Abstract

HERNANDEZ-BETANCOR, Iván et al. Prognostic value of serum homocysteine levels in elderly hospitalized patients. Nutr. Hosp. [online]. 2015, vol.31, n.6, pp.2590-2597. ISSN 1699-5198.  https://dx.doi.org/10.3305/nh.2015.31.6.9011.

Background and Objectives: increased serum homocysteine levels are related to vascular disease and increased mortality. The decrease of homocysteine is also associated with a worse prognosis in patients on hemodialysis; however, this relationship has not been well studied in other patients. Our goal is to study the prognosis of increased and decreased serum homocysteine levels in elderly patients admitted to a general internal medicine unit. Patients and Methods: we included 239 patients (121 women and 118 men; mean age, 78 years) in which we determined serum homocysteine levels and study its relationship with vascular risk factors, vascular disease: ischemic heart disease, ischemic stroke and peripheral arterial disease, nutritional status, creatinine, albumin, folate and B12 vitamin. Results: mortality during hospitalization of patients with homocysteine levels below 9 µmol/l was 33%, 9% for those with levels between 9 and 20 µmol/l and 17% for those with levels above 20 µmol/l. Low homocysteine values were related to increased comorbidity, higher degree of weight loss and decreased serum albumin levels. In a survival analysis using Kaplan-Meier curves, increased homocysteine was associated with increased mortality especially in patients with vascular disease. Conclusion: in elderly patients with multiple comorbidities, both decreased and increased serum homocysteine levels are associated with increased mortality.

Keywords : Homocysteine; Prognosis; Mortality; Cardiovascular disease; Elderly patients with multiple comorbidities.

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