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Endocrine Reviews 20 (5): 738
Copyright © 1999 by The Endocrine Society

Hyperhomocysteinemia and the Endocrine System: Implications for Atherosclerosis and Thrombosis

Vivian Fonseca, Susan C. Guba and Louis M. Fink

Department of Medicine, Section of Endocrinology, Tulane University Medical School (V.F.), New Orleans, Louisiana 70112; and the Department of Pathology, University of Arkansas for Medical Sciences and the John L. McClellan Memorial Veterans Hospital (S.C.G., L.M.F.), Little Rock, Arkansas

I. Introduction
II. Methionine-Homocysteine Metabolism
A. Methionine metabolism
B. Regulation of remethylation and transsulfuration of H(e)
III. Nomenclature and Methodology in the Measurement of Plasma H(e)
A. Methionine load test
IV. Determinants of Plasma Homocysteine
A. Physiological
B. Genetics of hyperhomocysteinemia
C. Nutritional
D. Hormones and H(e) metabolism
V. Homocysteine and Diabetes Mellitus (DM)
A. Hyperhomocysteinemia, renal failure, and diabetic nephropathy
B. Effect of glucose and insulin on H(e) metabolism
VI. Hyperhomocysteinemia and Cholesterol Metabolism
VII. Hyperhomocysteinemia in Premature Vascular Disease
A. Epidemiological and prospective studies
B. Studies in patients with established vascular disease
C. Negative studies
D. Effect of low plasma H(e) on cardiovascular disease
VIII. Possible Mechanisms of Accelerated Vascular Disease in Homocysteinemia
A. Platelet dysfunction
B. Coagulation abnormalities
C. Effects on the endothelium
D. Effects of hyperhomocysteinemia on the arterial wall
E. Coinheritance of factor V Leiden in homocystinuria
IX. Management of Hyperhomocysteinemia
A. Prevention of hyperhomocysteinemia
B. Treatment of hyperhomocysteinemia
X. Conclusion






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Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 1999 by The Endocrine Society