Homocysteine Levels of Cardiovascular Disease Patients Attending the Cardiac Unit at El Shifa Hospital, Gaza Strip

Abstract

Background: Cardiovascular disease (CVD) is the first leading cause of death among the Palestinians. Although Hyperhomocysteinemia has been strongly linked to CVD, biochemical tests are restricted to monitoring cardiac enzymes activities. Therefore, introducing homocysteine test in Gaza hospitals for CVD patients may provide a clearer picture on the patient condition and help in the disease management. Objective: To assess homocysteine of CVD in patients from Gaza Governorate, Gaza Strip. Material and methods: This case-control study comprised 82 CVD patients and 82 healthy controls. Questionnaire interview was applied. Serum homocysteine, cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), lactate dehydrogenase (LDH), Aspartate aminotransferase (AST), Creatine Kinase (CK) and creatine kinase muscle and brain (CKMB) were determined. Data were analyzed using SPSS version 18.0. Results: The mean ages of controls and cases were 44.7±10.2 and 45.5±8.8 years, respectively. CVD was more frequent among lower educated, smoker and unemployed individuals, families with less income and individuals with family history of CVD (P<0.05). BMI of cases was significantly higher than that of controls (31.1±6.4 vs. 25.7±3.7, P=0.000). Clinical data showed that, high blood cholesterol, hypertension, stroke, diabetes and obesity are risk factor of CVD. Among food stuff, daily consumption of meat was found to be a risk factors of CVD. The mean levels of homocysteine was significantly higher in cases compared to controls (22.2±7.0 vs. 13.4±3.7 µmol/l, P=0.000). The average levels of cholesterol, triglycerides and LDL-C were found to be higher in cases (236.7±50.0, 188.7±90.8 and 171.3±41.1 mg/dl, respectively) compared to controls (182.2±31.2, 133.6±69.2 and 113.8±27.9 mg/dl, respectively) with P<0.05. In contrast, HDL-C was significantly lower in cases than in controls (26.3±9.6 vs. 39.9±4.3 mg/dl, P=0.000). The mean activities of LDH and CKMB were significantly elevated in cases compared to controls (416.1±195.5 and 14.2±10.8 vs. 325.5±71.3 and 10.6±3.4 U/L) with P=0.005, P=0.038, respectively. Homocysteine levels were higher in low educated, smoker and unemployed individuals, less family income and family history of CVD (P<0.05). Homocysteine levels were also higher in high blood cholesterol, hypertensive, stroke, diabetic and obese individuals as well as in individuals who ate meat daily (P<0.05). Homocysteine levels were positively correlated with BMI (r=0.225, P=0.034), cholesterol (r=0.304, P=0.004), LDL-C (r=0.396, P=0.000), LDH (r=0.286, P=0.007) and negatively correlated with HDL-C (r=-0.403, P=0.000). Conclusions: Serum homocysteine was significantly higher in CVD patients compared to controls. Homocysteine levels were higher in low educated, smoker and unemployed individuals, less family income individuals as well as in individuals with family history of CVD. High blood cholesterol, hypertensive, stroke, diabetic and obese individuals as well as individuals who ate meat daily had also higher levels of homocysteine. Homocysteine levels were positively correlated with BMI, cholesterol, LDL-C, LDH and negatively correlated with HDL-C.