Article type: Research Article
Authors: Vayá, Amparo | Rivera, Leonor | Hernández-Mijares, Antonio | de la Fuente, Miguel | Solá, Eva | Romagnoli, Marco | Alis, R. | Laiz, Begoña
Affiliations: Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain | Endocrinology Service, Dr. Peset University Hospital, Valencia, Spain | Faculty of Sports Sciences and Physical Education, Catholic University of Valencia, Valencia, Spain
Note: [] Corresponding author: Amparo Vayá, Hemorheology and Hemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Avda de Campanar, 21, 46009 Valencia, Spain. Tel./Fax: +34 96 3862714; E-mail: [email protected]
Abstract: The association between morbid obesity and hyperhomocysteinemia (HH) remains controversial and the nature of this relationship needs to be clarified as several metabolic, lipidic, inflammatory and anthropometric alterations that accompany morbid obesity may be involved. In 66 morbidly obese patients, 47 women and 19 men aged 41 ± 12 years and 66 normo-weight subjects, 43 women and 23 men, aged 45 ± 11 years, we determined homocysteine (Hcy) levels along with lipidic, anthropometric, inflammatory and insulin resistance markers. In addition, we investigated the effect of Metabolic Syndrome (MS) and its components on Hcy levels. Obese patients had statistically higher Hcy levels than controls: 12.76 ± 5.30 μM vs. 10.67 ± 2.50 μM; p = 0.006. Moreover, morbidly obese subjects showed higher waist circumference, glucose, insulin, HOMA, leptin, triglycerides, fibrinogen, C reactive protein (CRP) (p < 0.001, respectively), and lower vitamin B12 (p = 0.002), folic acid and HDL-cholesterol (p < 0.001, respectively). In the multivariate regression analysis, waist circumference, glucose, leptin and folic acid levels were independent predictors for Hcy values (p < 0.050). When obese patients were classified as having MS or not, no differences in Hcy levels were found between the two groups (p = 0.752). Yet when we analysed separately each MS component, only abdominal obesity was associated with Hcy levels (p = 0.031). Moreover when considering glucose >110 mg/dL (NCEP-ATPIII criteria) instead of glucose intolerance >100 mg/dl (updated ATPIII criteria), it also was associated with HH (p = 0.042). These results were confirmed in the logistic regression analysis where abdominal obesity and glucose >115 mg/dL constitute independent predictors for HH (OR = 3.2; CI: 1.23–13.2; p = 0.032, OR: 4.6; CI: 1.7–22.2; p = 0.016, respectively). The results of our study indicate that increased Hcy levels are related mostly with abdominal obesity and with insulin resistance. Thus, HH may raise atherothrombotic and thromboembolic risk in these patients.
Keywords: Homocysteine, morbid obesity, waist circumference, insulin resistance
DOI: 10.3233/CH-2012-1544
Journal: Clinical Hemorheology and Microcirculation, vol. 52, no. 1, pp. 49-56, 2012
