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
Neurologyjournal_title
Neurologyauthors
Kloppenborg RP,Geerlings MI,Visseren FL,Mali WP,Vermeulen M,van der Graaf Y,Nederkoorn PJ,SMART Study Group.doi
10.1212/WNL.0000000000000168subject
Has Abstractpub_date
2014-03-04 00:00:00pages
777-83issue
9eissn
0028-3878issn
1526-632Xpii
WNL.0000000000000168journal_volume
82pub_type
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