Níveis de elevados de homocisteína plasmática e sua relação com o estresse oxidativo em pacientes com acidente vascular encefálico

Background: Elevated plasma homocysteine levels have been indicated as an independent risk factor for ischemic stroke. Objective: The objective of this study was to evaluate oxidative and nitrosative stress in patients with ischemic stroke with and without hyperhomocysteinemia (HHcy) and to verify whether HHcy is associated with oxidative stress in these patients. Methods: This study included 170 stroke patients, who were divided according to their levels of homocysteine (Hyperhomocysteinemia ≥13.59 μmol/L) and 220 healthy individuals (control group). Results: Stroke patients showed high levels of homocysteinemia when compared to the control group (p <0.001) adjusted for the variables: sex, ethnicity and age. Patients with stroke and hyperhomocysteinemia showed higher frequency of male subjects (p=0.001), lower Rankin scale (p=0.034), and lower glucose levels (p=0.020) when compared with stroke patients with lower levels of homocysteine. Patients with ischemic stroke and hyperhomocysteinemia had a trend to reduced NOx (p= 0.071) and increased TRAP (p= 0.003) levels when compared to the patients without hyperhomocysteinemia. The binomial logistic regression analysis showed that sex (p=0.032), glucose (p=0.017) and TRAP (p=0.019) were independently associated with hyperhomocysteinemia in patients with stroke. Conclusion: This is the first study in which homocysteinemia and oxidative and nitrosative stress markers were investigated in stroke patients. HHcy were associated with male sex, decreased glucose and increased TRAP. More studies are necessary to elucidate the complex relationship between homocysteine and redox status in these patients.