Abstract
To study the possible role of homocysteine in aneurysmatic progression, in 1994, 112
of 141 male patients with abdominal aortic aneurysm (AAA) diagnosed by population
screening were interviewed and examined. Creatinine clearance estimated and total
plasma homocysteine (P-tHcy) was measured by gas chromatography-mass spectrometry.
Of the 112 cases, 99 were followed with annual ultrasonography and blood pressure
measurements for 1–5 years (mean 2.5 years). The mean creatinine clearance was 70.8+/-23.1
ml/min, while the mean P-tHcy was 16.0+/-10.6 mmol/l, significantly increased compared
with an age- and sex-matched reference population (P < 0.01). However, no trend of correlation with AAA size or aneurysmal progression
was found concerning creatinine clearance and homocysteine level. There were still
no trend after adjustment for age, smoking, diastolic blood pressure, and initial
ankle blood pressure index. However, the homocysteine level was positively correlated
with decreasing creatinine clearance (r = 0.36,P < 0.01), and this correlation was still present after the same adjustments. A large
proportion of men with AAA have mild hyperhomocysteinemia; this does not influence
aneurysmal progression and may be due to coexisting impaired renal function. The finding
might explain why prospective and intervention studies cannot prove for certain that
hyperhomocysteinemia influences atherosclerotic progression, or that treatment is
beneficial.
