Factors associated with hyperhomocysteinemia in Crohn's disease

Aims - The incidence of thromboembolic disease is increased in patients wit h inflammatory bowel disease. Hyperhomocysteinemia is one of the risk facto rs for thrombosis. The aims were: 1) to assess the prevalence of hyperhomocysteinemia in a lar ge series of patients with Crohn's disease; 2) to search for clinical, and biological factors associated with: hyperhomocysteinemia. Patients and methods - One hundred seventy-one patients with Crohn's diseas e (64 mates, 107 females), median age 31 years (range: 16-82), were studied . The median duration of the disease was 7 years. The concentrations of hom ocysteine, folate, cobalamin and C-reactive protein were measured in serum from blood sample of each patient. Results - The mean concentration of seric homocysteine was 14.8 mu mol/L (N : 4.4 - 12.4 mu mol/L). Hyperhomocysteinemia was observed in 89 patients (5 2%). It was significantly associated with age, sex, smoking habit, serum co balamin level and history of ileal surgical resection (P < 0.05). In the gr oup of operated patients, there was a statistically significant association between hyperhomocysteinemia and the length of small bowel resected. In mu ltivariate analysis, sex and smoking, were associated with hyperhomocystein emia. Conclusion - More than half of the patients with Crohn's disease have hyper homocysteinemia. This result stresses the need for preventing reversible fa ctors associated with hyperhomocysteinemia, such as smoking and cobalamin d eficiency, in order to lower the thrombotic risk of patients with Crohn's d isease.