EVALUATION OF SERUM LEVEL OF HOMOCYSTEINE, VITAMIN B12 AND ZINC IN PATIENTS WITH ACUTE ISCHAEMIC STROKE

(A CASE STUDY OF ZARIA)

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Author

Presented To

Department of Medicine

ABSTRACT
Stroke has been a global burden, with increasing morbidity and mortality. Several risk factors have been identified, which include: hyperhomocysteinaemia, hypovitaminosis B12, and low zinc levels, which are the now target of preventive strategies. Limited studies have been done on the risk factors (analytes) in our environment hence the current study was undertaken to evaluate the serum levels of homocysteine, vitamin B12 and zinc in patients with acute ischaemic stroke in Zaria and healthy controls. One hundred ischaemic stroke patients on admission confirmed by brain CT-scan or Siri-raj stroke score of less than minus one.(-1) and equal number of apparently healthy age and sex-matched were recruited. Their serum homocysteine, and vitamin B12 were measured using enzyme linked Immunosorbent assay,and zinc was measured using direct colorimetric method. Stroke severity was determined using National Institute of Health Stroke Score (NIHSS). Mean serum homocysteine for patients was significantly higher than that of controls (p<0.05) and mean serum vitamin B12and zinc were significantly lower compared to that of controls (p<0.05), with an odds ratio of 0.04, 0.19 and 0.54 respectively. The reference intervals obtained from the healthy controls were found to be 0.90 -1.70μmol/l, 199.72-685.48pg/ml and 52.26-111.86μg/dl for homocysteine, vitamin B12 and zinc respectively. Hyperhomocysteinaemia was seen in 34%, hypovitaminosis B12 was seen in 81% and low zinc was seen in 46%. Patients with hyperhomocysteinaemia, hypovitaminosis B12 and low zinc presented with more severe neurologic deficits even though the difference was not statistically significant with p-values of 0.946, 0.735, and 0.566 respectively. Elevated serum homocysteine, low vitamin B12 and zinc were found to be associated with ischaemic stroke. There was negative correlation between homocysteine and vitamin B12 and stroke severity and therefore early management of those conditions may be an effective way of decreasing the incidence of stroke in our environment. Vitamin B12 and zinc supplements may be beneficial to patients at risk.