Hyperhomocysteinemia and Vitamin B12 deficiency as a risk factor for ischemic stroke: A case–control study from Northwestern India

• Main Authors: Banshi Lal Kumawat, Chandra Mohan Sharma, Mohit J Shah, Maulik A Panchal
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Indian Journal of Health Sciences and Biomedical Research KLEU
• Subjects: Folate; hyperhomocysteinemia; ischemic stroke; Vitamin B12 deficiency
• Online Access: http://www.ijournalhs.org/article.asp?issn=2542-6214;year=2018;volume=11;issue=3;spage=228;epage=233;aulast=Kumawat

BACKGROUND: Vitamin B12 (B12) deficiency, by virtue of causing hyperhomocysteinemia (HHC), may be implicated as an acquired risk factor of ischemic stroke (IS), which is also easily modifiable. There is a scarcity of data from India regarding the prevalence of B12 deficiency in IS patients. OBJECTIVES: The objective of this study is to explore the relationship between B12 and folate deficiency, HHC, and IS. DESIGN: The study was a case–control study. MATERIALS AND METHODS: Eighty cases of IS were compared with equal number of age- and sex-matched controls. Plasma total homocysteine (tHcy) level, serum B12, and folate levels were analyzed as continuous data (Student's t-test) as well as categorical data (Chi-square test). Odds ratio (OR) for the occurrence of IS was calculated for each variable. Correlation of tHcy with serum B12 and folate was studied using Pearson's coefficient. RESULTS: Mean homocysteine was higher in cases compared to controls (20.49 ± 12.64 vs. 13.09 ± 6.96 μmol/L, P < 0.001, while B12 (282.46 ± 161.52 vs. 480 ± 248.92 pg/ml, P < 0.001) and folate (10.49 ± 6.86 vs. 17.00 ± 5.52 ng/ml, P < 0.001) were lower. Both HHC (OR 4.48, 95% confidence interval: 1.99–10.07, P + 0.0003) and B12 deficiency emerged as significant risk factors for occurrence of IS. Negative correlation of homocysteine with B12 (r = 0.457, P < 0.0001) and folate (r = 0.337, P = 0.0001) was observed. CONCLUSIONS: HHC appears to be an important risk factor for IS in Indian population. B12 deficiency is a major acquired cause for the same while folate deficiency is relatively rare.