vitamin-b-12 and Convalescence

Homocysteine is a proposed causal risk factor for atherosclerosis, but this remains controversial. We measured fasting plasma homocysteine concentrations immediately after atherothrombotic stroke and in the convalescent period to investigate this controversy.. One hundred six patients (59 men and 47 women, mean age 57.2 [25 to 70] and 56.5 [26 to 69] years, respectively) were recruited within 24 hours of admission, and 82 patients were resampled at least 3 months later. Fasting total plasma homocysteine (tHcy) concentrations were measured by high-performance liquid chromatography.. Median tHcy in the acute phase of stroke was not significantly higher than in matched control subjects (men 9.2 [range 4.4 to 22.8] versus 8.7 [4.9 to 20] micromol/L, P:=0.09, Mann-Whitney U: test; women 8.1 [4.8 to 32.3] versus 7.6 [3.3 to 14.4] micromol/L, P:=0.58). Median plasma concentrations increased significantly in the convalescent period (from 8.5 [4.8 to 19.2] to 10.1 [4.3 to 31.5] micromol/L, P:<0.001, Wilcoxon signed rank test) and were then significantly higher than in control subjects in both men and women (P:=0.03 and 0.05, respectively, Mann-Whitney U: test). This did not appear to be explained by alteration in the known covariates red-cell folate, serum B(12), or creatinine concentrations.. Homocysteine concentrations are not elevated after recent atherothrombotic stroke but rise in the convalescent period. These data do not support the hypothesis that raised plasma homocysteine concentrations predate atherothrombotic stroke. Instead, they offer an explanation for the discrepancies between prospective and retrospective studies and suggest that elevated tHcy levels may be caused by the disease process itself.

Topics: Acute Disease; Adult; Aged; Arteriosclerosis; Brain; Case-Control Studies; Chromatography, High Pressure Liquid; Convalescence; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Intracranial Thrombosis; Lipids; Male; Middle Aged; Regression Analysis; Risk Factors; Scotland; Stroke; Stroke Rehabilitation; Tomography, X-Ray Computed; Vitamin B 12

Topics: Adrenal Glands; Adult; Aged; Clinical Trials as Topic; Convalescence; Drug Combinations; Drug Evaluation; Female; Humans; Hypotension; Liver Extracts; Male; Middle Aged; Tissue Extracts; Vitamin B 12; Vitamin B Complex

Topics: Body Height; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Cobalt Isotopes; Convalescence; Creatinine; Diarrhea; Diarrhea, Infantile; Diet Therapy; Dietary Proteins; Humans; Ileum; Infant; Infant Nutrition Disorders; Infant Nutritional Physiological Phenomena; Intrinsic Factor; Malabsorption Syndromes; Nutrition Disorders; Protein-Energy Malnutrition; Schilling Test; Vitamin B 12

Topics: Androstanes; Androstenols; Ascorbic Acid; Cobalt Isotopes; Convalescence; Cystine; Drug Synergism; Female; Genital Neoplasms, Female; Humans; Ovarian Neoplasms; Pantothenic Acid; Pyridoxine; Radioisotope Teletherapy; Thiamine; Uterine Cervical Neoplasms; Uterine Neoplasms; Vitamin A; Vitamin B 12; Vitamin B Complex

Topics: Convalescence; Ethylestrenol; Female; Humans; Iron; Male; Vitamin B 12

Topics: Body Weight; Convalescence; Gastrointestinal Diseases; Humans; Intestinal Diseases; Vitamin B 12; Vitamin B Complex