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RESEARCH ARTICLE

SA JOURNAL OF DIABETES & VASCULAR DISEASE

36

VOLUME 14 NUMBER 1 • JULY 2017

We determined homocysteine levels in 39 hypertriglycerid-

aemic and 38 hypercholesterolaemic subjects. No statistically

significant association was found between homocysteine and

hypertriglyceridaemia (

p

= 0.442) and hypercholesterolaemia

(

p

= 0.480) (Table 2). Three hypertriglyceridaemic subjects had

hyperhomocysteinaemia (7.7%) while five hypercholesterolaemic

subjects had hyperhomocysteinaemia (13.1%) (Table 3). The

insignificant association was supported by the findings of Vayá

et al

.

15

However, Nabipour

et al

. found significant associations

between lower HDL cholesterol and high homocysteine levels.

20

Homocysteine levels were estimated in 72 subjects with high

systolic blood pressure and 84 subjects with high diastolic blood

pressure, a total of 156 hypertensive subjects. Homocysteine

was statistically significantly associated with both systolic (

p

=

0.002) and diastolic (

p

= 0.033) blood pressure (Table 2). Eleven

hypersystolic subjects (15.3%) were hyperhomocysteinaemic while

16 hyperdiastolic subjects (19%) were hyperhomocysteinaemic

(Table 3). These findings are supported by various researchers, who

found hyperhomocysteinaemia to be significantly associated with

hypertension.

10,20-22

The association of homocysteine with hypertension may be

due to the fact that homocysteine induces arteriolar constriction,

renal dysfunction and increased sodium absorption, with

increased arteriolar stiffness.

18

It increases oxidative stress, which

causes oxidative injury to the vascular endothelium, diminishing

vasodilation by nitric oxide. It also stimulates the proliferation of

vascular smooth muscle cells and alters the elastic properties of the

vascular wall, leading to an increase in hypertension.

18

On the basis of our findings, the large body of supporting

evidence and the mechanisms of association, homocysteine levels

can be used to track blood pressure. Hyperhomocysteinaemia

reflects a causal effect rather than being concomitant to elevated

blood pressure.

In our present study we evaluated 95 obese subjects for

homocysteine association with obesity. We found a borderline

association (

p

= 0.080) (Table 2). Ten obese subjects were

hyperhomocysteinaemic (Table 3). The association was partly

supported by other researchers, who found increased prevalence

of hyperhomocysteinaemia in obese subjects.

10,15,36

Depending on

age and the pattern of obesity, homocysteine may be significantly

associated with obesity. This viewpoint is supported by the findings

of Vayá

et al

.

15

and El-Sammak

et al

.

37

Conclusion

We found no statistically significant relationship between baseline

plasma homocysteine levels and hyperglycaemia, dyslipidaemia

and obesity. There was, however, a significant relationship between

homocysteine levels and hypertension. According to our cross-

sectional study, high baseline plasma homocysteine level is a major

risk factor for hypertension and can be used in blood pressure

tracking in a large, community-based sample. The study supported

the hypothesis that plasma homocysteine is casually related to

elevated blood pressure.

Additional prospective investigations are recommended to

confirm these findings. A study evaluating the association between

plasma homocysteine levels and hyperglycaemia after a few days

of treatment withdrawal would probably yield better and more

reliable results. Unfortunately, withdrawing treatment from diabetic

Table 3.

Prevalence of hyperhomocysteinaemia with hyperglycae-

mia, hypertriglyceridaemia, hypercholesterolaemia, hypertension and

obesity

Hyperhomocystein-

aemia

Metabolic disorder

Prevalence

rate (%)

n

= 3

Hyperglycaemia (

n

= 45)

6.7

n

= 3

Hypertriglyceridaemia (

n

= 39)

7.7

n

= 5

Hypercholesterolaemia (

n

= 38)

13.1

n

= 11

Systolic blood pressure (

n

= 72)

15.3

n

= 16

Diastolic blood pressure (

n

= 84)

19.0

n

= 10

Obesity (

n

= 95)

10.5

Prevalence of hyperhomocysteinaemia = number of hyperhomocysteinaemic

subjects per number of subjects in the respective components of the metabolic

syndrome.