Serum Total Homocysteine Concentrations in Cerebral Small-Vessel Disease

Objective To study the relation between homocysteine (Hcy) levels and cerebral small-vessel disease (SVD),and atherosclerotic risk factors.Methods The subjects comprised patients with lacunar infarction (n=96)、atherothrombotic infarction (AI) (n=78)、without infarction (n=35).96 lacunar infarction were divided into subgroups:single large infarction (SLI) and multiple large infarction (MLI);Infarction with leukoaraiosis (LA) and Infarction without LA,according to brain MRI findings.The relations between tHcy and traditional atherosclerotic risk factors were analyzed.Results tHcy level in patients with infarction was higher than that in patients without infarction (P0.01),but their level had no difference between lacunar infarction and atherothrombotic infarction (P0.05).tHcy level was higher in MLI than that in SLI,which in LA than that in without LA (P0.01).Relations between tHcy and hypertension, diabetes,blood lipid,smoking were not significant.By multivariate regression and ROC analyses,tHcy (OR=1.335,Az=0.882) was an stronger marker to predict lacunar infarction,particularly with LA (OR=1.063).Conclusion Hyperhomocysteine were related to lacunar infarction and leukoaraiosis.It suggested that high level of tHcy may be important risk factor of cerebral small-vessel disease,and the mechanism involvled in cerebral infarction was still to elucidate.