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Determinants of Increased Plasma Homocysteine in 221 Stable Liver Transplant Patients

Departments of
¹ Internal Medicine (Atherosclerosis Unit),
² Surgery, and
³ Biochemistry, and the
⁴ Epidemiology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain

^aaddress correspondence to this author at: Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Ctra. Andalucía km 5.4, Madrid 28041, Spain; fax 34-1-3908358, e-mail cfmiranda@inicia.es

The plasma homocysteine concentration (tHcy) is affected by genetic and physiologic determinants, by life-style (including nutritional deficiencies of vitamins B₆, B₁₂, and folate), diseases, and by some drugs (1)(2)(3)(4). Moderately increased tHcy is considered an independent risk factor for atherosclerotic disease in the coronary, cerebral, and peripheral arteries (1)(2) and a significant predictor of mortality in patients with coronary disease (5)(6). In renal and cardiac transplant recipients, tHcy is markedly increased and is associated with impaired renal function (7)(8)(9)(10)(11)(12) and with low serum folate in some series (8)(9)(10)(11). Some studies (7)(10), but not others (8)(11)(12), have reported that cyclosporine treatment and whole blood cyclosporine concentration were determinants of tHcy in renal and cardiac transplant recipients. Data on tHcy in liver transplant recipients are limited, and increased tHcy has been associated with renal dysfunction but not with folate concentrations or cyclosporine therapy (13).

Our aims were to evaluate the prevalence of increased tHcy and factors that affect tHcy in liver transplant patients.

We studied 221 consecutive patients with clinically stable liver transplants seen between November 1999 and May 2000 at routine clinic visits. There were 141 men and 80 women. The immunosuppressive therapy for all patients was cyclosporine or tacrolimus. Twenty-five patients were also treated with mycophenolate, nine with azathioprine, and one with prednisone. Hypocaloric diets had been recommended for patients with diabetes and obesity, and alcohol abstention had been recommended for all patients. The patients who had received transplants <12 months before the study were excluded. Healthy volunteers (n = . . . [Full Text of this Article]

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References

The following articles in journals at HighWire Press have cited this article:

				A. Bosy-Westphal, M. Ruschmeyer, N. Czech, G. Oehler, H. Hinrichsen, M. Plauth, E. Lotterer, W. Fleig, and M. J. Muller Determinants of hyperhomocysteinemia in patients with chronic liver disease and after orthotopic liver transplantation Am. J. Clinical Nutrition, May 1, 2003; 77(5): 1269 - 1277. [Abstract] [Full Text] [PDF]