Importance of hyperhomocysteinemia as a risk factor for venous thromboembolism in a Taiwanese population. A case-control study

Objective: To determine the current status of hyperhomocysteinemia, which i s a known risk for venous thrombosis (DVT), in Taiwan. Subjects: 101 unsele cted patients with a minimum of one episode of deep leg DVT, either initial inpatients or current compliant outpatients in a teaching hospital. Method s: Various thrombophilic risks, gene polymorphism and clinical predispositi on were evaluated. Results and conclusions: Patients presented higher fast total plasma homocysteine (hcy) levels than age- and sex-matched controls d id (14.1 vs. 9.94 muM) Based on the 95th percentile of control values, hype rhomocysteinemia had a four- to nine-fold risk for DVT, irrespective of cli nical predisposition, as well as other thrombophilic risks surveyed. Polymo rphism of a metabolizing enzyme, methylenetetrahydrofolate reductase (MTHFR ), was not associated with DVT, although homozygous thermolabile mutation t ended to have higher plasma hey levels. Factor V Leiden was absent in analy sis of 80 patients. In complete evaluation (hcy, antithrombin (AT), protein S (PS), protein C (PC), lupus anticoagulant (LA), anticardiolipin antibody ) of a subset of 83 patients hyperhomocysteinemia was the most prevalent ri sk (33.7%), with PC or PS deficiencies following (22.9%). Thus, hyperhomocy steinemia is a prominent risk for DVT in Taiwan. (C) 2001 Elsevier Science Ltd. All rights reserved.