Stroke is the second major cause of deaths and common cause of disabilities worldwide. Increased level of homocysteine is considered as a critical but treatable risk factor for stroke. Homocysteine has many harmful effects on vascular system including thrombosis induction, increased in oxidative stress, stimulating mitogenesis and impaired endothelial function. Stroke patients with elevated homocysteine level have more frequently developed multiple infarctions and cerebral microangiopathy. In the present study, the serum homocysteine level was measured in Pakistani acute stroke patients.
Subjects selected for the study was divided in to two groups. Group 1 (Control) having 30 healthy individuals and in Group 2 (Patients) having 68 stroke patients. Both of the groups, controls and patients were sex and gender matched. The stroke subtypes (ischemic and hemorrhagic) was diagnosed by neurologists based on the neuroimaging (CT or MRI). Neurologic functions assessment was based on (NIHSS) Stroke Score. Biochemical parameters i.e. total cholesterol,triglycerides, high density lipoprotein, low density lipoprotienand serum homocysteine was measured by using commercially available kits at the end of the experiment.
The data was analyzed by using SPSS software. Student's t-test was applied on data to compare serum homocysteine concentrations and other continuous variable of patients and control groups. A chi-square test was used to analyze the qualitative findings. Differences will be considered significant at p < 0.05.Comparison among stroke cases and controls for homocysteine and other stroke risk factors were performed by using binary logistic regression analysis. The odds ratios (OR) and 95 confidence intervals (95% CI) were also estimated.
The results revealed that serum homocysteine level was significantly higher (p=0.001) in stroke patients. Other risk factor of stroke were also significantly high in stroke patients as hypertension (p=0.000), diabetes mellitus (p=0.009) and smoking (p=0.008). Clinical data revaeled that Systolic blood pressure (mmHg) (p=0.000), diastolic blood pressure (mmHg) (p=0.006), cholesterol (p=0.003), triglyceride (p=0.008), LDL cholesterol level (p=0.006) and serum creatinine level (p=0.010) was also significantly raised in stroke patients.
Concluded that in stroke patients, the measurement of serum homocysteine level may be effective and useful to get a clearer image about patients, condition and this is beneficial for disease prevention and management. Treating hyperhomocystenemia may be helpfull in formulating strategies in reducing stroke incidence and its complications in Pakistan.