The Evaluation of the Clinical Significance and the Normal Reference Range of the Plasma Homocysteine

Hong, Ki Sook; Chung, Ick Mo

Abstract

BACKGROUND: The cardiovascular diseases are a major cause of the mortality in Korean. The homocysteine(HCY) was accepted as a risk factor of the cardiovascular disease, recently. We estimate the normal reference range of the plasma HCY according to the age and sex, and the clinical significance in the cardiovascular disease.
METHODS
Blood from the 57 healthy people who are 34 women and 23 men(39-72 years old) and 26 patients(25-75 years old) who are diagnosed 8 stable angina, 10 unstable angina, 7 acute myocardial infarction and 1 old myocardial infarction was drawn into EDTA vacutainer tube. The HCY concentration was measured by the automated fluorescence polarizing immunoassay(FPIA, IMx, Abbott, USA).
RESULTS
Inter- and intra-assay coefficient of variations(CVs) ranged from 0.7% to 2.8% and from 1.1% to 1.6%, respectively. Low detection limits showed 0.05+/-0.08 micromol/L. The recovery rates were 98.6-99.9%. The mean plasma HCY concentration(M+/-SD) of the healthy people was 7.9+/-2.11 micromol/L and was increased with aging. The mean plasma HCY concentration in men was significantly higher than that in women(7.2 vs. 8.8 micromol/L, P=0.008). In the coronary artery disease group(CAD), the mean values were 13.1+/-13.18 micromol/L and the median value 8.0micromol/L. After excluding 3SD outliers, the mean values were 9.0+/-2.83 micromol/L(P=0.08 to the healthy group). In CAD, the ratio over the cut-off value of total cholesterol, HDL-cholesterol and triglyceride were 42.3%, 34.6%, and 26.9%, respectively, the ratio above the HCY 15 micromol/L was 15.4% which was the same positivity in LDL-cholesterol.
CONCLUSIONS
The plasma HCY in the normal control group was significantly increased with aging and was shown higher in men than in women. In CAD, the value was also increased more than normal control. Now multicenter study is needed in order to get the normal range of Korean to diagnosis, treatment and management of the cardiovascular disease.