Monitoring homocysteine levels

Oct 13, 2025 by wbrum.org 63 views

The Relationship Between Homocysteine Levels and the Severity of Patients with Acute Ischemic Stroke at the General Hospital of Adam Malik Hajj Center Medan

Introduction

Acute ischemic stroke is a leading cause of morbidity and mortality worldwide, with a significant impact on the quality of life of patients and their families. The severity of acute ischemic stroke can vary greatly, ranging from mild to severe, and is influenced by various factors, including homocysteine levels. Homocysteine, an amino acid, has been recognized as an independent risk factor for ischemic stroke and its prognosis. However, the relationship between homocysteine levels and the severity of acute ischemic stroke remains a topic of debate. This study aims to investigate the relationship between homocysteine levels and the severity of acute ischemic stroke patients treated at the General Hospital of Adam Malik Hajj, Medan.

Background

Ischemic stroke occurs when a blood vessel in the brain becomes blocked, leading to a lack of oxygen and nutrients to the brain tissue. Homocysteine, a non-essential amino acid, has been linked to an increased risk of ischemic stroke. Elevated homocysteine levels can damage blood vessels and interfere with the healing process of the brain after a stroke. The National Institute of Health Stroke Scale (NIHSS) is a widely used scale to measure the severity of stroke. The NIHSS assesses 11 items, including level of consciousness, gaze, visual field, motor strength, and speech.

Research Purposes

This study aims to determine the relationship between homocysteine levels and the severity of acute ischemic stroke patients treated at the General Hospital of Adam Malik Hajj, Medan. The study will investigate whether high homocysteine levels are associated with a higher severity of acute ischemic stroke.

Research Methods

This study used an analytical design with a cross-sectional approach. A total of 45 patients diagnosed with acute ischemic stroke were recruited from the hospital's stroke corner. The patients were divided into two groups based on their homocysteine levels: high (> 15 μmol/L) and normal (≤15 μmol/L). The degree of stroke severity was measured using the NIHSS. The study also collected demographic data, including age, sex, and medical history.

Research Results

The results showed that the acute phase of ischemic stroke had a variety of homocysteine levels, with a minimum value of 4.4 μmol/L and a maximum of 24.1 μmol/L, and an average homocysteine level of 11.5 μmol/L. Of the total subjects, as many as 34 patients (75.6%) experienced a mild stroke, while 11 patients (24.4%) experienced a moderate degree of stroke. Logistic regression test showed a significant relationship between homocysteine levels and the severity of the acute ischemic stroke. Patients with high homocysteine levels were estimated to be at risk of experiencing the severity of acute ischemic strokes up to 6,960 times greater than those who had normal homocysteine levels (p = 0.005; OR = 6,960; 95% CI: 1,523–31,811).

Discussion

This study found a significant relationship between homocysteine levels and the severity of acute ischemic stroke. The results are consistent with several previous studies that show that homocysteine can damage blood vessels and interfere with the healing process of the brain after a stroke. The study suggests that high homocysteine levels can be used as an indicator to predict the potential for stroke severity in patients. Appropriate handling of homocysteine levels through dietary interventions or vitamin supplementation can be an important strategy in stroke patient management.

Conclusion

In conclusion, this study found a strong relationship between homocysteine levels and the severity of acute ischemic stroke patients. Increased homocysteine levels have the potential to increase the risk of stroke severity, which shows the importance of monitoring homocysteine levels in the management of ischemic stroke patients. With a better understanding of this risk factor, it is expected to increase the prevention and treatment approach in stroke patients in the future.

Recommendations

Based on the findings of this study, the following recommendations are made:

Monitoring homocysteine levels: Homocysteine levels should be monitored regularly in patients with acute ischemic stroke to predict the potential for stroke severity.
Dietary interventions: Dietary interventions, such as increasing folate and vitamin B12 intake, can help reduce homocysteine levels and prevent stroke severity.
Vitamin supplementation: Vitamin supplementation, such as folic acid and vitamin B12, can help reduce homocysteine levels and prevent stroke severity.
Early detection and treatment: Early detection and treatment of acute ischemic stroke can help reduce the severity of the stroke and improve patient outcomes.

Limitations

This study has several limitations, including:

Small sample size: The study had a small sample size, which may limit the generalizability of the findings.
Cross-sectional design: The study used a cross-sectional design, which may not capture the temporal relationship between homocysteine levels and stroke severity.
Limited demographic data: The study collected limited demographic data, which may not fully capture the relationship between homocysteine levels and stroke severity.

Future Directions

Future studies should aim to:

Investigate the temporal relationship: Investigate the temporal relationship between homocysteine levels and stroke severity.
Collect more demographic data: Collect more demographic data to fully capture the relationship between homocysteine levels and stroke severity.
Investigate the effect of dietary interventions: Investigate the effect of dietary interventions on homocysteine levels and stroke severity.

By understanding the relationship between homocysteine levels and stroke severity, healthcare providers can develop more effective strategies to prevent and treat acute ischemic stroke.
Frequently Asked Questions (FAQs) About the Relationship Between Homocysteine Levels and Acute Ischemic Stroke

Q: What is homocysteine, and how is it related to acute ischemic stroke?

A: Homocysteine is an amino acid that is produced in the body. Elevated homocysteine levels have been linked to an increased risk of acute ischemic stroke. High homocysteine levels can damage blood vessels and interfere with the healing process of the brain after a stroke.

Q: What are the symptoms of acute ischemic stroke?

A: The symptoms of acute ischemic stroke can vary depending on the location and severity of the stroke. Common symptoms include:

Sudden weakness or numbness in the face, arm, or leg
Sudden confusion or trouble speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, or loss of balance
Sudden severe headache with no known cause

Q: How is the severity of acute ischemic stroke measured?

A: The severity of acute ischemic stroke is measured using the National Institute of Health Stroke Scale (NIHSS). The NIHSS assesses 11 items, including level of consciousness, gaze, visual field, motor strength, and speech.

Q: What are the risk factors for acute ischemic stroke?

A: The risk factors for acute ischemic stroke include:

High blood pressure
High cholesterol
Diabetes
Smoking
Family history of stroke
Age (stroke risk increases with age)
Homocysteine levels (elevated homocysteine levels have been linked to an increased risk of stroke)

Q: Can homocysteine levels be reduced?

A: Yes, homocysteine levels can be reduced through dietary interventions and vitamin supplementation. Folic acid, vitamin B12, and vitamin B6 are essential nutrients that can help reduce homocysteine levels.

Q: What are the benefits of reducing homocysteine levels?

A: Reducing homocysteine levels can help prevent stroke severity and improve patient outcomes. It can also reduce the risk of other cardiovascular diseases, such as heart attack and peripheral artery disease.

Q: How can I reduce my homocysteine levels?

A: You can reduce your homocysteine levels by:

Eating a balanced diet that includes folic acid-rich foods, such as leafy greens and legumes
Taking folic acid and vitamin B12 supplements
Avoiding smoking and excessive alcohol consumption
Exercising regularly
Maintaining a healthy weight

Q: Can I get tested for homocysteine levels?

A: Yes, you can get tested for homocysteine levels through a blood test. Your healthcare provider can order the test and interpret the results.

Q: What are the next steps if I have high homocysteine levels?

A: If you have high homocysteine levels, your healthcare provider may recommend:

Dietary changes to reduce homocysteine levels
Vitamin supplementation to reduce homocysteine levels
Regular monitoring of homocysteine levels
Lifestyle changes to reduce cardiovascular risk

Q: Can I prevent acute ischemic stroke?

A: Yes, you can prevent acute ischemic stroke by:

Maintaining a healthy lifestyle, including a balanced diet and regular exercise
Managing risk factors, such as high blood pressure and high cholesterol
Getting regular check-ups with your healthcare provider
Staying informed about stroke risk factors and prevention strategies

Q: What should I do if I or someone I know is experiencing symptoms of acute ischemic stroke?

A: If you or someone you know is experiencing symptoms of acute ischemic stroke, call emergency services immediately. Prompt medical attention can help reduce the severity of the stroke and improve patient outcomes.