This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Martínez-Berriotxoa, A Articles by Aguirre, C Search for Related Content PubMed PubMed Citation Articles by Martínez-Berriotxoa, A Articles by Aguirre, C Social Bookmarking                   What's this?

Homocysteine, antiphospholipid antibodies and risk of thrombosis in patients with systemic lupus erythematosus

Service of Internal Medicine, Hospital de Cruces Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain

G Ruiz-Irastorza

Service of Internal Medicine, Hospital de Cruces Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain

M-V Egurbide

Service of Internal Medicine, Hospital de Cruces Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain

M Rueda

Service of Biochemistry, Hospital de Cruces Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain

C Aguirre

Service of Internal Medicine, Hospital de Cruces Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain, caguirre{at}hcru.osakidetza.net

Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Antiphospholipid syndrome (APS) is one of the most important causes of thrombosis in SLE. In addition, an association between hyperhomocysteinemia and increased cardiovascular risk has also been reported. Our aim is to analyse the association of thrombosis with plasma total homocysteine (ptHcy), antiphospholipid antibodies (aPL) and other vascular risk factors in SLE patients. Fasting plasma levels of ptHcy, vitamin B12, folate, total cholesterol and creatinine were measured in 117 SLE patients. Clinical and immunological data were obtained from our prospective computerized database. aPL-positivity was defined according to Sapporo criteria. There was no association between aPL and ptHcy. ptHcy was higher in patients with arterial (median 13.02 versus 10.16 mmol/L, P = 0.010) but not venous thrombosis. In the subgroup analysis, this association was only seen in aPL-negative patients. In logistic regression, aPL (OR 6.60, 95% CI 1.86-23.34) and ptHcy (OR 1.10, 95% CI 1.01-1.19) were independently associated with arterial thrombosis. However, when hypertension, smoking and plasma total cholesterol were added to the model, only aPL (OR 7.38, 95% CI 2.02-26.91) and hypertension (OR 7.70, 95% CI 2.33-25.39), but not ptHcy, remained independently related to arterial events. aPL was the only variable independently related to venous thrombosis (OR 7.68, 95% CI 1.60-36.86). ptHcy concentrations are higher in SLE patients with arterial thrombosis. No interaction between homocysteine and aPL was found. Raised ptHcy may be a marker of increased vascular risk in aPL-negative SLE patients. The role of homocysteine as a marker of vascular risk may depend on the presence of traditional risk factors, although a modest intrinsic effect cannot be entirely excluded.

Key Words: anticardiolipin antibodies • antiphospholipid antibodies • atherosclerosis • homocysteine • lupus anticoagulant • morbidity • prognosis • systemic lupus erythematosus • thromboembolism • thrombosis • vascular risk factors

Lupus, Vol. 13, No. 12, 927-933 (2004)
DOI: 10.1191/0961203304lu2035oa


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. DANOWSKI, M. N. L. de AZEVEDO, J. A. de SOUZA PAPI, and M. PETRI Determinants of Risk for Venous and Arterial Thrombosis in Primary Antiphospholipid Syndrome and in Antiphospholipid Syndrome with Systemic Lupus Erythematosus J Rheumatol, June 1, 2009; 36(6): 1195 - 1199. [Abstract] [Full Text] [PDF]

				P.E. Lazzerini, P.L. Capecchi, E. Selvi, S. Lorenzini, S. Bisogno, M. Galeazzi, and F. Laghi Pasini Hyperhomocysteinemia: a cardiovascular risk factor in autoimmune diseases? Lupus, November 1, 2007; 16(11): 852 - 862. [Abstract] [PDF]

				A. Martinez-Berriotxoa, G. Ruiz-Irastorza, M.-V. Egurbide, M. Garmendia, J. Gabriel Erdozain, I. Villar, and C. Aguirre Transiently positive anticardiolipin antibodies and risk of thrombosis in patients with systemic lupus erythematosus Lupus, October 1, 2007; 16(10): 810 - 816. [Abstract] [PDF]

				G Ruiz-Irastorza, M-V Egurbide, J-I Pijoan, M Garmendia, I Villar, A Martinez-Berriotxoa, J-G Erdozain, and C Aguirre Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus Lupus, September 1, 2006; 15(9): 577 - 583. [Abstract] [PDF]