Genderspecific differences of homocysteinemia and its influence on oxidative stress parameters and endothelial function in patients with stable forms of coronary heart disease

One of the early manifestations of atherosclerotic lesions is endothelial dysfunction developing under conditions of reduced nitric oxide production, hyperhomocysteinemia, and oxidative stress. Bearing in mind high interest shown to gender-specific peculiarities of cardiovascular diseases, it appears important to study the relationship between these features in men and women with stable forms of coronary heart disease (CHD). Material and methods. The study included 102 patients with sable COPD divided into 2 groups (men and women) and 40 practically healthy subjects. Plasma homocysteine levels were measured by high-resolution gas-liquid chromatography with fluorescent detector with the use of Eko-Novo Milikhrom A-02 apparatus (Russia). Standard methods were used to measure plasma lipids, products of their peroxidation (dienic conjugates and products reacting with 2-thibarbituric acid), antioxidant enzymes (glutathioneperoxidase, and superoxide dismutase in erythrocytes), activity of the ceruloplasmin-transferrin system (by electron paramagnetic resonance method), final metabolites of nitric oxide using the Gries reaction. The endothelial function was studies by ultrasound with the evaluation of endothelium-dependent vasodilation. Results. The mean levels of homocystein and final NO metabolites in men with stable CHD were 1.5 times higher (р=0,01) and 12% lower (р = 0,03) than in women. Endothelial dysfunction was more pronounced in men (р< 0,05). Conclusion. Patients with CHD exhibit significant gender-specific differences in blood levels of of homocystein and final NO metabolites as well as in endothelium-dependent vasoreactivity associated with intensification of lipid peroxidation and impairment of antioxidative protection.