Introduction: Polycystic ovarian syndrome (PCOS) is a common disease among women in fertility ages and cause severe insulin resistance.Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome. This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients.Materials and Methods: This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normoovulatory controls were reviewed for fasting glucose, insulin, HOMOCYSTEINE, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) plasma levels in the blood sample of the 3rd day of their menstrual cycle. Insulin resistance was determined with the fasting glucose (mmol/L) to insulin (mIU/L) ratio and HOMA-IR.Independent-samples T test and linear regression test were utilized to analyze the obtained data.Results: HOMOCYSTEINE levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant (IR) (LogHOMA-IR≥0.57) and non-insulin resistant (NIR) patients. The IR group had significantly higher HOMOCYSTEINE (p value=0.02), fasting insulin and glucose levels (p-value<0.001) rather than NIR group.Conclusion: PCOS patients have a leaning toward hyperhomocysteinaemia regardless of insulin resistance. Regarding resistance indices, insulin resistance is also common in them. There is an association found between insulin resistance and hyperhomocysteinaemia in PCOS patients.

Elevated total plasma HOMOCYSTEINE (they) levels constitute a risk factor for coronary artery disease (CAD). A possible relationship was investigated between admission plasma HOMOCYSTEINE level and the angiographic severity and extension of coronary artery disease in patients with CAD. This study looks at the relationship between total plasma HOMOCYSTEINE and severity of coronary artery disease. From April 2006 to December 2006, 100 consecutive patients (65 male and 35 female) that referred to our institute for coronary artery bypass graft surgery enrolled. Fasting blood samples for HOMOCYSTEINE were obtained on admission. Plasma HOMOCYSTEINE concentration was measured with high-performance liquid chromatography (HPLC). Our patients presented in Group 1, total plasma HOMOCYSTEINE >12 micromoles per liter and Group 2, total plasma HOMOCYSTEINE =<12 micromoles per liter. Vessel score assessed the number of vessels with significant stenosis and grading of atherosclerosis (Extent Score) was intended to assess the atherosclerotic involvement of the entire arterial length and circumscribe. Our study was shown age > 60 years was correlated with high they, but gender, hypertension, history of smoking, hypercholesterolemia, family history, and diabetes mellitus were not statistically difference between two groups. A positive correlation was found between abnormal plasma HOMOCYSTEINE level and vessel score (r = 0.35; p=0.002). Moreover, a positive correlation was also found with extent score (r = 0.46; p =0.002). As results of these scoring, there was a better correlation between the they level and the extent of CAD when compared with the vessel score (r = 0.68, p < 0.001). Abnormal elevated HOMOCYSTEINE levels in patients with coronary artery disease correlated with the extent of atherosclerotic disease.

BACKGROUND: The role of novel biomarkers like homocystein as a risk factor of coronary artery disease (CAD) is being increasingly recognized. Since there is a marked geographical variation in plasma homocystein concentration and because of importance of hyperHOMOCYSTEINEmia as a CAD risk factor and due to the paucity of studies in Iran evaluating this risk factor in our population, we evaluated the association between plasma total HOMOCYSTEINE (tHcy) concentration and CAD risk in Iranian population.METHODS: In a case-control study, we compared the level of tHcy of forty five patients of angiographically proven CAD with forty five subjects without CAD as control group matched for age and gender. The patients with diabetes, hypertension, thyroid dysfunction, chronic renal failure, hyperlipidemia and obesity and other conventional CAD risk factors were excluded from the study. Plasma tHcy was measured using immunoturbidimetry. The results were compared between groups using student t test.RESULTS: CAD patients had significantly higher mean plasma tHcy than control group (17.1±5.3 versus 14.2±3.8, P=0.004).CONCLUSION: This study denoted that high plasma HOMOCYSTEINE concentration was associated to CAD risk in Iranian people.

Elevated total plasma HOMOCYSTEINE (tHcy) levels constitute a risk factor for coronary artery disease (CAD). A possible relationship was investigated between admission plasma HOMOCYSTEINE level and the angiographic severity and extension of coronary artery disease in patients with CAD. This study looks at the relationship between total plasma HOMOCYSTEINE and severity of coronary artery disease. From April 2006 to December 2006, 100 consecutive patients (65 male and 35 female) that referred to our institute for coronary artery bypass graft surgery enrolled. Fasting blood samples for HOMOCYSTEINE were obtained on admission. Plasma HOMOCYSTEINE concentration was measured with high-performance liquid chromatography (HPLC). Our patients presented in Group 1, total plasma HOMOCYSTEINE >12 micromoles per liter and Group 2, total plasma HOMOCYSTEINE =<12 micromoles per liter. Vessel score assessed the number of vessels with significant stenosis and grading of atherosclerosis (Extent Score) was intended to assess the atherosclerotic involvement of the entire arterial length and circumscribe. Our study was shown age > 60 years was correlated with high tHcy, but gender, hypertension, history of smoking, hypercholesterolemia, family history, and diabetes mellitus were not statistically difference between two groups. A positive correlation was found between abnormal plasma HOMOCYSTEINE level and vessel score (r=0.35; p=0.002). Moreover, a positive correlation was also found with extent score (r=0.46; p=0.002). As results of these scoring, there was a better correlation between the tHcy level and the extent of CAD when compared with the vessel score (r=0.68, p<0.001). Abnormal elevated HOMOCYSTEINE levels in patients with coronary artery disease correlated with the extent of atherosclerotic disease.

Aim: To find the possible role of plasma HOMOCYSTEINE level as a contributing factor in venous and arterial thrombosis in patients with Behcet’s disease (BD).Methods: In a case control study, two groups of BD patients were included: 47 with thrombosis and 49 without thrombosis. All patients fulfilled the International Study Group Criteria for BD and the confirming diagnostic procedures for vascular thrombosis were either Doppler sonography or angiography. Forty-nine controls were selected by consecutive sampling among age and sex matched healthy subjects. Plasma HOMOCYSTEINE level was measured by ELISA in all. The clinical and laboratory characteristics of the disease were compared between the two groups of BD patients. Comparisons were done by ANOVA and Chi square tests; correlations were analyzed with Pearson test.Results: The mean plasma HOMOCYSTEINE level was significantly higher in BD patients (14.9±13.9 mMol/L) than in healthy controls (9.9±6.7 mMol/L), P<0.02. The difference was also signi_cant when comparing the three groups by ANOVA: BD patients with thrombosis (24.2±13.2 mMol/L), BD patients without thrombosis (5.9±7.0 mMol/L), and healthy controls (P<0.0001). We found no correlation between plasma HOMOCYSTEINE level and any organ involvement other than thrombosis. The mean plasma HOMOCYSTEINE level was lower in HLA-B51 positive BD patients (11.6±12.1 vs. 21.7±16.3 mMol/L, P<0.05), but the difference was not significant in those with thrombosis (20.9±13.2 vs. 29.5±12.7 mMol/L, P=0.18). Conclusion: Hyperhomocysteinaemia may be an independent risk factor for vascular thrombosis in patients with BD. This is the first study showing a negative correlation between HLA-B51 and plasma HOMOCYSTEINE level.

This refers to Dr. Ziaee et al.’s manuscript published in your valuable journal about serum HOMOCYSTEINE level entitled “Effects of folic acid plus levothyroxine on serum HOMOCYSTEINE level in hypothyroidism”. In this clinical trial study the efficacy of concomitant administration of folic acid and levothyroxine versus single levothyroxine prescription on serum HOMOCYSTEINE level was compared with hypothyroid patients. The authors concluded that “levothyroxine can decrease serum HOMOCYSTEINE level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum HOMOCYSTEINE level more successfully (1).”