Homocysteine (HCY), a non-protein α-amino acid with the formula HSCH2CH2CHC(NH2)CO2H, is a homologue of the amino acid cysteine, differing by an additional methylene bridge (-CH2-). It can be recycled into methionine or converted into cysteine with the aid of certain B-vitamins. HCY is not only obtained from the diet, but also biosynthesized from methionine via a multi-step process.
The normal value of HCY is 5.0-13.9μmol/L in population. High serum concentration of HCY more than 15µmol/L is termed hyperhomocysteinemia (HHCY), which is an independent risk factor for several disorders including cardiovascular diseases, stroke and osteoporotic fractures. Lack of vitamins such as folate, pyridoxine (B6) or cobalt amine (B12) will lead HCY levels rise, which is a result of biochemical reactions. Supplementary pyridoxine, folic acid, cobalt amine or trimethyl glycine will decrease concentration of HCY in the blood.
Cardiovascular disease is a responsible for 40-50% of all deaths in patients with chronic kidney disease. The kidney is the main organ where HCY is removed and further metabolized. Elevated mean serum HCY level is associated with an accelerated decline in renal function. Also, it is an independent risk factor for the development of chronic kidney disease in the general population.
The HCY levels in the body is called H (H Score), H value can predict the risk of a heart attack or stroke, as well as the risk of Alzheimer's disease more accurately when compared with gene screen. HCY levels are typically higher in men than that in women, and increase with ageing.
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