International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(14), July, 2012

Pages: 45-49

Date of Publication: 31-Jul-2012


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CORRELATION OF HOMOCYSTEINE WITH MALONDIALDEHYDE AND LIPID PARAMETER IN CORONARY ARTERY DISEASE PATIENTS

Author: Sharma Anita, Sharma Ashish, Agrawal Apurva

Category: Healthcare

Abstract:Aim: To investigate the association of Homocysteine with lipid parameter and oxidative stress Methods: Population based cross sectional study included 60 coronary artery disease patients who visited Himalayan Institute of Medical Sciences during may 2008 to april 2009. Homocysteine and lipid profile was estimated by fully autoanalyzer, MDA level for oxidative stress was estimated by colorimetric technique on RA 50 Semi autoanalyzer. Statistical analysis: Pearson correlation and ?t test? from which p values were obtained. Results: Plasma level of Homocysteine and Malondialdehyde were significantly higher (p=0.000) in cases (CAD patients) than controls. Homocysteine shows significant positive correlation with Total Cholesterol, VLDA, LDL,Triglyceride and Malondialdehyde. Homocysteine shows negative but insignificant correlation with HDL. Conclusion: Levels of Homocysteine and Malondialdehyde obtained were found to be positively correlated with each other and with lipid parameters in this study. This indicates that Homocysteine enhances the oxidative stress by lipid peroxidation, which may be one of the cause for development of coronary artery disease.

Keywords: Coronary artery disease CAD), Homocysteine(Hcy), Malondialdehyde(MDA)

Full Text:

INTRODUCTION
Coronary artery disease is the commonest cause of heart disease and the most important single cause of death in the affluent countries of the world. Along with the known classical risk factors for the development of coronary artery disease (CAD) like cigarette smoking, hypertension, low HDL, diabetes mellitus, obesity and physical inactivity, few emerging risk factors have also been identified, like lipoprotein ?a‘, homocysteine, prothrombotic factor and pro- inflammatory factor [1]. Homocysteine is naturally occurring sulfur containing intermediate product in normal metabolism of methionine, an essential amino acid. Homocysteine (Hcy) is metabolized by two major pathways which require vitamin B6, B12 and folic acid [2]. Homocysteine increases the damage to the cardiovascular system in different ways, one of them is the formation of reactive oxygen species from the auto oxidation of homocysteine. The auto-oxidation of homocysteine also produces reactive oxygen species including superoxide and hydrogen peroxide and enhances oxidative stress Aldehydes such as thiobarbituric acid reacting substances (TBARS) have been widely accepted as a general marker for free radical production. The most commonly measured TBARS is malondialdehyde (MDA) [3].

The results of more than 75 clinical and epidemiological studies have indicated a positive correlation between total homocysteine levels and CAD, peripheral arterial disease, stroke, and venous thrombosis. However vary few studies have been done to established correlation between homocysteine and oxidative stress in patients of CAD. Therefore this study was undertaken with a view to establish hyperhomocysteinemia and it‘s correlation with oxidative stress as one of the risk factors for coronary artery disease.

MATERIALS AND METHOD
The present study was conducted on 60 patients of coronary artery disease over a period of 12 months (Feb 2008- Jan 2009) in the Department of Biochemistry and Cardiology of Himalayan Institute of Medical Sciences, Swami Rama Nagar, Doiwala, Dehradun. The patients were from the intensive care unit of Cardiology department at HIMS. The patients included in the study satisfied the following criteria: The study also included 30 normal age matched healthy adults (20 males and 10 females), who served as controls. Approval from ethical committee was taken prior to study. Written informed consent was taken from all the participants after explaining detailed methodology to them

Collection of samples
All samples were collected in the morning after 12 hrs of overnight fasting. 2 ml of blood was drawn by venepuncture from the antecubital vein in an EDTA vacutainer for estimation of plasma MDA and homocysteine, and 2 ml of blood was collected in a plain vacutainer for estimation of lipid profile. Estimation of plasma homocysteine, serum total cholesterol, HDL cholesterol and triglycerides were done on SYNCHRON CX5, Automated Chemistry Analyzer of Beckman Coulter Ltd. Serum LDL cholesterol and VLDL cholesterol were calculated by using Friedewald‘s formula. Estimation of plasma malondialdehyde was done by colorimetric technique on RA 50 semi automated chemistry analyzer. Cholesterol was measured by a timed end point method of Allan and Poon (1974). The concentration of triglycerides is measured by a time endpoint method of Bucco and David (1973). The homocysteine levels in the plasma was estimated using the Hcy enzymatic assay as marketed by Diazyme [4]. MDA was measured by method of ceconi,Cargoni,Pasini et al(1992).The result of all the parameters undertaken were tabulated and statistclly analysed by the Pearson correlation and ?t test? from which p value were obtained.

RESULT
Table 1 below represents the mean values obtained for lipid profile, homocysteine and MDA in the case study group as compared with control group. Levels of Triglyceride, Total Cholesterol, LDL-C, VLDL-C were higher in study group than in controls, whereas level of HDL-C was lower in the study group compared to controls. The difference is statistically significant only for TAG, VLDL-C and HDL-C. Plasma level of Hcy and MDA were significantly higher (p=0.000) in cases (CAD patients) than controls. Hcy showed significant positive correlation with Total Cholesterol, LDLC,VLDL-C and triglycerides and insignificant negative correlation with HDL-C.


DISCUSSION
Statistically significant positive correlation between plasma Hcy and MDA obtained in our observations is supported by the study of Moselhy and Denerdash and vishnupriya and surapaneni which shows positive correlation between plasma Hcy and MDA levels with p value<0.001. Although the exact mechanism of Hcy toxicity is unknown, it is believed that tHcy or its metabolite adversely affects vascular endothelium inducing atherosclerosis by several mechanisms. e.g Auto oxidation of homocysteine generates hydrogen peroxide which has a toxic effect on endothelial cells. Hcy promotes lipids peroxidation and oxidation of low density lipoproteins. This modified oxidized LDL causes alteration of NO metabolism, alteration of functions and oxidative damages on vascular endothelial cells and platelets [4]. Auto-oxidation of homocysteine to the homocysteine radical, with the concomitant generation of superoxide anion, hydrogen peroxide, and hydroxyl radical, are the contributing factors for vascular injury that is associated with homocysteinemia . Hcy auto-oxidation and thiolactone formation promote the production of free radicals which are known to be initiators of lipid peroxidation in cells [6]. Hcy enhance lipid peroxidation. Lipid peroxidation occur more in hyperlipidemic state which can further enhance oxidative stress.

CONCLUSION
Levels of Hcy and MDA obtained were found to be positively correlated with each other and with lipid parameters in this study. This indicates that Hcy enhances the oxidative stress by lipid peroxidation, which may be one of the cause for development of coronary artery disease.

References:

1. Hackam D G, Anand S S. Emergency Risk Factors for Atherosclerosis Vascular Disease. J Am Med Assoc. 2003;290:932-40.

2. Kurban S, Mehmetoglu T, Oran B, Kiyici A. Homocysteine levels and total antioxidant capacity in children with acute rheumatic fever. Clinical biochemistry. 2007;41:26-29.

3. Tanriverdi H, Evrengul H, Enli Y, Kuru O, Seleci D, Tanriverdi S et al. Effect of Homocysteine-Induced Oxidative Stress on Endothelial Function in Coronary Slow-Flow. Cardiology 2007;107:313-320.

4. Jones B G, Rose F A, Judball N. Lipid Peroxidation and Homocysteine induced toxicity. Atherosclerosis 1994; 105: 16570.

5. Loscalzo J. The oxidant stress of hyperhomocysteinemia. J Clin. Invest. 1996; 98 : 5-7

6. Harker L A, Slichter S J, Scott C R, Ross R. Homocysteinemia. Vascular injury and arterial thrombosis. N Engl J Med 1974; 291: 537- 43.

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
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A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
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A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
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A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
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A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
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A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
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A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
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A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
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A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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