Nura H Alkali, Hillary Watt, Sunday A Bwala, Amos Gadzama.
Association of plasma homocysteine and ischemic stroke in a Nigerian population.
Pak J Med Sci Jan ;22(4):405-8.

Objective: Epidemiologic evidence suggests that raised plasma homocysteine is an independent risk factor for ischaemic stroke. However, other studies found no association between plasma homocysteine and stroke. Our objective was to determine the relationship between plasma homocysteine concentrations and ischaemic stroke in the Nigerian population where there is no existing published data. Design: Case-control study. Setting: University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Fifty patients with ischaemic stroke and 50 control subjects, aged and sex-matched, were studied in relation to plasma homocysteine and other vascular risk factors. Main Outcome Measures: Comparison of mean plasma homocysteine between stroke cases and control subjects and Odds Ratios for stroke in patients with hyperhomocysteinemia. Results: Mean plasma homocysteine was significantly higher in stroke cases than in control subjects (mean ± SD: 20.8±10.2µmol/L vs. 13.1±4.5µmol/L; P<0.001). Other factors associated with ischaemic stroke were obesity, hypertension and elevated serum cholesterol. Using logistic regression analysis, there was an adjusted Odds Ratio of 1.9 (95% CI, 1.16–3.08) for ischaemic stroke for every 5µmol/L increase in plasma homocysteine concentrations. Conclusions: Raised plasma homocysteine was significantly associated with ischaemic stroke and treating hyperhomocysteinemia may be an effective way of decreasing the incidence of stroke.

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