Search

Aims: The aims of this study were to explore the left ventricular (LV) structural remodeling and its risk factors in type 2 diabetes mellitus (T2DM) patients with or without hyperhomocysteinemia (h...

Coronary conduit ectasia speaks to a type of atherosclerotic coronary course sickness found in 3-8 % of patients going through coronary angiography We meant to utilize homocysteine level for ahead of schedule and simple location of coronary vein ectasia to improve the dreariness and mortality in patients with coronary supply route ectasia Subjects and strategies: patients were partitioned into two gatherings: gathering (1) 50 patients with detached CAE and gathering (2) 50 patients with typical coronary corridors. All subjects were oppressed Echocardiography and CRP and Plasma Homocysteine levels. Results : The echocardiographic proof of LVH was altogether higher in bunch 1 and there was no critical contrast between the two gatherings with respect to LVEDD, LVESD and LVEF the methods for Homocysteine and CRP were fundamentally higher in gathering (1) while no huge distinction between the two gatherings in regards to the serum creatinine level.With significance of huge positive connection between's number of ectatic fragments and Homocysteine level.Conclusion: Our discoveries recommend that hyperhomocysteinemia may assume a significant part in early analysis of coronary vein ectasia.

Background: Epilepsy is one of the most common neurological disorders in children. It often requires long-term antiepileptic drug (AED) therapy. AEDs are frequently associated with cognitive and behavioral dysfunctions. Also, there is a relationship between AEDs use and homocysteine levels. Elevated homocysteine has been associated with cognitive dysfunction. However, such effect among epileptic children has not been well-studied. Aim of the work: To study plasma homocysteine level in children under treatment with AEDs and its relation to intelligence quotient (IQ). Patients and Methods: A case control study included 56 epileptic children on AED therapy for at least 6 months, and 36 healthy children (Controls). Study was conducted at Al-Azhar University Hospital (Damietta) from June 2016 to June 2018. Plasma homocysteine was measured using Enzymatic Recycling (Biotecnica Instruments SpA). IQ testing was conducted using Stanford-Binet Intelligence Scales, Fifth Edition. Results: Epileptic children exhibited significant elevation of Homocysteine level (P=0.005), and significant affection of all IQ parameters. There was significant negative correlation between homocysteine level with total working memory, total verbal IQ and total IQ. Multivariate regression analysis revealed that homocysteine showed a significant and independent association with total working memory, total verbal IQ and total IQ. None of the other studied factors revealed such association. Conclusion: Homocysteine was a significant and independent risk factor for low total working memory score, low total Verbal IQ and low total IQ scores. Further studies are required to confirm these results, and to evaluate the effect of homocysteine-lowering treatment on cognitive function in epileptic children.

Objectives: To investigate the association between plasma homocysteine (Hcy) status and metabolic syndrome (MS) among Saudi patients attending King Abdulaziz Medical City in Riyadh, Saudi Arabia. Methods : A record-based cross-sectional study of 446 patients was carried out. All consecutive plasma Hcy levels from 2015 to 2018 were extracted. International Diabetes Federation criteria for MS were used to classify the patients. A multivariate regression model was developed to examine the associations between plasma Hcy and MS. Results: The mean plasma Hcy level was 10.52 µmol/L, and 40% of the patients exhibited elevated Hcy status. Male patients had significantly elevated Hcy levels compared to female patients ( p less than 0.001). In addition, plasma Hcy levels were significantly higher in patients diagnosed with diabetes ( p =0.021) and hypertension ( p less than 0.001). The prevalence of MS within the study population was 51%. Homocysteine levels were associated with the presence of MS independent of demographic, anthropometric and biochemical variables (odd ratio 1.018; 95% confidence intervals 1.011 -1.047). Conclusion: Plasma Hcy levels were elevated in 40% of the MS patients. Homocysteine had weak association with the presence of MS. Additionally, it was associated with some of its components individually. This study has raised the importance of investigating the association between Hcy status and MS among a representative sample of Saudi population. Additionally, examining possible association and interaction between Hcy level and specific component of MS is suggested to be explored in future studies. Saudi Med J 2020; Vol. 41 (9): 947-954 doi: 10.15537/smj.2020.9.25273 How to cite this article: Saeed A, Al Shehri M, Al Saleb A, Othman F, Al Hazmi M, Al Amri F, Ferwana M, Al Yousef MZ, Al Turki M. The association between plasma homocysteine level and metabolic syndrome. A record-based study of Saudi patients attending King Abdulaziz Medical City in Riyadh, Saudi Arabia. Saudi Med J. 2020 Sep;41(9):947-954. doi: 10.15537/smj.2020.9.25273.

BACKGROUND: Oral isotretinoin is an effective therapy for acne. However, isotretinoin can induce hyperhomocysteinemia and decreased serum folic acid level, which may be a risk for cardiovascular disease and thrombosis, as well as psychoses. Besides, many recent types of research emphasise the safety and effects of the low dose isotretinoin therapy. AIM: The aim of our study was to evaluate the effect of the low-dose isotretinoin on the plasma homocysteine and serum folic acid level in the Vietnamese population. METHODS: We conducted a longitudinal study to evaluate the effectiveness of the low-dose therapy on the plasma homocysteine and serum folic acid level of 52 acne patients after 6-8-week treatment at University Medical Center Ho Chi Minh City, Viet Nam. Patients had moderate-severe acne with the prolonged course, and most of them had a scar. RESULTS: With a low dose of oral isotretinoin (0.37 ± 0.11 mg/kg/day), after 6-8-week treatment, patients dropped the severity of disease, increased the plasma homocysteine level and decreased the serum folic acid level with significant differences in comparison to those before treatment. However, these changes do not exceed the normal range. CONCLUSION: In overall, low dose isotretinoin treatment had effectiveness in decrease the severity of disease and no increasing the plasma homocysteine level as well as the serum folic acid level.

Background: CKD is defined as the presence of kidney damage, manifested by abnormal albumin excretion or decreased kidney function, quantified by measured or estimated glomerular filtration rate (GFR), that persists for more than 3 months. Methods: The hospital based cross-sectional study was conducted on 100 patients with CKD. Patients fell within the ages of 20 to 85 years and either were with stage 2–5 CKD. They were recruited from the outpatient clinic of the Division of general medicine govt. medical college, Bharatpur (Rajasthan). Patients’ diagnoses and CKD staging were confirmed by an experienced Physician. Results: Mean value of homocysteine level was 15.35 μmol/L in stage 2-3 and 28.34 μmol/L in stage 4-5 of CKD patients. Conclusion: Level of homocysteine increased according to the stages of CKD. Keywords: Homocysteine, GFR, CKD.

Objective: The aim of this study was to evaluate correlation between plasma homocysteine and coronary artery disease (CAD) in Indian patients. Methods: This study included 150 patients, 100 subjects in study group with angiographically diagnosed CAD and 50 subjects in control group with a normal coronary angiogram. In the study group, patients were divided into three subgroups viz.: CAD only, CAD with hypertension and CAD with type 2 diabetes mellitus. Plasma homocysteine, lipid profile and other risk factors were compared. Results: Mean homocysteine levels in study group (38.34 ± 15.25 μmol/L) were significantly higher (p < 0.01) than control group (9.41 ± 4.22 μmol/L). No association was found between homocysteine level and conventional risk factors. Furthermore, no significant correlation was found between plasma homocysteine and lipid components in different groups of patients. Conclusion: The study demonstrated that increased levels of homocysteine are independently related to CAD. However, further studies involving a larger sample size will be required to substantiate the findings of the current study.

Yuefeng Zhu,1 Jie Shen,2 Qun Cheng,3 Yongqian Fan,1 Weilong Lin1 1Department of Orthopedics, 2Department of Pharmacy, 3Department of Osteoporosis, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China Objective: To study the relationship of plasma homocysteine (Hcy), bone turnover biomarkers (BTB), and bone mineral density (BMD) with osteoporotic fracture (OPF) in elderly people.Methods: Eighty-two patients (aged 65 years or older) admitted to our orthopedics department between October 2014 and May 2015 were randomly divided into three groups: 1)OPF group: 39 cases with the mean age 81.82±5.49 years, which included 24 females and 15males; 2)high-energy fracture (HEF) group: 22 cases with the mean age 78.88±5.75 years, which included 16females and six males; 3) non-bone-fracture group: 21 cases with mean age 79.75±5.47years without bone fracture, which included 14 females and seven males. PlasmaHcy, BTB, and BMD were measured. Analysis of variance and multiple regression analysis were used in the statistical analysis.Results: There was no significant difference in either age or sex among the three groups. There were significant differences in plasma Hcy and hip BMD between the OPF and HEF groups; there was also significant difference in plasma Hcy, 25-(OH) Vit D, and hip BMD between the OPF and non-fracture groups. There was no difference in lumbar spine BMD between the OPF group and the other two groups. There was no significant difference in plasma Hcy, 25-(OH) Vit D, hip or lumbar spine BMD between the HEF and non-fracture group. There was no significant difference in procollagen type I N-propeptide of type I collagen, serum C-terminal cross-linking telopeptide of type I collagen, and parathyroid hormone among the three groups. Plasma Hcy was linearly correlated with age and serum C-terminal cross-linking telopeptide of type I collagen, but not correlated with either hip or lumbar spine BMD or any other BTBs.Conclusion: In this study, we found that the plasma Hcy level in elderly patients with OPF is higher than that of nonosteoporotic patients. It is not correlated with BMD, but positively correlated with bone resorption markers. An increased Hcy level appears to be a risk factor for OPFs in elderly people. Keywords: elderly patient, osteoporosis, fracture, homocysteine, bone mineral density, bone turnover marker

The study was designed to evaluate the changes of plasma homocysteine (Hcy) level in children with postural tachycardia syndrome (POTS) and explore its significance. A total of 65 subjects were recruited in our study, of whom 35 children were in the POTS group and 30 healthy children were in the control group. Plasma Hcy levels were determined in all subjects. The relationship between the plasma Hcy level and the symptom score was analyzed in the 35 POTS patients. The relationship between the plasma Hcy level and the change in heart rate from the supine to upright position (ΔHR) and between the plasma Hcy level and the rate of increase in heart rate from the supine to upright position (ΔHR/sHR × 100%) were analyzed in all subjects. The plasma Hcy levels were significantly higher in the children with POTS than those in the control group (9.78 [7.68, 15.31] μmol/L vs. 7.79 [7.46, 9.63] μmol/L, P < 0.05). The plasma Hcy levels were positively correlated with symptom scores in the POTS patients (n = 35, r = 0.522, P < 0.01). The plasma Hcy levels were also positively correlated with ΔHR (n = 65, r = 0.332, P < 0.01) and ΔHR/sHR × 100% (n = 65, r = 0.341, P < 0.01) in all the subjects. In conclusion, the plasma Hcy levels were elevated in the children with POTS positively correlated with the severity of POTS, suggesting that Hcy might be involved in the pathogenesis of POTS.

WOS: 000363083300005, Objectives: This study aims to evaluate the relationship between serum homocysteine levels and atherosclerotic plaques in carotid arteries in female patients with rheumatoid arthritis (RA). Patients and methods: Fifty-eight females with RA (mean age 45.50 +/- 11.69 years; range 42 to 60 years) and 22 female controls (mean age 47.3 +/- 8.9 years; range 38 to 62 years) with mechanical low back pain were included in the study. RA patients were divided into two groups: patients who were under methotrexate (MTX) therapy at least for two years (MTX group, n=32), and patients who did not receive MTX at least for past two years (non-MTX-disease-modifying antirheumatic drug group, n=26). RA patients' disease activity scores in 28 joints were calculated. Carotid intima-media thickness and presence of atherosclerotic plaque were evaluated by high-resolution B-mode ultrasonography. Results: Plasma homocysteine levels were higher in MTX and non-MTX-disease-modifying antirheumatic drug groups compared to controls (16.88 +/- 6.84 and 10.37 +/- 2.54 mu mol/L, respectively) and the difference was statistically significant (p=0.001). In MTX, non-MTX-disease-modifying antirheumatic drug and control groups, atherosclerotic plaque was detected in 11 (34.5%) and four (15.4%) patients, and one patient (4.5%), respectively. Carotid intima-media thickness was significantly higher in MTX group compared to other two groups and the difference was statistically significant (p=0.002). Pearson correlation analysis revealed a significant correlation between intima-media thickness and homocysteine levels in MTX group (r=0.49, p=0.006). Conclusion: According to our study results, methotrexate treatment in female patients with RA increases plasma homocysteine levels and prevalence of atherosclerotic plaque. High homocysteine levels in these patients may be a cause of atherosclerosis.

Summary Cardiovascular diseases (CVD) of atherosclerotic origin and accompanying complications are a major cause of mortality in the world and Ukraine, in particular. Endothelial dysfunction is the key cause of atherosclerosis and atherothrombosis. One of the causes of endothelial dysfunction is hyperhomocysteinemia that may occur on the background of MTHFR (methylenetetrahydrofolate reductase) mutation. Thus, the goal of the study was to investigate the interrelation between homocysteine (Hc) level and MTHFR polymorphism in patients with acute coronary syndrome (ACS). 161 patients with ischemic heart disease and ACS have been examined. The control group comprised 87 healthy individuals. Homocysteine level was the highest in the patients having ACS with ST-segment elevation and complicated course, and was 1.8 times higher than Hc level in the control group. The patients with the most severe ACS course comprised 27 % of homozygotes for the major allele C and 41 % of homozygotes for the minor allele T. Comparing the distribution of MTHFR gene C677T polymorphism in patients with ACS that were stratified by plasma Hc level, we observed a statistically significant association, P < 0.030 by chi-square test. We confirmed that these patients had a high T/T genotype frequency of MTHFR C677T polymorphism. The obtained data proved the association of T/T genotype of MTHFR C677T polymorphism with increased Hc level as well as ACS severity.

Background: Homocysteine is an small amino acid, containing sulfur that if increased causing various complications, such as cardiovascular diseases are heart. Objective: The relationship between homocysteine and age, sex, underlying disease, cigarette consumption was determined. Materials and Methods: In this cross - sectional study, 94 patients with chronic arterial disease were studied. Data on age, sex, Chronic disease (diabetes, hypertension, hyperlipidemia), smoking status were collected from all patients. Information collected by questionnaires were entered into SPSS software And using descriptive and inferential statistics (t-test and chi-square) were analyzed. Results: In this study, 31 (33%) women and 63 (67%) were male with a mean age of 69 years were enrolled. 16% of patients with lower homocysteine levels (10). The results showed that homocysteine levels in persons with high blood pressure, chronic disease, smoking, male gender and age above 40 years were above 10 and was a significant difference with Control group (p

Homocysteine (Hcy) is a four-carbon amino acid with a free thiol group, which is formed by demethylation of methionine, together with the help of some vitamins (B12, B6 and folate). The mechanisms responsible for hyperhomocysteinaemia in rheumatoid arthritis (RA) are not clear. However, drugs such as methotrexate has shown to have an effect on homocysteine metabolism, and interfers with vitamin metabolism and absorption. The aim of study was to assess plasma homocysteine level among Sudanese rheumatoid arthritis patients and to correlate homocysteine level with various types of treatment. A case control study was performed in Khartoum state, Sudan. A total of 60 Sudanese were enrolled in this study (30 RA patients and 30 healthy controls), 6 (20%) were males and 24 (80%) were females. Homocysteine levels were assessed using A15 analyzer. The consents were obtained from patients and it was approved by ethical committee of AL Neelain University. The mean SD was determined and then compared between cases group and controls group by calculating the P.value, the data was analyzed using SPSS. Homocysteine was found to be increased in 26 (86.7%) out of 30 RA cases. There was a significant difference in homocysteine level (P-value: 0.000) between cases and controls; with a mean of 24.6, 15.06 μmol/L; respectively. There was a significant in homocysteine levels with different types of treatment (P-value: 0.000). Plasma homocysteine level increases in Rheumatoid arthritis.

Hyperhomocysteinemia has been proposed as an important cardiovascular risk factor. However, little is known about the association between homocysteine (Hcy) levels and peripheral microvascular endothelial dysfunction (MED). This study included patients who underwent non-invasive microvascular

article i nfo Background: Accumulating data suggest that hyperhomocysteinemia is associated with the risk of ischemic stroke (IS) and coronary heart disease (CHD) in the general population, but the relationship remains unclear in hypertensive patients. We examined the association of total homocysteine (tHcy) with IS and CHD in hyper- tensive patients. Methods: A total of 5935 Chinese hypertensive patients were recruited in a community-based cross-sectional study from 60 communities in Shenzhen, China. Plasma tHcy was quantitatively measured using the enzyme cycle method. Conventional risk factors for IS and CHD were obtained through questionnaire interviews and physicalexaminations. We includedcerebralinfarction, embolismandsmall-vesseldiseaseasIS; and myocardial infarction,anginapectoris,coronary revascularization, and cardiac arrestas CHD. ISand CHD wereretrospective- ly adjudicated by specialists via interviews, hospital records or relevant tests. Results: Significantly higher values of tHcy were observed in IS patients than in non-IS controls among both men and women.GreatertHcy level wasdosedependentlyassociatedwith anincreasedrisk of ISpresenceinwomen, men and them combined (p-trend: 0.002, 3.8 × 10 −4 and 0.001). The odds ratios (95% CI) of IS for tHcy ≥30 (vs. b15) μmol/L were 2.84 (1.73-4.34) in men, 4.41 (1.62-9.15) in women, and 2.86 (1.72-4.75) in their combination after adjusting for other main risk factors of IS. We did not find any significant association be- tween tHcy and presence of CHD after the adjustment for covariates. Conclusions:Plasma homocysteine level is positively associated with the presence of IS, but not CHD, in Chi- nese hypertensive patients.

Hyperhomocysteinemia is strongly associated with cardiovascular diseases. Previous studies have shown that phytoestrogenα-zearalanol can protect cardiovascular system from hyperhomocysteinemia and ameliorate the level of plasma total homocysteine; however, the underlying mechanisms remain to be clarified. The aim of this research is to investigate the possible molecular mechanisms involved in ameliorating the level of plasma homocysteine byα-zearalanol. By the successfully established diet-induced hyperhomocysteinemia rat models, we found that, afterα-zearalanol treatment, the activity of cystathionineβ-synthase, the key enzyme in homocysteine metabolism, was significantly elevated and level of nitrative stress in liver was significantly reduced. In correlation with this, results also showed a decreased nitration level of cystathionineβ-synthase in liver. Together data implied that alleviation of plasma homocysteine level by phytoestrogenα-zearalanol might be related to the reduction of cystathionineβ-synthase nitration.

International audience; Altered homocysteine metabolism defined as hyperhomocysteinemia is implicated as pathogenic factor in several cardiovascular diseases and atherosclerosis. The purpose of this study was to investigate the efficacy of prune extract, a good source of phenolic antioxidants, on lowering plasma homocysteine level in male hyperhomocysteinemic mice from average weight of 28 g. The administration of lyophilized prune extract was carried out by intraperitoneal injection one day preceding and one hour before sacrifice of mice. Prune extract decreased significantly plasma homocysteine level, correlated with an increased activity of S-adenosylhomocysteine (SAH) hydrolase and NAD(P)H: quinone oxydoreductase-1 activities. Our results suggest a beneficial effect of prune extract on hyperhomocysteinemia with reduction of homocysteine level by its conversion on to SAH by S-adenosylhomocysteine hydrolase, which is activated by NAD(+), a by-product of NAD(P)H: quinone oxydo reductase-1. (C) 2017 Elsevier Ltd. All rights reserved.

Background: Patients with vascular dementia (VaD) exhibit particularly elevated levels of plasma total homocysteine (tHcy) compared to patients with other psychogeriatric diseases. Methods: We investigated the main determinants (age, renal impairment, cobalamin/folate status and presence of extracerebral vascular disease) of plasma tHcy in 525 patients with VaD. Furthermore, 270 patients with depression were used as a reference group to reveal the potential specificity of elevated plasma tHcy in patients with VaD. Results: Elevated plasma tHcy levels in patients with VaD could only partly be attributed to cobalamin/folate deficiency or renal impairment. Plasma tHcy might also be related to the vascular disease process since patients with depression and vascular disease exhibited similar plasma tHcy levels to patients with VaD. Conclusion: Our findings suggest that elevated plasma tHcy might be a sensitive marker for the vascular disease process in patients with VaD and that the level also is a reflection of changes in the other main determinants of plasma tHcy.

Backgrounds: The cause o f id iopath ic Parkinson 's d isease (IPD ) is unknown, but reduced activ ity o f com plex I o f the e lectron -transport cha in has been im p licated in the pathogenes is o f IPD . H yperhom ocyste inem ia is a wellestab lished risk factor for card iovascu lar and cerebrovascu lar d iseases. However, recent evidence suggests that changes in the m etabo lic fate of hom ocyste ine, lead ing to hyperhom ocyste inem ia, m ay a lso p lay a ro le in the pathophys io logy of IPD . M ethods: Age and sex-m atched 41 drug -na ive IPD patients (16 m en and 25 wom en) and 161 hea lthy contro ls (66 m en and 95 wom en) were inc luded in th is study. The ir fasting p lasm a hom ocyste in and fo la te leve l, and the genotypes of m ethylenetetrahydrofo late reductase (M THFR ) were ana lyzed. Resu lts : The p lasm a leve l o f hom ocyste ine was h igher in untreated IPD patients (12 .0±2 .9 μm ol/L) com pared to the contro ls (9 .0±2 .6 μm ol/L) (p=0 .001 ). The frequenc ies of M THFR C677T genotypes were not d ifferent between patients (CC :CT:TT=7 :23 :11 ) and contro ls (CC :CT:TT=27:86 :48 ) (p=0 .930 ). The ad justed odds ratio o f hom ocyste ine was rem arkab le (ad justed OR=1 .149, 95% confidentia l interva l=1 .66 -2 .28 , p=0 .004 ). Conclus ions : IPD patients have higher plasma homocysteine level than healthy controls but MTHFR C667T genotype was not related to the homocysteine leve l. It can be suggested that increased p lasm a hom ocyste ine leve l m ay contribute to the pathogenes is o f IPD . Journal of Movement Disorders 1(2):71-74, 2008

The effects of betaine on the plasma homocysteine concentration were investigated in partially folate deficient rats. The rats were fed a test diet containing folic acid at a dose of 8 (control) or 0.5 (low folate) mg/kg. After a 4-week feeding, the plasma homocysteine concentration in the low-folate group increased to 1.6-fold that in the control group. Betaine supplementation (30 g/kg diet) significantly suppressed the plasma homocysteine level elevation and led to an upward trend in liver betaine-homocysteine methyltransferase (BHMT) activity, whereas no change was observed with supplementation with choline (10 g/kg diet), a precursor of betaine. The results of this study suggest that betaine suppresses the plasma homocysteine level elevation induced by low folate intake, and the suppression is associated with the metabolic pathway driven by BHMT.

Background: Thromboembolic disease is a major cause of morbidity and mortality in many countries. Our previous study found that Chinese subjects carried the same polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene as described in Western studies. The aim of the present study was to determine the influence of MTHFR polymorphism, B vitamins and other factors on plasma homocysteine (Hcy) levels and risk of thromboembolic disease in Chinese. Methods: One hundred and six subjects were enrolled into the study. They were categorized into 4 groups: healthy individuals (n = 42); those with diabetes mellitus (n = 20); those with deep vein thrombosis (DVT) (n = 11); and those with coronary artery disease (CAD) (n = 33). Plasma levels of folic acid, vitamins B6 and B12, Hcy, and fasting blood sugar were measured; total cholesterol, triglycerides, complete blood count, and 677 C→T mutation in MTHFR were determined. Results: Plasma Hcy was lowest in the healthy subjects, higher in diabetics, followed by patients with DVT, and highest in patients with CAD (p < 0.001, ANOVA). MTHFR C677T polymorphism was the common factor affecting plasma logHcy levels in all 4 groups of subjects. Triglycerides affected plasma logHcy in the CAD patients. For the 4 groups as a whole, MTHFR polymorphism, triglycerides, and vitamin B12 were the most significant factors influencing plasma Hcy. Conclusion: We suggest that high plasma Hcy is an important risk factor for CAD. Other factors including MTHFR polymorphism, vitamin B12, triglycerides, total cholesterol, and gender might affect Hcy levels in different diseases and conditions. (J Chin Med Assoc 2005;68(12):560-565)

Purpose To compare plasma homocysteine levels between patients with dry eye disease and normal control subjects. Methods Plasma homocysteine (enzyme immunoassay), vitamin B12, and folate levels were determined in 38 patients with dry eye and in 38 controls. Results Characteristics of the dry eye and control groups were similar. The mean plasma homocysteine level was 16.38 ± 6.98 μmol/L in the dry eye group and 14.39 ± 5.11 μmol/L in the control group (P = 0.10, t test). Hyperhomocysteinemia was present in the 43.9% of the dry eye patients and 33.3% of the controls (P = 0.43, χ test). There were no statistical differences between dry eye and control groups regarding plasma vitamin B12 and folate levels (P = 0.72 and P = 0.69, respectively, t test). Conclusions Plasma homocysteine levels in dry eye patients may be inadequate to give homocysteine a role in pathogenesis. However, in ocular diseases like glaucoma, plasma homocysteine levels are significantly higher, and associated dry eye disease may cause an additional increase in plasma homocysteine levels.