Endocrine Abstracts

Moderately elevated plasma homocysteine levels (>12 μmol/l) are highly prevalent in the general population and are associated with an increased risk for cardiovascular disease. Homocysteine is an amino acid produced during catabolism of the essential amino acid methionine. Metabolism of homocysteine requires an adequate supply of folic acid, vitamin B12 and vitamin B6.

Moderate hyperhomocysteinemia may be caused by a variety of factors: chronic disorders (hypothyroidism, diabetes mellitus, systemic lupus erythematosus, chronic renal failure), nutritional deficiencies (folic acid, vitamin B12, vitamin B6), drugs (methotrexate, anticonvulsant agents, cyclosporine), postmenopausal status, smokers, enzyme deficiencies.

Measurement of plasma homocysteine was performed by ELISA method, during the fasting state.

Hypothyroidism is associated with increased cardiovascular morbidity, which might be explained by the atherogenic lipid profile and/or hyperhomocysteinemia.

We studied plasma homocysteine and folate levels in a group of 25 patients with primary hypothyroidism, before and during levothyroxine treatment. After achieving euthyroidism, plasma homocysteine and folate were also measured before and after three months of daily folate supplimentation. In some of our patients with plasma homocysteine lower than 10 μmol/l during levothyroxine therapy, a significant decrease of plasma homocisteine levels was achieved after the folate supplementation.