in patients with symptomatic atherosclerotic disease, 663 patients (aged 57 ± 9 years) had vascular screening and 1.5-tesla MRI at baseline and after a mean follow-up of 3.9 years. Multiple regression analysis was used to estimate the longitudinal association between total homocysteine level, defined as a continuous variable and as hyperhomocysteinemia (the highest quintile of homocysteine), and progression of white matter lesion volume, lacunar infarcts, and estimated glomerular filtration rate. RESULTS:After adjusting for age, sex, follow-up time, and vascular risk factors, hyperhomocysteinemia was significantly associated with increased risk of white matter lesion progression (odds ratio 2.4, 95% confidence interval [CI] 1.5-4.1) and lower estimated glomerular filtration rate at follow-up (B = -3.4 mL/min, 95% CI -5.9 to -0.9) and borderline significantly associated with new lacunar infarcts (odds ratio 1.8, 95% CI 0.9-3.4). CONCLUSIONS:Our findings implicate a role for homocysteine in the development of a generalized small-vessel disease in which both brain and kidney are affected.

journal_name

Neurology

journal_title

Neurology

authors

Kloppenborg RP,Geerlings MI,Visseren FL,Mali WP,Vermeulen M,van der Graaf Y,Nederkoorn PJ,SMART Study Group.

doi

10.1212/WNL.0000000000000168

subject

Has Abstract

pub_date

2014-03-04 00:00:00

pages

777-83

issue

9

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000000168

journal_volume

82

pub_type

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