ACTA FAC MED NAISS 2023;40(1):13-21

Review article

UDC: 616-008:577.122.3]:616.1
DOI: 10.5937/AFMNAI40-36742

                Running title: Prevention of Hyperhomocysteinemia

 

Current Knowledge on the Prevention of Hyperhomocysteinemia
as a Risk Factor for Cardiovascular Diseases

Bojana Miladinović1, Vladana Živković2, Dušanka Kitić1, Maja Nikolić3,4

 

1Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia
2University of Niš, Faculty of Medicine, Niš, Serbia
3University of Niš, Faculty of Medicine, Department of Hygiene with Medical Ecology, Niš, Serbia
4Public Health Institute Niš, Niš, Serbia

 

SUMMARY

 

Introduction. Homocysteine is an amino acid that is formed in the metabolism of methionine as the quantitatively most important metabolite. Its chemical structure has been known for 90 years and its biological roles are still being investigated. Under normal conditions, homocysteine is present in plasma at the concentration of 5 - 9 μmol/l. When the cell capacity for homocysteine is reached, it is transported to the extracellular space, until the intracellular level is normalized. If the cell is unable to reach the required levels of homocysteine, it accumulates in the blood and hyperhomocysteinemia occurs.

Discussion. It has been determined that many factors, such as congenital enzyme deficiency, age, sex, inadequate diet (vitamin B complex deficiency) increase the level of homocysteine in the blood. Impaired kidney function, diabetes, hyperthyroidism, as well as many medications, can have an effect on homecysteinemia. Increased concentration of homocysteine in the blood accelerates the process of atherosclerosis by several different mechanisms and represents an independent risk factor for the occurrence of cardiovascular diseases and adverse cerebral events. The prevalence of hyperhomocysteinemia is estimated at 5% in the general population and 13 - 47% among patients with symptomatic atherosclerotic vascular disease.

Conclusion. For these reasons, the level of homocysteine in the blood should be monitored and corrective measures should be implemented, which include sufficient intake of folic acid, vitamins B12 and B6, in doses that depend on fasting homocysteine levels and after the methionine load test.

 

Keywords: homocysteine, prevention, atherosclerosis, chronic noncommunicable diseases

 

Corresponding author:

Maja Nikolić

e-mail: mani@ni.ac.rs