Hyperhomocysteinemia Marks Cardiovascular Disease Risk in Rheumatoid...

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Hyperhomocysteinemia Marks Cardiovascular Disease Risk in Rheumatoid

Arthritis

NEW YORK (Reuters Health) Sept 09 - In a study of Chilean patients with

rheumatoid arthritis (RA), homocysteine level was the only cardiovascular

risk marker present at significantly higher levels in patients than in age-

and sex-matched control subjects.

Prompted by the increased mortality rate in patients with rheumatoid

arthritis--mainly due to cardiovascular disease--a team of researchers from

Pontificia Universidad Cat lica de Chile in Santiago, led by Dr. Marcela

Cisternas, studied 54 patients with RA and 32 control subjects. They

describe their findings in the journal of Rheumatology for August.

The median homocysteine level was 10.0 mol/L in patients versus 8.3 mol/L in

control subjects (p = 0.001). When the investigators excluded subjects older

than 60, the differences remained significant (p = 0.003). In the two RA

patients with cerebrovascular disease and the two with stable angina, median

homocysteine was 15.1 mol/L compared with 9.9 mol/L in patients with no

history of atherosclerotic events (p = 0.001).

The researchers observed no correlation between levels of homocysteine and C

reactive protein, or methotrexate therapy independent of folate

supplementation.

The frequencies of traditional cardiovascular risk factors, such as

hypertension, diabetes, family history and obesity, were similar in patients

and controls; in fact, the number of risk factors per subject was higher in

controls. The ratios of total and LDL cholesterol to HDL cholesterol were

significantly lower in patients.

Dr. Cisternas' team suggests that hyperhomocysteinemia in RA could be due to

enzymatic defects in homocysteine metabolism due to chronic illness,

disturbances of the GI system, or impaired renal function.

J Rheumatol 2002;29:1619-1622.