Background: In normal population, serum homocysteine (Hcy) is considered as a marker ofÂ atherosclerotic and cerebro-cardiovascular diseases. It is not clear whether this phenomenon alsoÂ occurs in chronic kidney disease particularly among pre-dialytic population. This study aims toÂ determine relationship between serum Hcy concentrations and carotid arteries intima-media thicknessÂ (CA-IMT) of pre-dialytic chronic kidney disease (CKD) patients.
Method: A cross-sectional study was carried out on pre-dialytic CKD patients. Morning fasting blood samples were taken for lipid profile, blood sugar, blood urea nitrogen, serum creatinine concentrations. Total fasting serum Hcy concentrations were measured using chemiluminescent assay. CA-IMT of patients were measured by USG B-Mode Logiq-5 (General Electric), with 7.5 MHz linear transducer at both left and right, common and bifurcation of carotid arteries.
Results: Ninety (74 males, 16 females) of pre-dialytic
patients, age 54 - 7 years, SBP 137Â±20 mmHg, DBP 78Â±13 mmHg, BMI 23.9Â±4.4 kg/m2 FBS 94Â±16Â mg/dL and 2h pp BS 125Â±31 mg/dL, total-C 201Â±65 mg/dL, LDL-C 129Â±62 mg/dL, HDL-C 40Â±13Â mg/dL, TG 144Â±81 mg/dL, phosphate 3.8Â±1.3 mg/dL, calcium 8.7Â±1.1, and CaXP 32Â±8, and totalÂ serum Hcy 17.11Â±6.91 Î¼mol/L, e-GFR (CG formula) 36Â±17 ml/minutes were included in this study.Â There were significant negative correlation between Hcy concentrations and left common CA-IMT (rÂ = 0.28; B = -11.01; p = 0.02) and right bifurcation CA-IMT (r =0.26; B = -11.01; p=0.042). WhileÂ there were a trend of negative correlation between total serum Hcy and right common CA-IMT (r=Â 0.21; B = -8.27; p=0.10) and left bifurcation CA-IMT (r= 0.20; B=-6.69; p=0.11).
Conclusion: ThereÂ is a negative association between total serum Hcy concentrations and atherosclerotic process in carotidÂ arteries. The inverse relationship may support phenomenon of inverse epidemiology among predialytic
CKD patients and seemed that serum Hcy reflects nutritional marker rather than a marker of