Premium
Hyperhomocysteinemia in liver transplant recipients: Prevalence and multivariate analysis of predisposing factors
Author(s) -
Herrero J. Ignacio,
Quiroga Jorge,
Sangro Bruno,
Beloqui Oscar,
Pardo Fernando,
Cienfuegos Javier A.,
Prieto Jesús
Publication year - 2000
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2000.7571
Subject(s) - hyperhomocysteinemia , medicine , homocysteine , gastroenterology , creatinine , renal function , liver transplantation , liver function tests , liver function , risk factor , diabetes mellitus , univariate analysis , liver disease , transplantation , endocrinology , multivariate analysis
Liver transplant recipients have an increased risk for cardiovascular disease because of a high incidence of obesity, arterial hypertension, diabetes mellitus, and hyperlipidemia. Hyperhomocysteinemia has been found to be an important risk factor for cardiovascular disease in large studies. Fasting serum levels of homocysteine were measured in 105 liver transplant recipients, and hyperhomocysteinemia was defined as a fasting serum homocysteine level greater than 13 μmol/L. Patients with versus without hyperhomocysteinemia were compared. The possible association of hyperhomocysteinemia with age, sex, cause of liver disease, time elapsed since liver transplantation, immunosuppressive therapy, folic acid level, liver function test results, renal function, and other cardiovascular risk factors was investigated. Patients with serum homocysteine levels greater than 15 μmol/L were treated with folic acid, 10 mg/d, and serum homocysteine levels were measured again 1 to 3 months later in 10 patients. Hyperhomocysteinemia was detected in 28 patients (27%). In univariate analysis, it was associated with hepatitis C virus infection, treatment with mycophenolate mofetil, and greater serum levels of alkaline phosphatase, γ‐glutamyl transpeptidase, urea, and creatinine. In multivariate analysis, only greater serum levels of creatinine ( P = .006) were associated with hyperhomocysteinemia. Treatment with folic acid resulted in a decrease in fasting serum homocysteine levels in 9 of the 10 patients tested ( P = .01). Hyperhomocystinemia, associated with renal dysfunction, is a frequent finding in liver transplant recipients. Treatment with folic acid may reduce fasting homocysteine levels.