ACTA FAC MED NAISS 2023;40(1):13-21 |
Review article
UDC:
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
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