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Hyperhomocysteinemia Is Associated with Venous Thrombosis in Patients with Short Bowel Syndrome
Author(s) -
Compher Charlene W.,
Kinosian Bruce P.,
EvansStoner Nancy,
Huzinec Jill,
Buzby Gordon P.
Publication year - 2001
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860710102500101
Subject(s) - medicine , hyperhomocysteinemia , vitamin b12 , venous thrombosis , thrombosis , homocysteine , malabsorption , short bowel syndrome , gastroenterology , surgery , parenteral nutrition
Background: Hyperhomocysteinemia is associated with venous thrombosis and vitamin deficiency. Patients with short bowel syndrome have increased risk of venous thrombosis due to central catheters, and of vitamin deficiency due to malabsorption. The current investigation was designed to evaluate the relationship between history of venous thrombosis and current hyperhomocystinemia and vitamin deficiency in patients with short bowel syndrome. Methods: Plasma total homocysteine (tHcy), serum vitamin B 12 , folate, B 6 , and methylmalonic acid (MMA) were measured. Venous thrombosis was documented by venogram or ultrasound. Results: Ten of 17 patients had venous thromboses, including 17 of 38 observed superior and 12 of 26 inferior veins. Total homocysteine was correlated with number of thromboses. The relative risk of multiple thromboses in the highest tHcy tertile was 3.6‐fold that of the lowest tertile. Vitamin B 12 and folate levels were within normal limits, but B 12 deficiency by MMA or tHcy level was apparent in 7 patients. Vitamin‐deficient patients had higher tHcy and MMA than those without deficiency. Conclusions: Venous thrombosis in patients with short bowel syndrome is related to hyperhomocystinemia, which is also related to vitamin B 12 deficiency, not detected by serum vitamin B 12 concentration. Whether treatment of vitamin deficiencies and associated reduction in tHcy will reduce recurrent venous thrombosis in these patients is not known. (Journal of Parenteral and Enteral Nutrition 25: 1–8, 2001)