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Hyperhomocysteinemia is a risk factor for postoperative ischemia in adult patients with moyamoya disease

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Abstract

Growing evidence has suggested that hyperhomocysteinemia (HHcy) is a risk factor for cerebral infarction. However, the effect of HHcy on postoperative cerebral ischemia is still unclear. We aim to investigate the relationship between HHcy and postoperative ischemia of adult patients with moyamoya disease (MMD). A total of 138 adult patients with MMD were prospectively recruited from July 1 to December 31, 2019. After excluding 14 patients accepting conservative therapy, all 124 patients who underwent surgical treatment were enrolled. Patients were grouped according to postoperative ischemia and HHcy presentation, respectively. Clinical data and laboratory examinations were compared by statistical analyses. Potential risk factors were evaluated by univariate and multivariate logistic regression analysis. Comparing to the normal, patients with postoperative ischemia were higher in serum homocysteine (Hcy) level (P = 0.039) and HHcy ratio (P = 0.035). Furthermore, HHcy was more common in males (P = 0.007) than females. Logistic analysis results showed that HHcy (OR 5.234, 95% CI 1.127–24.315; P = 0.035) was an independent risk factor. HHcy was significantly associated with postoperative ischemia in MMD patients. Our study found that HHcy was correlated to the risk of postoperative ischemia. HHcy can be used as an indicator and a potential therapeutic target for postoperative ischemia in adult patients with MMD. URL: http://www.chictr.org. Unique identifier: ChiCTR2000031412.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon reasonable request.

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All authors have read and approved the final manuscript.

Code availability

The SPSS software (version 26.0) was used for all the statistical analyses.

Funding

This work was supported by grants from the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (2015BAI12B04); Beijing Municipal Organization Department talents project (2015000021469G219); National Natural Science Foundation of China (81701137 and 81870904); and Beijing Municipal Administration of Hospitals’ Mission Plan (SML20150501).

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  1. Junsheng Li and Peicong Ge contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Nan Si Huan Xi Road 119, Fengtai District, Beijing, 100070, China

    Junsheng Li, Peicong Ge, Qian Zhang, Fa Lin, Rong Wang, Yan Zhang, Dong Zhang, Wen Wang & Jizong Zhao

  2. China National Clinical Research Center for Neurological Diseases, Beijing, China

    Junsheng Li, Peicong Ge, Qian Zhang, Fa Lin, Rong Wang, Yan Zhang, Dong Zhang, Wen Wang & Jizong Zhao

  3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Junsheng Li, Peicong Ge, Qian Zhang, Fa Lin, Rong Wang, Yan Zhang, Dong Zhang, Wen Wang & Jizong Zhao

  4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China

    Junsheng Li, Peicong Ge, Qian Zhang, Fa Lin, Rong Wang, Yan Zhang, Dong Zhang, Wen Wang & Jizong Zhao

  5. Beijing Translational Engineering Center for 3D Printer in Clinical Neuroscience, Beijing, China

    Junsheng Li, Peicong Ge, Qian Zhang, Fa Lin, Rong Wang, Yan Zhang, Dong Zhang, Wen Wang & Jizong Zhao

  6. Savaid Medical School, University of the Chinese Academy of Sciences, Beijing, China

    Jizong Zhao

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  1. Junsheng Li
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Contributions

Junsheng Li analyzed the results and wrote the manuscript. Peicong Ge made the statistical comparison. Qian Zhang and Fa Lin collected the patient data. Dong Zhang, Yan Zhang, and Rong Wang revised the manuscript. Jizong Zhao and Wen Wang designed the study.

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Correspondence to Wen Wang or Jizong Zhao.

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Li, J., Ge, P., Zhang, Q. et al. Hyperhomocysteinemia is a risk factor for postoperative ischemia in adult patients with moyamoya disease. Neurosurg Rev 44, 2913–2921 (2021). https://doi.org/10.1007/s10143-021-01482-9

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