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Eur J Vasc Endovasc Surg. 2004 Jan;27(1):75-9.

Abdominal aortic aneurysm and its correlation to plasma homocysteine, and vitamins.

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Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, Rhondda Cynon Taff, S Wales, UK.



Hyperhomocysteinemia is a recognised independent risk factor in the genesis of atherosclerotic diseases. However, very little is known about the relationship between homocysteine and abdominal aortic aneurysm (AAA). Vitamins, namely B12 and folic acid have been implicated in the regulation of plasma homocysteine levels. However, there has been no prospective study that has analysed the relationship of AAA and plasma homocysteine in light of serum vitamin levels.


To study the relationship between plasma homocysteine, serum B12 and folic acid levels, and AAA.


Case control study including 38 AAA patients and 36 controls. Fasting homocysteine, B12 and folic acid were determined in serum separated within 1 h of blood collection using a fluorescence polarisation immunoassay technique (FPIA).


Twenty-six (68%) of the AAA patients had elevated levels of homocysteine compared to 2 (6%) in the case control group. The mean homocysteine level in the AAA group was 19.4 micromol/L (SE +/- 1.1) (95% CI 17.17-21.65) and in the control group was 10.9 micromol/L (SE +/- 1) (95% CI 9.95-11.88) (p<0.001). Mean vitamin B12 levels in the AAA and the controls was 332.11 pg/L (SE +/- 16.44) and 414.33 pg/L (SE +/- 19.72), respectively (p<0.004). Mean folic acid in the AAA was 8.02 (SE +/- 0.71) and the control was 9.8 etagm/L (SE +/- 0.69), (ns).


This study confirms significantly higher levels of plasma homocysteine in AAA patients but lower levels of B12. Use of supplemental vitamins that should lower plasma homocysteine may modify vascular disease progression. Clinical trials in this direction are warranted.

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