ABSTRACT

AIM. To study the effect of hyperhomocysteinemia in combination with and without hypercholesterolemia on the development of various pathogenetic variants of ischemic stroke.

MATERIALS AND METHODS. The study included 80 patients (33 with normohomocysteinemia, 47 with hyperhomocysteinemia), with an average age of 70.8 ± 10.9 years, who had suffered ischemic stroke of various etiologies according to TOAST with a verified CT focus. Laboratory parameters (total blood count, lipid spectrum, homocysteine concentration), clinical parameters (muscle strength, speech function, swallowing), clinical scales (SHRM, NIHSS) were evaluated.

RESULTS AND DISCUSSION. An increase in homocysteine levels demonstrated a weak positive relationship with the values of CPM (r = 0.24) and NIHSS (r = 0.25); a moderate negative relationship with muscle strength in the affected arm (r = -0.42) and leg (r = -0.34); a moderate positive relationship with the size of the infarction focus (r = 0.50). The group with hyperhomocysteinemia, in contrast to the second, significantly showed a more pronounced volume of the infarction focus and impaired muscle strength in the affected arm, p<0.05. No reliable data were found for the contribution of homocysteine to the heterogeneity of ischemic strokes.

CONCLUSION. The results of the study show the contribution of a high concentration of homocysteine to the severity of paresis of the affected limbs and the size of the stroke site, but at the same time do not determine the pathogenetic heterogeneity of ischemic stroke.

KEYWORDS: hyperhomocysteinemia, ischemic stroke, hypercholesterolemia, forceful paresis, heart attack site

For citation: Klebanskiy D.V., Predtechenskaya E.V. The Role of Hyperhomocysteinemia to the Development of Pathogenetic Variants of Ischemic Strokes: Cohort Study. Comorbidity Neurology. 2025; 2 (2): 14-21. https://doi.org/10.62505/3034-185x-2025-2-2-14-21

*For correspondence: Denis V. Klebanskiy, Clinical Postgraduate Student, Assistant Professor at the Department of Fundamental Medicine and the Department of Obstetrics and Gynecology at the V.L. Zelman Faculty of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia, e-mail: ritmandme@gmail.com

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ADDITIONAL INFORMATION

Denis V. Klebanskiy, Clinical Postgraduate Student, Assistant Professor at the Department of Fundamental Medicine and the Department of Obstetrics and Gynecology, V.L. Zelman Faculty of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia. E-mail: ritmandme@gmail.com. ORCID: https://orcid.org/0009-0009-9799-8412

Elena V. Predtechenskaya, Dr. Sci. (Med.), Professor, Department of Neuroscience, V.L. Zelman Faculty of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia. E-mail: elena_pred@mail.ru. ORCID: https://orcid.org/0000-0003-3750-0634

Author contributions. All authors confirm that their authorship complies with the international ICMJE criteria (all authors made a significant contribution to the development of the concept, the conduct of the study and the preparation of the article, read and approved the final version before publication). Special contributions: Klebansky D.V. selection of patients for research and material processing, text preparation, statistical data processing, statistical data processing; Predtechenskaya E.V. - research concept and design, scientific management, editing relevance, introduction, list of references.

Funding. The authors state that there is no external funding for the study.

Disclosure. The authors declare no apparent or potential conflicts of interest related to the publication of this article.

Ethics Approval. The study was approved by the Independent Ethics Committee of the Novosibirsk State Clinical Hospital of Emergency Medicine No. 2 (Novosibirsk, Russia) (Protocol No. 4 dated 11.10.2023).

Informed consent to publication. All patients, and if it was impossible to review and sign, the persons responsible for the patients (relatives, social workers, etc.) signed an informed consent on behalf of the patients who underwent the examination and participated in this study.

The content is available under the Creative Commons Attribution 4.0 License.

©2025. Denis V. Klebanskiy, Elena V. Predtechenskaya