Serum homocystein level and vascular thrombosis in patients with Behçet disease

Abstract

Objective: Behçet disease (BD) is a multisystemic inflammatory disorder of unknown aetiology that in some patients will present with thrombosis. However, the mechanism of thrombosis is unknown. In this study, we investigate the correlation between homocystein level in BD patients with vascular thrombosis. Patient and methods:One hundred and twenty-three patients who fullfilled the criteria of the International Study Group for BD (n = 77, 62.6% females and n = 46, 37.4% males) were included in this cross-sectional study. Patients were divided into two groups: with thrombosis (n = 23, 18.7%) and without thrombosis (n = 100, 81.3%). All patients underwent colour Doppler sonography for documentation of vascular thrombosis. Serum homocystein was measured by ELISA method, folate and B12 were measured by radioimmunoassay.Results: Patients with vascular involvement, vein and/or arterial thrombosis were enrolled. Mean serum homocystein level was significantly higher in the group with thrombosis (P = 0.012) and in male patients than females (18.10 ± 5.5 vs. 13.21 ± 4.1). In multiple regression analysis, the only factors that persisted for thrombosis were age and sex (P = 0.02, P < 0.0001, respectively). Serum folate and B12 were not correlated with thrombosis in BD. Conclusions:In this study, we found that mean homocystein levels were higher in BD patients with thrombosis and it may have a role in the process of thrombosis in BD.

Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

“…38 With regard to vascular involvement in general, that is, analyzing articles dealing with the full spectrum of thrombophlebitis, venous/arterial occlusions, and aneurysms in different districts, the effect size of plasma HC favored the vascular group though the heterogeneity decreased (within the same range) by restricting the analysis to studies dealing only with VT; however, the heterogeneity dropped to moderate maintaining the same effect size, once the two outlier studies with the highest HC in the thrombotic group were omitted. 30 67 A higher plasma HC concentration in thrombotic BD patients had been noted in a previous meta-analysis ( p < 0.0001, I 2 = 48%), 9 but the authors did not discriminate between venous and arterial occlusions 17 19 20 29 63 64 and their effect size is comparable to our overall vascular group with medium heterogeneity. We also detected a strong effect size of plasma HC for patients with ocular involvement, with moderate to low heterogeneity.…”

“…The initial database search yielded 184 entries plus another 2 found on Google; following the screening and exclusion processes indicated in Fig. 1 , we identified 53 studies (52 full papers and one abstract) 6 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 examining the relationship between HC and BD (48 case–control and 5 cohort studies) that were included in our systematic review and meta-analysis ( Table 1 ). Of the 48 case–control studies, one did not report the mean ages of participants 22 and another did not report gender data (both full papers), 31 whereas a third (in abstract form only) did not report the mean ages and the gender data 40 : two missing data each for mean age of participants and for male/female ratio (4.1%) are unlikely to compromise the results of the sensitivity analysis; of the five cohort studies one did not report the mean age of participants.…”

Homocysteine in Vascular Behçet Disease

“…However, the association between hcy and thrombosis remains statistically significant in many of the studies that considered in the analysis the impact of other potential risk factors, such as male sex or smoking habits. 8,12,25,[27][28][29][30]32,34,35 Furthermore, hcy appeared to be a risk factor for thrombosis even in the 2 studies in which immunosuppressive therapy had been withdrawn before measurement. 28,36 Third, 3 studies 4,25,28 have included also some patients with aneurysms as vascular manifestations.…”

“…Eleven studies, 4,8,12,24,25,[27][28][29][30]32,36 for a total of 236 patients with thrombosis and 518 patients without thrombosis, were included in the metaanalysis. In these patients, mean levels of hcy were significantly higher in patients with thrombosis compared with patients without thrombosis (mean difference 3.30 mol/L; 95% CI 2.09 to 4.51; Figure 3), again suggesting an association between the high levels of hcy and the development of thrombosis.…”

Role of Serum Homocysteine and Venous Doppler Ultrasonography in Venous Insufficiency in Behcet's Disease at Zagazig University Hospitals

“…Although involvement of all types and sizes of blood vessels may occur, in the lower extremity venous thrombosis predominates. Endothelial injury due to vascular inflammation is considered to be an important factor of thrombosis [3].…”