PMID- 30053565 OWN - NLM STAT- MEDLINE DCOM- 20181211 LR - 20181211 IS - 1878-8769 (Electronic) IS - 1878-8750 (Linking) VI - 119 DP - 2018 Nov TI - Hyperhomocysteinemia as a Risk Factor for Intracranial Aneurysms: A Case-Control Study. PG - e272-e275 LID - S1878-8750(18)31610-3 [pii] LID - 10.1016/j.wneu.2018.07.132 [doi] AB - OBJECTIVE: Homocysteine, an amino acid derived from methionine metabolism, has gained great importance as an important risk factor for cardiovascular diseases as the result of its thrombogenic properties and endothelial injury association. However, its role in the etiology and screening of intracranial aneurysms (IAs) has not been well studied. We aimed to test the hypothesis of a positive association between hyperhomocysteinemia (HHcy) and IAs. METHODS: A case-control study was performed at a vascular neurosurgery unit in Brazil between 2016 and 2017. In total, 180 patients were included: 142 patients with previous IAs (case group) and 38 patients with a previous diagnosis of arteriovenous malformation and no aneurysms on imaging evaluation (control group). HHcy was defined as homocysteine levels greater than 15 mumol/L. Multivariate models were designed to adjust for potential confounders: age, sex, hypertension, dyslipidemia, and smoker status. RESULTS: The case group was older (56.3 +/- 12.6 years vs. 40.9 +/- 14.0 years, P < 0.001) and had a greater prevalence of women (76.1% vs. 55.3%, P = 0.012), as well as hypertension (45.1% vs. 2.6%, P < 0.001), dyslipidemia (60.6% vs. 10.5%, P = 0.001), and smokers (41.5% vs. 0.0%, P < 0.001). Median homocysteine in the cases was similar to the controls (10.5 mumol/L [8.3-14.0] vs. 10.7 mumol/L [8.2-13.3], respectively, P = 0.450). There was a trend toward greater HHcy prevalence in the case group (20.4% vs. 7.9%, P = 0.073). HHcy was associated with greater age, male sex, hypertension, and smoking status. After multivariate adjustment, HHcy had no association with IAs (odds ratio 1.34, 95% confidence interval 0.30-5.97, P = 0.703). CONCLUSIONS: No association was found between HHcy and IAs. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Rosi, Jefferson AU - Rosi J AD - Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil. FAU - Morais, Barbara A AU - Morais BA AD - Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil. Electronic address: babyamorais@gmail.com. FAU - Pecorino, Lucas S AU - Pecorino LS AD - School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. FAU - Oliveira, Allan R AU - Oliveira AR AD - School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. FAU - Solla, Davi J F AU - Solla DJF AD - Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil. FAU - Teixeira, Manoel J AU - Teixeira MJ AD - Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil. FAU - Figueiredo, Eberval G AU - Figueiredo EG AD - Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil. LA - eng PT - Journal Article DEP - 20180724 PL - United States TA - World Neurosurg JT - World neurosurgery JID - 101528275 SB - IM MH - Adult MH - Aged MH - Case-Control Studies MH - Female MH - Humans MH - Hyperhomocysteinemia/complications/diagnostic imaging/*epidemiology MH - Intracranial Aneurysm/diagnostic imaging/*epidemiology/etiology MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Prevalence MH - Retrospective Studies MH - Risk Factors OTO - NOTNLM OT - Cerebrovascular disease OT - Homocysteine OT - Hyperhomocysteinemia OT - Intracranial aneurysm OT - Risk factor EDAT- 2018/07/28 06:00 MHDA- 2018/12/12 06:00 CRDT- 2018/07/28 06:00 PHST- 2018/05/01 00:00 [received] PHST- 2018/07/13 00:00 [revised] PHST- 2018/07/14 00:00 [accepted] PHST- 2018/07/28 06:00 [pubmed] PHST- 2018/12/12 06:00 [medline] PHST- 2018/07/28 06:00 [entrez] AID - S1878-8750(18)31610-3 [pii] AID - 10.1016/j.wneu.2018.07.132 [doi] PST - ppublish SO - World Neurosurg. 2018 Nov;119:e272-e275. doi: 10.1016/j.wneu.2018.07.132. Epub 2018 Jul 24.