Higher Arterial Elasticity Index in Hemodialysis Patients with Severe Hyperhomocysteinemia

高同胱胺酸血症之血液透析病人患有較高動脈彈性指數

邱怡文(Yi-Wen Chiu) ； 郭弘典(Hong-Tien Kou) ； 蔡哲嘉(Jer-Chia Tsai) ； 黃尚志(Shang-Jyh Hwang) ； 陳鴻鈞(Hung-Chun Chen) ； 賴永勳(Yung-Hsiung Lai)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 263-263

並列摘要

Background: Hyperhomocysteinemia is noted in 75-64% of uremic patients on hemodialysis (HD). It increases the risk of cardiovascular diseases, which is the major cause of mortality in hemodialysis patiens. Arterial dlasticity index (AEI) is a noninvasive measurement to reflect the elasticity of brachial artery. It may relate with the risk of cardiovascular diseases and severity of arteriosclerosis and endothelial dysfunction. The purpose of this study is to investigate the association of severity of hyperhomocysteinemia with AEI, methyleneterahydrofolate reductase (MTHFR) genotypes and the status of folic acid and vitamin B12 in HD patients.
Materials and Methods: One hundred and night regular HD patiens (49M/60F, mean age 53.4±13.3 years) were enrolled in this study. HD duration was 57.4±57 months. They discontinued folic acid therapy at least 3 to 5 months. Their plasma Hcy levels were greater than 15 μmol/L. We defined mild or severe hyperhomocysteinemia groups based on their plasma Hcy levels below or higher than the median value. AEI was determined by Cardio Vision Ms-2000 from the mean values of three times of measurement prior to HD. Unpaired t/test was used for statistical analysis.
Result: The distribution of AEI with the degree of below 70, 71-179 (moderate risk), 180-300 (high risk) was 83,17, and 9 patients, respectively. The comparison of two groups were showed as followed.
Discussion: Our study showed that AEI was significantly higher in patients with severe hyperhomocysteinemia. It implies that reduced vascular elasticity in those patients, AEI could act as a useful noninvasive tool to reflect the severity of vascular damage caused by hyperhomocysteinemia. Older age was also noted in patients with severe hyperhomocysteinemia. However, higher AEI was not ascribed to older age in those patients. In conclusion, we should treat those patients with sever hyperhomocysteinemia more aggressively to lower the risk of cardiovascular diseases.