Estimation of Homocysteine and its Relationship with Vitamin B12 and Folic Acid Levels in Patients with Cardiovascular Disease
DOI:
https://doi.org/10.32792/utq/utjsci/v12i1.1367Abstract
Globally, one of the leading causes of death is cardiovascular disease (CVD). The plasma levels of homocysteine rise after myocardial ischemia and are involved in numerous methylation processes. This study aimed to evaluate homocysteine levels and their relationship with vitamin B12 and folic acid (vitamin B9) in patients with cardiovascular disease and early-stage heart disease due to hypertension, lipidemia, etc. The present study included 120 participants aged between 30 to 70 years and was divided into three groups. Forty patients with acute myocardial infarction (G1), forty patients with early-stage heart disease (G2), and forty healthy participants (G3). Quantitative determination of homocysteine, vitamin B12, and vitamin B9 is measured based on the competitive enzyme-linked immunosorbent assay (ELISA) technology. Acute myocardial infarction and early-stage heart disease patients also had their total cholesterol, triglyceride, HDL, and LDL levels examined. The study showed that raised homocysteine levels are linked with deficiencies in vitamin B9 and vitamin B12 (P ≤0.0001). A highly significant positive correlation between homocysteine and lipid profile between G1 and G3, and G2 and G3 (P-value≤0.0001). Also, a significant positive correlation exists between homocysteine and triglyceride between G2 and G3 (P-value=0.012). A negative correlation between homocysteine, vitamin B9, and vitamin B12 at G1, G2, and G3 groups (P-value≤0.0001). The study's findings indicated that increased homocysteine levels, which are caused by deficiencies in vitamin B12 and vitamin B9, raise the risk of cardiovascular disease.
Received: 2025-03-28
Revised: 2025-04-23
Accepted: 2025-04-26
References
H. Jakubowski and Ł. Witucki, "Homocysteine Metabolites, Endothelial Dysfunction, and Cardiovascular Disease," International Journal of Molecular Sciences, vol. 26, p. 746, 2025.
M. E. Al-Gazally, A. H. Al-Saadi, and A. H. Radeef, "Effect of homocysteine on ischemic stroke and myocardial infarction in Iraqi population," International Journal of PharmTech Research, vol. 8, pp. 139-145, 2015.
M. Qadir, S. Aslam, B. Lail Shah, A. Akbar, S. K. Jadoon, and B. L. Shah, "Hyperhomocysteinemia Causing Myocardial Infarction in a Young Patient: A Case Report," Cureus, vol. 17, 2025.
Z. Bajic, T. Sobot, R. Skrbic, M. Stojiljkovic, N. Ponorac, and D. Djuric, "Homocysteine, vitamins B6 and folic acid in experimental models of myocardial infarction and heart failure- how strong is that link? Biomolecules 2022; 12 (4): 536," vol. 1993, ed, 1991.
M. Li, R. Ren, K. Wang, S. Wang, A. Chow, A. K. Yang, et al., "Effects of B Vitamins on Homocysteine Lowering and Thrombotic Risk Reduction—A Review of Randomized Controlled Trials Published Since January 1996," Nutrients, vol. 17, p. 1122, 2025.
C. Tinelli, A. Di Pino, E. Ficulle, S. Marcelli, and M. Feligioni, "Hyperhomocysteinemia as a risk factor and potential nutraceutical target for certain pathologies. Front Nutr. 2019; 6: 49," ed, 2019.
M. Y. Semme, M. R. R. Salam, and F. A. Budiamin, "THE ROLE OF FOLATE, VITAMIN B12 AND B6 IN HYPERHOMOCYSTEINEMIA AS THE RISK FACTOR OF CARDIOVASCULAR DISEASE: NARRATIVE REVIEW," Healthy Tadulako Journal (Jurnal Kesehatan Tadulako), vol. 10, pp. 387-398, 2024.
G. B. Yahn, J. E. Abato, and N. M. Jadavji, "Role of vitamin B12 deficiency in ischemic stroke risk and outcome," Neural regeneration research, vol. 16, pp. 470-474, 2021.
K. Halczuk, J. Kaźmierczak-Barańska, B. T. Karwowski, A. Karmańska, and M. Cieślak, "Vitamin B12—Multifaceted in vivo functions and in vitro applications," Nutrients, vol. 15, p. 2734, 2023.
R. C. Langan and A. J. Goodbred, "Vitamin B12 deficiency: recognition and management," American family physician, vol. 96, pp. 384-389, 2017.
S. Yuan, A. M. Mason, P. Carter, S. Burgess, and S. C. Larsson, "Homocysteine, B vitamins, and cardiovascular disease: a Mendelian randomisation study," BMC Medicine, vol. 19, pp. 1-9, 2021.
H. S. Jasim, A. I. Arif, and A. A. Noaman, "Serum Levels of Zinc, Selenium and Homocystine among Iraqi Patients with Type-2 Diabetes Mellitus," 2009.
S. V. Shevchuk, K. P. Postovitenko, I. A. Iliuk, H. V. Bezsmertna, Y. O. Bezsmertnyi, I. V. Kurylenko, et al., "The relationship between homocysteine level and vitamins B12, B9 and B6 status in patients with chronic kidney disease," 2019.
W. Herrmann and M. Herrmann, "The controversial role of HCY and vitamin B deficiency in cardiovascular diseases," Nutrients, vol. 14, p. 1412, 2022.
Y. Otsu, R. Ae, and M. Kuwabara, "Folate and cardiovascular disease," Hypertension Research, vol. 46, pp. 1816-1818, 2023.
A. Hirata, "Is renal function the key to disease risk management in elevated homocysteine levels?" Hypertension Research, vol. 47, pp. 1976-1977, 2024.
S. O. Nomura, H. S. Bhatia, P. K. Garg, A. B. Karger, W. Guan, J. Cao, et al., "Lipoprotein (a), high-sensitivity c-reactive protein, homocysteine and cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis," American Journal of Preventive Cardiology, vol. 21, p. 100903, 2025.
D. Liu, C. Fang, J. Wang, Y. Tian, and T. Zou, "Association between homocysteine levels and mortality in CVD: a cohort study based on NHANES database," BMC Cardiovascular Disorders, vol. 24, p. 652, 2024.
R. A. Byrne, X. Rossello, J. Coughlan, E. Barbato, C. Berry, A. Chieffo, et al., "2023 ESC guidelines for the management of acute coronary syndromes: developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC)," European Heart Journal: Acute Cardiovascular Care, vol. 13, pp. 55-161, 2024.
S. O. Amen, S. T. Baban, S. H. Yousif, Z. T. Baban, A. H. Hawez, and D. M. F. Jalal, "High prevalence of vitamin D deficiency in patients with acute myocardial infarction: An Iraqi single-center study," Medical journal of Babylon, vol. 17, pp. 358-362, 2020.
M. H. Aldholae, M. A. Al-Huthi, and D. J. A. M. Almkdad, "Risk Factors of Myocardial Infarction among Patients Admitted to Al-Wahdah Teaching Hospital, Yemen," Open Access Library Journal, vol. 11, pp. 1-25, 2024.
A. Gupta, S. Tsang, A. Hajduk, H. M. Krumholz, M. G. Nanna, P. Green, et al., "Presentation, treatment, and outcomes of the oldest-old patients with acute myocardial infarction: the SILVER-AMI study," The American journal of medicine, vol. 134, pp. 95-103, 2021.
T. Wang, Z. Zhao, X. Yu, T. Zeng, M. Xu, Y. Xu, et al., "Age-specific modifiable risk factor profiles for cardiovascular disease and all-cause mortality: a nationwide, population-based, prospective cohort study," The Lancet Regional Health–Western Pacific, vol. 17, 2021.
M. Alkhouli, F. Alqahtani, H. Jneid, M. Al Hajji, W. Boubas, and A. Lerman, "Age-stratified sex-related differences in the incidence, management, and outcomes of acute myocardial infarction," in Mayo Clinic Proceedings, 2021, pp. 332-341.
B. O. Sharif and S. Y. Lafi, "Common Risk Factors of Myocardial Infarction and Some Socio-Demographic Characteristics in Sulaimani City," Kurdistan Journal of Applied Research, vol. 6, pp. 136-143, 2021.
M. Walli-Attaei, A. Rosengren, S. Rangarajan, Y. Breet, S. Abdul-Razak, W. Al Sharief, et al., "Metabolic, behavioural, and psychosocial risk factors and cardiovascular disease in women compared with men in 21 high-income, middle-income, and low-income countries: an analysis of the PURE study," The Lancet, vol. 400, pp. 811-821, 2022.
S. Habib, T. Al-Khlaiwi, A. Almushawah, A. Alsomali, and S. Habib, "Homocysteine as a predictor and prognostic marker of atherosclerotic cardiovascular disease: a systematic review and meta-analysis," European Review for Medical & Pharmacological Sciences, vol. 27, 2023.
C.-C. Shih, Y.-L. Shih, and J.-Y. Chen, "The association between homocysteine levels and cardiovascular disease risk among middle-aged and elderly adults in Taiwan," BMC cardiovascular disorders, vol. 21, pp. 1-8, 2021.
Z. Hassan Muslem, S. M. Ali, and A. N. Al Marayati, "Correlation between plasma homocysteine and ischemic heart disease in young Adults," F1000Research, vol. 13, p. 1477, 2024.
L. Ren, J. Guo, W. Zhao, R. Zuo, S. Guo, C. Jia, et al., "Serum homocysteine relates to elevated lipid level, inflammation and major adverse cardiac event risk in acute myocardial infarction patients," Biomarkers in Medicine, vol. 17, pp. 297-306, 2023.
D.-F. Wu, Q.-C. Liao, F. Lu, Z. Wang, K. Yu, and J.-L. Deng, "Hyperhomocysteinemia Is Associated With Lipid Profiles and Lipid Ratio in Patients With Coronary Artery Disease," 2021.
L. Zhou, J. Liu, Y. An, Y. Wang, and G. Wang, "Plasma homocysteine level is independently associated with conventional atherogenic lipid profile and remnant cholesterol in adults," Frontiers in Cardiovascular Medicine, vol. 9, p. 898305, 2022.
M. Venkateshwarlu and C. Gayathri, "Study of significance of estimation of lipid profile in patients with acute myocardial infarction," Int J Inf Res Rev, vol. 2, pp. 1028-1030, 2015.
K. Sowndarya, A. Hegde, N. M. Pawar, and R. Shenoy, "Elevated Homocysteine Levels and Vitamin Deficiencies as Potential Risk Markers for Coronary Artery Disease in Apparently Healthy Adults," Biomedical and Biotechnology Research Journal (BBRJ), vol. 8, pp. 487-492, 2024.
M. H. Hussien and M. A. Auda, "Biochemical study of the relationship between homocysteine, folic acid and NLR ratio in patients with hypertension," 2022.
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