Prospective study of homocysteine level in cerebrovascular disease in non diabetic patients at tertiary care centre
Introduction: Stroke is one of the major cause of morbidity, mortality and disability all over the world. There are studies which suggests that elevated serum homocysteine is an independent risk factor for stroke. Various factors have been been proposed by different studies for this. Material and methods: A prospective study was carried on 60 cerebrovascular accident patients over a period of 18 months at Gajra Raja medical college and JAH Group of hospital Gwalior from Jan 2020 to Jun 2021. Clinical information including age, sex, history of current evidence of hypertension (HTN, diabetes Mellitus (DM) , history of cardiac disease, life style, diet pattern, family history of vascular diseases were recorded for all subjects. Serum homocysteine was estimated by enzymatic method. Results: In this study of 60 patients with cerebrovascular accidents, 36 were males and 24 were female patients. Most patients were between 4th to 6th decade of life.There was no statistically significant difference between age/sex and stroke with relation to serum homocysteine. There were 18 out of 40 hypertensive patients who had hypertension. The difference was statistically significant (p value <0.05). seventeen out of 43 patients with vegetarian diet had raised homocysteine level, 5 out of other 17 patients were on mixed diet who had raised homocysteine. The difference was statistically significant (p value<0.05). Nineteen out of 39 patients with sedentary lifestyle had raised homocysteine levels and 3 out of 21 with active lifestyle had raised homocysteine levels. The difference was statistically significant (p value <0.05). Eleven patients were smokers. Out of them 04 (06%) had raised homocysteine level and 49 were nonsmoker patient. Among them, 18(30%) had raised homocysteine level. The difference was statistically insignificant. (p value >0.05). Serum homocysteine levels were elevated in cerebrovascular accident patients significantly, both in cases of infarct and hemorrhage. Further serum homocysteine levels were higher in patients with sedentary lifestyle, hypertension, vegetarian and obesity. Serum homocysteine did not show any relation with age, sex, alcohol and smoking. Conclusion: Hyperhomocysteinemia is an important risk factor for cerebrovascular accidents. Hence, it should be to investigate all cases of cerebrovascular accidents and also in those who are at risk of developingstroke.
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Copyright (c) 2022 Shilpi Sikarawar, Reema Bhushan, Ashish Kumar Patel, Sudha Iyengar
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