Başkent Üniversitesi Makaleler

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Subject: search.filters.subject.Homocysteine

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    Role of Folic Acid in Atherosclerosis After Kidney Transplant: A Double-blind, Randomized, Placebo-controlled Clinical Trial
    (Başkent Üniversitesi, 2009-03) Farjad, Reza; Einollahi, Behzad; Nafar, Mohsen; Khatami, Fatemeh; Kardavani, Babak; Farhangi, Soudabeh; Kalantar, Akbar; Firouzan, Ahmad; Pour-Reza-Gholi, Fatemeh
    Objectives: We investigated the effects of folic acid supplementation on plasma total homocysteine levels and carotid intima-media thickness after kidney transplant. Materials and Methods: Sixty patients who had undergone a kidney transplant were studied in this double-blind, randomized, placebo-controlled clinical trial. Those subjects were randomized to receive either 5 mg/d of oral folic acid or an equivalent dosage of placebo. The main outcome variables were the plasma total homocysteine level and carotid intima-media thickness (determined via B-mode sonography) at baseline and 2, 4, and 6 months after kidney transplant. We used independent and paired sample t tests for data analysis. Results: The mean age of the patients was 40.9 ± 10 years, and 32 of those subjects (58.2%) were men. In the control group, the plasma total homocysteine levels were 19 µmol/L at baseline, 18.7 µmol/L after 2 months, 19.3 µmol/L after 4 months, and 20 µmol/L after 6 months; and the carotid intima-media thickness measurements were 0.81 mm at baseline, 0.82 mm after 2 months, 0.84 mm after 4 months, and 0.85 mm after 6 months. In the folic acid group, the plasma total homocysteine levels were 18.5 µmol/L at baseline, 4.7 µmol/L after 2 months, 12.9 µmol/L after 4 months, and 10.9 µmol/L after 6 months; and the carotid intima-media thickness measurements were 0.73 mm at baseline, 0.73 mm after 2 months, 0.72 mm after 4 months, and 0.71 mm after 6 months. Conclusions: Folic acid supplementation reduces both the plasma total homocysteine level and carotid intima-media thickness shortly after kidney transplant.
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    Determinants of Fasting Total Serum Homocysteine Levels in Liver Transplant Recipients
    (Başkent Üniversitesi, 2006-06) Akoglu, Bora; Wondra, Kathrin; Caspary, Wolfgang F.; Dominik, Faust
    Objectives: Homocysteine (HCY) is a sulfur-containing amino acid considered to be a marker for a relative folate deficiency. Hyperhomocysteinemia is a known risk factor for development of cardiovascular disease, vascular dementia, depression, and possibly some carcinogeneses. Liver transplant recipients have an increased risk for cardiovascular disease because of a high incidence of obesity, arterial hypertension, diabetes mellitus, and hyperlipidemia. The aim of this study is to elucidate the determinants for hyperhomocysteinemia as an additional risk factor in these patients. Materials and Methods: Seventy stable liver transplant recipients, 48 men (mean age, 50 ± 11 years) and 22 women (mean age, 52 ± 13 years) had their serum homocysteine levels tested after orthotopic liver transplantation. For mainstay immunosuppression, 53 patients were treated with tacrolimus, 10 with cyclosporine, 3 with mycophenolate mofetil, and 4 with sirolimus. Fasting blood samples were obtained and analyzed immediately (within 1 hour) for total serum homocysteine by high-performance liquid chromatography. Results: In all patients, mean homocysteine levels were 22.7 ± 14 µmol/L (normal range, 9-15 µmol/L). Forty-six patients were found to have homocysteine levels > 15 µmol/L, and all 70 recipients had homocysteine levels > 9 µmol/mL. In our patients, increased homocysteine levels correlated well with body mass index and renal function. Homocysteine levels in patients receiving cyclosporine were higher than those in patients receiving tacrolimus (22.3 ± 6 vs 17.9 ± 12 µmol/L, P < .05). Conclusions: Overall, homocysteine levels are significantly increased in liver transplant recipients. Homocysteine levels correlate well with obesity, renal function, and the particular immunosuppressant protocol. Therefore, a specific treatment for patients after liver transplantation (eg, one with folates) might reduce the risk of complications resulting from hyperhomocysteinemia.