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Home > Journals > Italian Journal of Vascular and Endovascular Surgery > Past Issues > Giornale Italiano di Chirurgia Vascolare 2000 September;7(3) > Giornale Italiano di Chirurgia Vascolare 2000 September;7(3):189-99



A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

Frequency: Quarterly

ISSN 1824-4777

Online ISSN 1827-1847


Giornale Italiano di Chirurgia Vascolare 2000 September;7(3):189-99


Hyperhomocysteinemia in patients with adbominal aortic aneurysms: a new pathogenetic factor?

Pratesi C., Pulli R., Dorigo W., Lombardi R., Brunelli T. *, Fedi S. *, Pepe G. *, Rogolino A. *, Giusti B. *, Marcucci R. *, Farsi A. *, Prisco D. *, Abbate R. *

From the Department and School of Specialisation in Vascular Surgery
* Institute of Clinical Medicine University of Florence, Florence, Italy

Background. To eval­u­ate chang­es in the plas­ma lev­els of homo­cys­teine in ­patients ­with abdom­i­nal aor­tic aneu­rysms com­pared to ­healthy con­trols and ­patients ­with poly­dis­trict ath­ero­scler­o­sis.
Methods. A ­total of 47 ­patients ­were exam­ined ­from 1 April 1997 to 31 July 1998, under­go­ing endo­aneu­rys­mec­to­my and ­graft fol­low­ing aneu­rysm of the infra­ren­al abdom­i­nal aor­ta. This ­group was com­pared to 73 ­patients ­with poly­dis­trict ath­ero­scler­o­sis and 58 con­trol sub­jects. Having eval­u­at­ed the clin­i­cal char­ac­ter­is­tics of all ­patients and the inci­dence of the var­i­ous ­risk fac­tors and asso­ciat­ed pathol­o­gies, the plas­ma lev­el of homo­cys­teine was deter­mined in all ­three ­groups ­using liq­uid chrom­a­tog­ra­phy, as ­well as the fre­quen­cy of C677T muta­tion in the ­gene cod­ify­ing ­enzyme 5-10 ­MTHFR ­through the ­assay of genom­ic DNA. The sta­tis­ti­cal anal­y­sis of ­data was per­formed ­with par­a­met­ric ­tests (ANO­VA), ­using mul­ti­var­i­ate anal­y­sis to deter­mine the cor­re­la­tion ­between the pathol­o­gy and ­risk fac­tors.
Results. The plas­ma lev­els of homo­cys­teine ­were sig­nif­i­cant­ly high­er in ­patients ­with AAA com­pared to ­both poly­dis­trict ath­e­ros­cle­rot­ic ­patients and con­trols. Multivariate anal­y­sis ­showed ­that homo­cys­teine is an inde­pen­dent ­risk fac­tor for abdom­i­nal aor­tic aneu­rysm. The prev­a­lence of homo­zy­gous sub­jects for C677T muta­tion in the ­gene of ­enzyme 5-10 ­MTHFR was high­er, but not sta­tis­ti­cal­ly sig­nif­i­cant in ­patients affect­ed by abdom­i­nal aor­tic aneu­rysms. The pres­ence of muta­tion in the ­MTHFR ­gene, and in par­tic­u­lar the homo­zy­gous gen­o­type, was sig­nif­i­cant­ly asso­ciat­ed ­with homo­cys­teine plas­ma lev­els.
Conclusions. These ­results sug­gest ­that hyper­hom­o­cys­teine ­plays a path­o­gen­ic ­role in ­patients ­with abdom­i­nal aor­tic aneu­rysm, offer­ing ­major oppor­tu­nities ­from a ther­a­peu­tic ­point of ­view, for the reduc­tion of homo­cys­teine lev­els and pre­ven­tion of endo­the­lial dam­age.

language: English, Italian


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