Homocysteine, cysteine and methionine are associated with 90-day prognosis in intracerebral hemorrhage patients.
Higher levels of homocysteine and cysteine are linked to worse outcomes in intracerebral hemorrhage patients, while lower methionine levels may be protective.
Where it sits
this study against the rest of the mazdutide (ibi362) corpusSummary and findings
This study examined the relationship between plasma homocysteine, cysteine, and methionine levels and 90-day prognosis in 212 intracerebral hemorrhage patients. It found that higher levels of homocysteine and cysteine were associated with poorer outcomes, while lower levels of methionine were protective. The study also evaluated the predictive value of these biomarkers for prognosis.
Abstract
<h4>Objectives</h4>This retrospective study explored the associations of plasma homocysteine (Hcy), cysteine (Cys) and methionine (Met) levels with 90-day prognosis in intracerebral hemorrhage (ICH) patients and evaluated their predictive value for ICH prognosis.<h4>Methods</h4>A total of 212 ICH patients and 215 age- and sex-matched healthy controls were enrolled. ICH patients were categorized into favorable and unfavorable prognostic groups based on their 90-day prognosis. Plasma Hcy, Cys and Met levels were compared between groups. Multivariate logistic regression and ROC curve analyses were used to assess their prognostic correlations and predictive efficacy. Restricted Cubic Spline (RCS) analysis explored the nonlinear relationship between Met and prognosis. The predictive model was internally validated and compared with classic ICH prognostic scoring systems.<h4>Results</h4>ICH patients had significantly higher Hcy, Cys and Met levels than healthy controls. Unfavorable prognosis patients presented higher Hcy and Cys levels but lower Met levels. High Hcy (OR = 1.235, 95%CI 1.137-1.342) and Cys (OR = 1.017, 95%CI 1.008-1.025) were independent risk factors for poor prognosis. Met exerted a dual nonlinear effect and played a protective role at levels <32.88 μmol/L (OR = 0.924, 95%CI 0.860-0.992). The combined three biomarkers yielded the optimal predictive performance (AUC = 0.819), superior to all single and pairwise biomarker combinations.<h4>Conclusion</h4>Elevated Hcy, Cys and Met levels are observed in ICH patients. High Hcy and Cys predict unfavorable prognosis. Met exhibited concentration-dependent correlational trends, lower odds of adverse outcomes were observed for Met <32.88 μmol/L. Combined detection of the three biomarkers yielded the highest predictive accuracy in internal single-center validation, pending external prospective verification before clinical translation.
Background
This study addresses the prognostic value of plasma homocysteine, cysteine, and methionine levels in patients with intracerebral hemorrhage (ICH). Prior research has indicated that these biomarkers may be linked to various neurological conditions, but their specific role in ICH prognosis remains unclear. Understanding these associations could enhance prognostic assessments and inform clinical decision-making.
Methods
The study was a retrospective analysis involving 212 ICH patients and 215 age- and sex-matched healthy controls. Patients were categorized based on their 90-day prognosis into favorable and unfavorable groups. Plasma levels of homocysteine, cysteine, and methionine were compared between these groups, and multivariate logistic regression and ROC curve analyses were conducted to evaluate prognostic correlations.
Results
ICH patients exhibited significantly higher levels of homocysteine, cysteine, and methionine compared to healthy controls. The odds ratios for high homocysteine and cysteine predicting poor prognosis were 1.235 (95%CI 1.137-1.342) and 1.017 (95%CI 1.008-1.025), respectively. Methionine levels below 32.88 μmol/L were associated with a protective effect (OR = 0.924, 95%CI 0.860-0.992). The combined predictive model using all three biomarkers achieved an AUC of 0.819.
Interpretation
The findings suggest that elevated homocysteine and cysteine levels are associated with unfavorable outcomes in ICH patients, while lower methionine levels may confer a protective effect. Although the study presents statistically significant results, the clinical significance of these findings requires further validation. Limitations such as the retrospective design and single-center nature may affect the applicability of the results in broader clinical settings.
Key findings
- ICH patients had significantly higher Hcy, Cys and Met levels than healthy controls.
- High Hcy (OR = 1.235, 95%CI 1.137-1.342) and Cys (OR = 1.017, 95%CI 1.008-1.025) were independent risk factors for poor prognosis.
- Met <32.88 μmol/L exerted a protective role (OR = 0.924, 95%CI 0.860-0.992).
- The combined three biomarkers yielded the optimal predictive performance (AUC = 0.819).
Limitations
- retrospective study design
- single-center analysis
- small sample size may limit generalizability
- no external validation of predictive model