S26_ab6

Is there an association of plasma homocysteine levels with vascular involvement in patients with Behçet's syndrome ?

C. Korkmaz¹, B. Bozan², M. Kosar², F. Sahin³, Z. Gülbas⁴

¹Division of Rheumatology and ⁴Division of Hematology, Department of Internal Medicine, and Department of ³Biostatistics, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey; Medicinal and Aromatic Plant and Drug Research Centre, ²Faculty of Pharmacy, Anadolu University, Eskisehir, Turkey.

ABSTRACT
Objective
To assess whether or not plasma homocysteine levels play a part in vascular involvement in Behçet's syndrome (BS).

Methods
74 consecutive BS patients fulfilling the criteria of the International Study Group for BS, 35 healthy control (HC) and 14 rheumatoid arthritis (RA) patients on methotrexate (MTX) were studied. BS patients were then classified as those with and without vascular involvement. Fasting plasma homocysteine, folate, and vitamin B12 concentrations were measured by enzyme immunoassay and chemiluminescent immunoassay methods respectively.

Results
Plasma homocysteine levels were found to be higher in the BS patients than in the healthy control (16.08 ± 7.5 vs. 12.9 ± 6.3 mmol/L, p < 0.03). The homocysteine levels in the RA group on MTX were higher compared with both the BS and HC groups (28.7 ± 9.9; p < 0.0001). No remarkable difference pertaining to homocysteine levels was found between BS patients with or without thrombosis (p < 0.86). Hyperhomocysteinemia was also detected in 11 out of 22 (50%) of the patients with vascular involvement, which proved to be of no significant difference in comparison with those without vascular involvement (20/52, 38%; c² = 0.26, p > 0.05 ). Active BS smokers exhibited a higher concentration of homocysteine in contrast to non-smoker BS sufferers (20 ± 8.4 vs 14.1 ± 6.1 mmol/l; p < 0.004). Smoking was determined to have a positive correlation with vascular involvement (r = 0.26, p < 0.046), as well as with homocysteine levels (r = 0.31, p < 0.012) in BS. Upon logistic regression analysis, smoking was found to have a significant relationship with vascular involvement (odds ratio 3.12 [95% CI 2.02 - 4.22] p = 0.04). There was no significant difference between the study groups with respect to their B12 vitamin and folate levels. We were unable to make any correlation between homocysteine and vitamin B12 or folate in any of the groups (p > 0.05).

Conclusions
No association was found between homocysteine levels and vascular involvement in our BS patients. We determined that smoking seems to pose a risk for vascular involvement in BS patients.

Key words
Behçet's syndrome, hyperhomocysteinemia, vascular involvement, smoking.

This study was supported by a grant from the Osmangazi University Research fund (99/5).
Please address correspondence to: Cengiz Korkmaz, Visnelik Mah. Alifuat Güven C. Akasya Sok. 11/11, 26020 Eskisehir, Turkey.
E-mail: ckorkmaz@ogu.edu.tr