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Crit Care Med. 2000 Apr;28(4):991-5.

High prevalence of hyperhomocysteinemia in critically ill patients.

Author information

1
Universitätsklinik für Innere Medizin III, Universität Wien, Vienna, Austria.

Abstract

OBJECTIVE:

To test the hypothesis that the prevalence of hyperhomocysteinemia is increased in critically ill patients and correlates with disease severity and mortality in these patients.

DESIGN:

A prospective study.

SETTING:

Three medical intensive care units at the University of vienna Medical School serving both medical and surgical patients.

PATIENTS:

All consecutive admissions (n = 56) during a period of 4 wks. A total of 112 age- and gender-matched healthy individuals constituted the control group.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Blood samples were drawn within 24 hrs after admission for analysis of total homocysteine (tHcy), folate, vitamin B6 levels, and vitamin B12 levels as well as to identify the 677C-->T polymorphism in the gene coding for the enzyme 5,10-methylenetetrahydrofolate reductase. Acute Physiology and Chronic Health Evaluation III scores at admission and 24 hrs after admission as well as 30-day survival were documented in all patients. Hyperhomocysteinemia was more prevalent in critically ill patients (16.1%; 95% confidence interval, 7.6% to 28.3%) compared with age- and gender-matched healthy individuals (5.4%; 95% confidence interval, 2.0% to 11.3%; chi-square test; p = .022). There was no difference in tHcy plasma concentrations in the first 24 hrs after admission to an intensive care unit between survivors and nonsurvivors. The 5,10-methylenetetrahydrofolate reductase 677C-->T polymorphism had no influence on tHcy levels and survival of intensive care unit patients.

CONCLUSIONS:

The prevalence of hyperhomocysteinemia is increased in critically ill patients compared to age- and gender-matched healthy individuals. The clinical significance of this finding remains to be determined.

PMID:
10809271
[Indexed for MEDLINE]

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