PMID- 21411090
OWN - NLM
STAT- MEDLINE
DCOM- 20111014
LR  - 20131121
IS  - 1879-1484 (Electronic)
IS  - 0021-9150 (Linking)
VI  - 216
IP  - 2
DP  - 2011 Jun
TI  - Homocysteine and cerebral small vessel disease in patients with symptomatic 
      atherosclerotic disease. The SMART-MR study.
PG  - 461-6
LID - 10.1016/j.atherosclerosis.2011.02.027 [doi]
AB  - OBJECTIVE: High homocysteine level is a risk factor for atherosclerosis and has 
      been associated with lacunar infarcts (LIs), white matter lesions (WML) and 
      cognitive dysfunction. It is unclear whether homocysteine is associated with 
      cerebral small vessel disease (cSVD) on top of pre-existent atherosclerosis. We 
      evaluated the association between homocysteine and cSVD in a large cohort of 
      patients with symptomatic atherosclerotic disease. METHODS: Within the SMART-MR 
      study, a prospective cohort study of patients with symptomatic atherosclerotic 
      disease, we estimated cross-sectional associations of total plasma homocysteine 
      (THCY) and hyperhomocysteinemia (HHCY) with WML volume and presence of LI, using 
      automated brain segmentation in MRIs of 1232 patients and cognitive function in 
      763 patients. WML were expressed as a logarithmic transformed percentage of total 
      brain volume. RESULTS: Linear regression analyses adjusted for age, sex, vascular 
      risk factors and extent of atherosclerosis showed that THCY and HHCY were 
      significantly associated with larger WML volumes (B=0.01%: 95% CI 0.002-0.02%, 
      and B=0.21%: 95% CI 0.04-0.39%). Increasing THCY was significantly associated 
      with an increased risk of LIs (OR 1.04, 95% CI 1.01-1.07, per 1 mumol). Moreover, 
      HHCY was associated with worse cognitive function (B=-0.12: 95% CI -0.22 to 
      -0.01). CONCLUSION: In patients with symptomatic atherosclerotic disease, higher 
      homocysteine levels are associated with higher WML volume, presence of LI and 
      slightly worse cognitive function.
CI  - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved.
FAU - Kloppenborg, Raoul P
AU  - Kloppenborg RP
AD  - Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
FAU - Nederkoorn, Paul J
AU  - Nederkoorn PJ
FAU - van der Graaf, Yolanda
AU  - van der Graaf Y
FAU - Geerlings, Mirjam I
AU  - Geerlings MI
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110224
PL  - Ireland
TA  - Atherosclerosis
JT  - Atherosclerosis
JID - 0242543
RN  - 0LVT1QZ0BA (Homocysteine)
SB  - IM
MH  - Aged
MH  - Atherosclerosis/*blood
MH  - Brain/pathology
MH  - Cognition Disorders/blood
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Female
MH  - Homocysteine/*blood/metabolism
MH  - Humans
MH  - Hyperhomocysteinemia/blood
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Neuropsychological Tests
MH  - Risk Factors
EDAT- 2011/03/18 06:00
MHDA- 2011/10/15 06:00
CRDT- 2011/03/18 06:00
PHST- 2010/10/27 00:00 [received]
PHST- 2011/01/24 00:00 [revised]
PHST- 2011/02/14 00:00 [accepted]
PHST- 2011/03/18 06:00 [entrez]
PHST- 2011/03/18 06:00 [pubmed]
PHST- 2011/10/15 06:00 [medline]
AID - S0021-9150(11)00188-2 [pii]
AID - 10.1016/j.atherosclerosis.2011.02.027 [doi]
PST - ppublish
SO  - Atherosclerosis. 2011 Jun;216(2):461-6. doi: 
      10.1016/j.atherosclerosis.2011.02.027. Epub 2011 Feb 24.