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

Authors Seemungal T, Lun JCF, Davis G, Neblett C, Chinyepi N, Dookhan C, Drakes S, Mandeville E, Nana F, Setlhake S, King CP, PintoPereira L, Delisle J, Wilkinson TM, Wedzicha JA

Published 15 October 2007 Volume 2007:2(3) Pages 313—321


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 Pinto Pereira2, 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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