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Homocysteine in Health and Disease

Ian Graham, FRCPI, FCCP
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Royal College of Surgeons in Ireland and Trinity College; Dublin, Ireland (Graham)

Requests for Reprints: Ian Graham, FRCPI, FCCP, The Charlemont Clinic, Charlemont Mall, Dublin 2, Ireland.

Ann Intern Med. 1999;131(5):387-388. doi:10.7326/0003-4819-131-5-199909070-00010
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Is an elevated plasma homocysteine level bad for you? Homocystinuria, the consequence of a severely elevated plasma homocysteine level of genetic origin, was first described in 1962 (12). Patients with homocystinuria frequently experience thromboembolic events. Thirty years ago, McCully (3) noted that several different metabolic defects were characterized by two common factors: homocystinuria and premature thromboembolic disease. This implied that the elevated plasma levels of homocysteine, rather than any other metabolite, was the cause. With this information, McCully and Wilson evolved the homocysteine theory of arteriosclerosis (4), from which it has been suggested that a moderately elevated plasma homocysteine level may be a cardiovascular risk factor in the general population.



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