Elevated Serum Homocysteine Associated with Distal Type of Single Small Subcortical Infarction

Title:Elevated Serum Homocysteine Associated with Distal Type of Single Small Subcortical Infarction

Volume: 17 Issue: 5

Author(s): Conghui Liu, Yuan Gao, Bo Song, Yunchao Wang, Lulu Pei, Sangsang Li, Yuming Xu*Yusheng Li*

Affiliation:

• Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan,China

• Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan,China

Keywords: Single Small Subcortical Infarction (SSSI), lenticulostriate artery (LSA), homocysteine (Hcy), cerebral small vessel disease (CSVD), atherosclerosis, white matter hyperintensities (WMHs).

Abstract:

Objective: The aim of this investigation was to examine the association between the serum homocysteine (Hcy) level and the distal single small subcortical infarction (dSSSI).

Methods: Consecutive patients were prospectively recruited in a registered hospital-based ischemic stroke database. Baseline characteristics and risk factors of single small subcortical infarction (SSSI), including the serum Hcy level, were assessed. The SSSI located in the lenticulostriate artery (LSA) territory was divided into proximal single small subcortical infarction (pSSSI) and dSSSI based on a standard template on axial diffusion-weighted imaging (DWI). The association between the serum Hcy level and dSSSI was analysed by multivariate logistic regression analysis.

Results: Out of 3,247 patients, a total of 572 patients were included in the final analysis. We found that dSSSI had a higher serum Hcy level than pSSSI. Elevated Hcy level was independently correlated with dSSSI. Compared with the lowest quartile, the upper quartiles of Hcy level were independently associated with dSSSI, the odds ratio for the second quartile was 1.748 (95%CI 1.019 to 3.000), 1.824 (95% CI 1.060 to 3.140) for the third quartile, and 2.010 (95% CI 1.155 to 3.497) for the fourth quartile. The restricted cubic spline showed that the higher level of Hcy, the greater risk of developing dSSSI.

Conclusion: The dSSSI shows higher serum Hcy level than pSSSI. Elevated serum Hcy is more closely related to dSSSI. In the future, the effectiveness of Hcy-lowering therapy for dSSSI needs to be explored by further clinical studies.

Cite this article as:

Liu Conghui , Gao Yuan, Song Bo , Wang Yunchao, Pei Lulu , Li Sangsang , Xu Yuming *, Li Yusheng *, Elevated Serum Homocysteine Associated with Distal Type of Single Small Subcortical Infarction, Current Neurovascular Research 2020; 17 (5) . https://dx.doi.org/10.2174/1567202617666201029145824