Prevalence and risk factors of hyperhomocysteinemia in Tunisian patients with Crohn's disease

Background and aims: The role of hyperhomocysteinemia (HHC) and its determinants in Crohn's disease (CD) remain uncertain. This study was aimed to determine the prevalence of HHC and its main risk factors in Tunisian patients with CD. Methods: This study included 89 patients with CD and 103 age- and sex-matched healthy subjects. Fasting venous blood was collected in all subjects allowing the assessment of homocysteine, folate, vitamin 812, C-reactive protein and creatinine levels. Logistic regression models were applied to identify factors associated with HHC in CD patients. Results: Plasma homocysteine was higher (13.69 +/- 4.84 mu mol/l vs. 10.77 +/- 2.80 mu mol/l; p<0.01) and HHC was more frequent (31.5% vs. 7.8%; p<0.001) in patients compared with controls. The association between HHC and CD persisted after adjustment for smoking, body mass index and serum folate, vitamin B-12, creatinine and C-reactive protein. In patients with CD, multivariate analysis showed that HHC was positively associated with age [multi-adjusted odds-ratio (95% confidence interval): 1.14 (1.06-1.24); p<0.001], active disease [7.54 (1.15-49.3); p=0.03], disease duration >2 years [8.69 (1.53-49.3); p=0.02] and inversely related to plasma folate [0.64 (0.48-0.84); p=0.002] and vitamin B-12 (0.993 (0.987-0.999); p=0.02]. Conclusion: HHC is common in Tunisian patients with CD and is related to B vitamins deficit, as well as disease activity and duration. Further studies should test the effect of correction of HHC by vitamin B supplementation on progression and complications of CD. (C) 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.