Study of the Influence of Homocysteine and Vitamin D Metabolism on the Development of Destructive Vascular Wall Processes
Abstract
To date, it has been established that in the progression of cardiovascular (CV) disorders, an increase in the level of homocysteine (HC) and hypovitaminosis D play an important role. According to the latest recommendations, the modern clinician should consider risk factors not as a diagnostic sign, but as a prognostic, contributing factor, which to some extent can lead to destructive changes in the vascular wall.
The aim. To study the morphological changes of the vascular wall depending on the degree of hyperhomocysteinemia and hypovitaminosis D.
Materials and methods. We analyzed data from 54 patients who, in addition to determining the level of HC and vitamin D, underwent morphological studies of fragments of the great saphenous vein and aorta. Samples were obtained during coronary artery bypass grafting. Depending on the degree of hyperhomocysteinemia and the level of vitamin D, the patients were divided into 3 groups.
Results. Morphological examination of the great saphenous vein and aorta showed normal structure of the vascular wall in patients with normal levels of HC and vitamin D (78.5% and 71.4%, respectively). Patients from the groups 2 and 3 with hyperhomocysteinemia had more pronounced changes in the venous wall, regardless of the level of vitamin D. These data suggest a probable association of HC levels with the changes in the vascular wall. It was also noted that the patients of group 3 had more pronounced inflammatory infiltration of the vascular wall.
Conclusions. Hyperhomocysteinemia and hypovitaminosis D are independent predictors of CV disorders and have a detrimental effect on the vascular wall and blood coagulation system, creating conditions for the progression of atherosclerosis. The higher is the level of HC, the more pronounced are morphological changes in the vascular wall of the vein, leading to hypertrophy of all layers, regardless of the level of vitamin D.
References
- Nykonenko OS, Chmul KO, Nykonenko AO, Osaulenko VV, Efimenko NF. Prognostic value of homocysteine and vitamin D for patients with ischemic heart disease and multifocal atherosclerosis.Zaporozhyemedicaljournal.2018;20(1):31-5. https://doi.org/10.14739/23101210.2018.1.121880
- Wang N, Chen C, Zhao L, Chen Y, Han B, Xia F, et al. Vitamin D and nonalcoholic fatty liver disease: bi-directional Mendelian randomization analysis. E Bio Medicine. 2018;28:187-93. https://doi.org/10.1016/jebiom.2017.12.027
- Moretti R, Caruso P, Dal Ben M, Conti C, Gazzin S, Tiribelli C. Vitamin D, homocysteine, and folate in subcortical vascular dementia and Alzheimer dementia. Front Aging Neurosci. 2017;9:169. https://doi.org/10.3389fnagi.2017.00169
- Ніконенко ОС, Чмуль КО, Ніконенко АО, Молодан ОВ, Осауленко ВВ. Сократительная функция миокарда левого желудочка при нарушении метаболизма гомоцистеина у больных ишемической болезнью сердца. Вісник серцево-судинної хірургії. 2018;3:17-23.
- Nikonenko AS, Chmul KO, Nikonenko AA, Osaulenko VV. [The contractive function of the myocardium of the LV in the disturbance of homocysteine metabolism in IHD patients]. Cardiovascular Surgery Herald. 2018;3:17-23. Russian.
- Аронов ДМ, Лупанов ВП. Некоторые аспекты патогенеза атеросклероза. Атеросклероз и дислипидемии. 2011;1(2):48-56.
- Aronov DM, Lupanov VP. [Atherosclerosis and coronary heart disease: some aspects of pathogenesis]. Ateroskleroz i Dislipidemii. 2011;1(2):48-56. Russian.
- Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S49-73. https://doi.org/10.1161/01cir.0000437741.48606.98
- Щербак СГ, Сарана АМ, Макаренко СВ, Камилова ТА, Максимов АГ. Некоторые генетические особенности метаболизма гомоцистеина, фолатов и монооксида азота как факторы риска ишемической болезни сердца. Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2016;8(1):123-30.
- Sherbak SG, Sarana AM, Makarenko SV, Kamiliva TA, Maximov AG. [Some genetical peculiarities of metabolism of homocysteine, folate, and nitric oxide as risk factors of ischemic heart disease]. Herald of the Northwestern State Medical University named after I.I. Mechnikov. 2016;8(1):123-30. Russian.
- Наумов АВ, Данильчик ИВ, Сарана ЮВ. Три пути реметилирования гомоцистеина. Журнал Гродненского государственного медицинского университета. 2016;2(54):27-32.
- Naumov AV, Danilchyk IV, Sarana YuV. [Three Ways of Homocysteine Remethylation]. Journal of the Grodno State Medical University. 2016;2(54):27-32. Russian.
- Наумов АВ. Гомоцистеин. Медико-биологические проблемы: монография. Минск: Профессиональные издания; 2013.
- Naumov AV. Gomocistein. Mediko-biologicheskie problemy. Minsk: Professionalnye izdanija; 2013. Russian. problemy. Minsk: Professionalnye izdanij
- Скворцов ЮИ, Королькова АС. Гомоцистеин как фактор риска развития ИБС (обзор). Саратовский научно-медицинский журнал. 2011;7(3):619-24.
- Skvortsov YuI, Korolkova AS. [Homocysteine as a risk factor of ischemic heart disease development (review)]. Saratov Journal of Medical Scientific Research. 2011;7(3):619-24. Russian.
- Фефелова ЕВ, Цыбиков НН, Терешков ПП, Сепп АВ, Изместьев СВ. Механизм гиперкоагуляции при экспериментальной гипергомоцистеинемии. Тромбоз, гемостаз и реология. 2015;4(64):27-30.
- Fefelova EV, Tsybikov NN, Tereshkov PP, Sepp AV, Izmestyev SV. [Mechanism of Hypercoagulation at Experimental Hyperhomocysteinemia]. Tromboz, gemostaz i Reologia. 2015;4(64):27-30. Russian
