Among patients with rheumatoid arthritis (RA), the presence of white matter lesions (WML) is significantly associated with total homocysteine levels, conclude Japanese investigators.
RA patients have increased morbidity and mortality, largely due to increased cardiovascular and cerebrovascular disease. Previous studies have indicated that WML are a prognostic factor for stroke, and that plasma total homocysteine is linked to cerebrovascular events.
To determine whether WML correlate with total homocysteine in RA patients, Futoshi Anan, from Oita Red Cross Hospital, and colleagues performed brain magnetic resonance imaging in 65 RA patients.
The patients were divided into 25 WML-positive patients with an average age of 61 years, and 40 WML-negative patients with an average age of 60 years. The team then compared total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose, and total homocysteine levels between the groups.
The team reports in the journal Metabolism: Clinical and Experimental that the duration of RA was longer in WML-positive than in WML-negative patients, at 10.6 years versus 7.1 years. There were no significant differences in terms of resting systolic blood pressure, diastolic blood pressure, and heart rate.
WML-positive patients had higher fasting plasma glucose, triglycerides, and total homocysteine levels than WML-negative patients, along with lower HDL cholesterol levels. Multivariate analysis indicated that the only significant and independent risk factor for WML was high total homocysteine levels, at an odds ratio of 1.35.
The team says: “The novel and important findings of the present study reveal that a greater proportion of the RA patients in the WML-positive group had greater total homocysteine than those in the WML-negative group.”