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Raynaud's phenomenon linked to homocysteine level

TEL-AVIV, ISRAEL. Raynaud's phenomenon (RP) involves a disruption of blood flow to fingers or toes resulting in cold, numbness, and a characteristic white colour of the affected parts. RP is often associated with scleroderma or systemic lupus erythematosus (secondary RP), but can also occur as a separate disease entity (primary RP or Raynaud's disease). The cause of the phenomenon is unknown, but it is believed that an abnormality in the endothelium (the single layer of cells that line the blood vessels) is involved.

Now researchers at Tel-Aviv University report that high blood plasma levels of homocysteine are closely associated with RP. Their study involved 10 patients with primary RP, 10 patients with RP secondary to scleroderma, and 20 healthy controls. The researchers measured plasma levels of homocysteine and folate (folic acid) in fasting blood samples taken from all participants. They found the average (mean) homocysteine level of controls to be 5.9 micromol/L; patients with primary RP had a mean homocysteine level of 15.5 micromol/L while patients with secondary RP had a mean level of 11.6 micromol/L. A level above 10.5 micromol/L is considered excessive and is associated with an increased risk for heart disease and stroke. Homocysteine levels tend to be inversely proportional to folate levels. In this study controls had a mean folate level of 8.84 nanograms/mL, patients with primary RP had a mean level of only 4.79 ng/mL while patients with secondary RP had a mean level of 7.15 ng/mL. The researchers speculate that high homocysteine levels may be, at least in part, responsible for the abnormal behaviour of the endothelium in RP patients. They suggest further work to investigate this connection and, if indeed proven, recommend that RP patients be treated with folic acid supplementation.
Levy, Yair, et al. Elevated homocysteine levels in patients with Raynaud's syndrome. Journal of Rheumatology, Vol. 26, November 1999, pp. 2383-85

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