Plasma homocysteine is elevated in COPD patients and is related to COPD severity

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Authors: Terence AR Seemungal, Johanna Cho Fook Lun, Gershwin Davis, Carlos Neblett, Nkhabe Chinyepi, et al

Published Date October 2007 , Volume 2007:2(3)

Terence AR Seemungal¹, Johanna Cho Fook Lun¹, Gershwin Davis², Carlos Neblett¹, Nkhabe Chinyepi¹, Christina Dookhan¹, Samantha Drakes¹, Elizabeth Mandeville¹, Fatima Nana¹, Seatshogeng Setlhake¹, Celia Poon King², Lexley PintoPereira², Jerome Delisle³, Thomas MA Wilkinson⁴, Jagwiga A Wedzicha⁴

¹Departments of Clinical Medical Sciences; ²Paraclinical Sciences; ³Centre for Medical Sciences Education; ⁴Faculty of Medical Sciences University of the West Indies, St Augustine Campus, Trinidad and Tobago; Academic Unit of Respiratory Medicine, University College Medical School, University College London, England

Background: Although recent studies have found that total plasma homocysteine (tHCY) and chronic obstructive pulmonary disease (COPD) are both risk factors for cardiac disease, there have been few studies of plasma homocysteine levels in COPD patients. We tested the hypothesis that total plasma homocysteine (tHCY) would be elevated in patients diagnosed with COPD compared with controls.

Methods: We studied 29 COPD outpatients and 25 asymptomatic subjects (controls) over age 55 years with measurement of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), St. Georges Respiratory Questionnaire (SGRQ) score, tHCY and serum C-reactive protein (sCRP).

Results: There was no difference between controls vs. COPD patients in mean age or gender but mean (SD) FEV₁ was 2.25 (0.77) vs 1.43 (0.60) L; FEV₁% predicted 76.1 (17.2) vs 49.1 (16.3) p < 0.001 in both cases. Median (IQR) tHCY was 8.22 (6.63, 9.55) in controls vs 10.96 (7.56, 13.60) micromol/l for COPD, p = 0.006 and sCRP 0.89 (0.47, 2.55) vs 2.05 (0.86, 6.19) mg/l, p = 0.023. tHCY(log) was also higher in (r, p) smokers (0.448, 0.001), patients with low FEV₁% (−0.397, 0.003), males (0.475, <0.001), but high SGRQ Total score (0.289, 0.034), and high sCRP (0.316, 0.038). tHCY(log) was independently related to (regression coefficient, p) sCRP(log) (0.087, 0.024), male gender (0.345, <0.001) and presence of COPD (0.194, 0.031). Median (IQR) tHCY GOLD Stage I and II 8.05 (7.28, 11.04), GOLD Stage III and IV: 11.83(9.30, 18.30); p = 0.023.

Conclusions: Plasma homocysteine is significantly elevated in COPD patients relative to age and sex-matched controls and is related to serum CRP and COPD severity.

Keywords: COPD, Homocysteine, CRP, SGRQ, FEV₁

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