Hyperhomocysteinemia: An independent risk factor for atherosclerotic vascular disease

Abstract

Homocysteine (HCY) is a thiol-containing amino acid, toxic to the vascular endothelium, that results from the demethylation of methionine. Elevated levels of HCY are associated with an increased risk of atherosclerosis and thrombosis. High plasma HCY levels are found in homocystinuria. This genetic condition is due to metabolic defects involved in the enzymatic control of HCY metabolism. Moderate hyperhomocysteinemia is also found in 20-30% of patients with coronary and peripheral vascular disease. There are probably multiple mechanisms involved in the pathogenesis of hyperhomocysteinemia in these patients, including heterozygosity for metabolic defects involved in the enzymatic control of HCY, as well as dietary factors. Subjects to be looked into are as follows: What is the exact relationship between hyperhomocysteinemia and vascular disease? Is this relation independent of other risk factors? Can the treatment of hyperhomocysteinemia slow down the process of atherosclerosis?