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Plasma Homocysteine in Renal Failure, Diabetes Mellitus, and Alcoholism

  • Chapter
Homocysteine Metabolism: From Basic Science to Clinical Medicine

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 196))

Abstract

Homocysteine, a sulfhydryl amino acid, is the demethylated derivative of methionine [1]. Greatly elevated plasma levels of homocysteine are found in subjects with homocystinuria [1]. These patients exhibit early arteriosclerosis as well as arterial and venous thrombosis. Recently, milder hyper-homocysteinemia has been reported in patients with premature vascular disease, many of whom may be heterozygous for homocystinuria [2–8]. Other conditions such as folate and vitamin B12 deficiency also cause elevation of homocysteine in plasma [1,9,10]. Adenosyl-methionine, the precursor of homocysteine, is the principal methyl donor in mammals. After a methyl transfer reaction (transmethylation), adenosyl-homocysteine is hydrolyzed to homocysteine and adenosine. Homocysteine may be either catabolized in the transsulfuration pathway via cystathionine and cysteine to inorganic sulfur, or remethylated back to methionine, mainly by the folate- and vitamin B12-dependent enzyme methionine synthase [1]. Patients with chronic renal failure, whether dialyzed or not, have a high risk of premature vascular disease, especially coronary and cerebrovascular accidents [11,12]. Among other factors that could increase the risk of vascular disease in chronic renal failure is mild hyperhomocysteinemia. Likewise, patients with diabetes mellitus and patients with heavy alcohol consumption have an increased risk of premature vascular disease, which could possibly be related to hyperhomocysteinemia. It is therefore of interest to study plasma homocysteine in all these diseases.

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Authors
  1. Bjorn Hultberg
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  2. Anders Andersson
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  3. Margret Arnadottir
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Editor information

Editors and Affiliations

  1. The Adelaide Hospital, Trinity College, Dublin, Ireland

    Ian Graham MD

  2. Department of Clinical Biology, University of Bergen, Bergen, Norway

    Helga Refsum MD  & Per Magne Ueland MD  & 

  3. Jean Mayer Usda Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

    Irwin H. Rosenberg MD

  4. Tufts University School of Nutrition Science and Policy, Medford, MA, USA

    Jill M. Shuman MS, RD, ELS

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Hultberg, B., Andersson, A., Arnadottir, M. (1997). Plasma Homocysteine in Renal Failure, Diabetes Mellitus, and Alcoholism. In: Graham, I., Refsum, H., Rosenberg, I.H., Ueland, P.M., Shuman, J.M. (eds) Homocysteine Metabolism: From Basic Science to Clinical Medicine. Developments in Cardiovascular Medicine, vol 196. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5771-5_19

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  • DOI: https://doi.org/10.1007/978-1-4615-5771-5_19

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7645-3

  • Online ISBN: 978-1-4615-5771-5

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