What is the relationship between homocysteine levels and stroke risk?
Elevated levels of plasma homocysteine are associated with 2- to 3-fold increased risk for atherosclerotic vascular disease, including stroke. A meta-analysis of epidemiological studies found a 19% (95% CI, 5 31) reduction in odds of stroke per 25% lower homocysteine concentration after adjustment for other cardiovascular risk factors or renal function. Another meta-analysis found that for each 5- mol/L increase in homocysteine, the odds of stroke increased by 59% (95% CI, 29 96), and for each 3- mol/L decrease in homocysteine, the odds of stroke decreased by 33%. Additionally, a meta-analysis of 29 studies comparing the MTHFR C677T genotype between 4454 stroke patients and 7586 control subjects found a significant association between the MTHFR C677T genotype and stroke risk. 