Faculty Collaboration Database

Terminal ileum resection is associated with higher plasma homocysteine levels in Crohn's disease. J Clin Gastroenterol 2001 Aug;33(2):132-6

Date

07/27/2001

Pubmed ID

11468440

DOI

10.1097/00004836-200108000-00008

Scopus ID

2-s2.0-0034941560 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

BACKGROUND: Elevated plasma total homocysteine (tHcy) is associated with a higher risk of thrombosis. Crohn's disease (CD) is associated with hypercoagulability of undefined etiology. We investigated tHcy in patients with CD and its relationship with vitamin status, disease activity, location, duration, and history of terminal ileum (TI) resection.

STUDY: We examined fasting plasma tHcy, folate, serum vitamin B12 levels, and sedimentation rate in consecutive adult patients with CD. Harvey-Bradshaw index of CD activity and history of TI resection and thromboembolism were recorded.

RESULTS: Median plasma tHcy was 10.2 micromol/L in 125 patients with CD. Men (n = 60) had higher plasma tHcy than women (n = 65) (11.2 vs. 9.1 micromol/L; p = 0.004). Patients with a history of TI resection showed lower serum B12 levels (293 vs. 503 pg/mL; p < 0.001) and higher plasma tHcy levels (11.0 vs. 9.35 micromol/L; p = 0.027) than patients without such history. Multivariate analysis showed history of TI resection, serum B12, and creatinine levels to be significant predictors of elevated plasma tHcy. Fourteen patients with CD with a history of thrombosis had an elevated median plasma tHcy of 11.6 micromol/L.

CONCLUSIONS: Terminal ileum resection contributes to elevated plasma tHcy levels in CD cases. We recommend tHcy screening in patients with CD, especially in those with prior history of TI resection, and the initiation of vitamin supplementation when appropriate.

Author List

Vasilopoulos S, Saiean K, Emmons J, Berger WL, Abu-Hajir M, Seetharam B, Binion DG

Author

William L. Berger MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Blood Sedimentation
Creatinine
Crohn Disease
Female
Folic Acid
Follow-Up Studies
Homocysteine
Humans
Ileum
Male
Thrombophilia
Vitamin B 12