Plasma S-adenosylhomocysteine: A potential risk marker for cerebral venous thrombosis

• Fasting plasma tHcy, SAH and SAM were significantly higher in CVT patients.
• Elevated SAH had higher percentage classification on discriminant analysis.
• Sensitivity and specificity as risk predictors were higher for elevated plasma SAH.

BackgroundDespite a plethora of studies suggesting that hyperhomocysteinemia is associated with an increased risk for arterial and venous thrombosis, there is paucity of data on the role of the S-adenosylhomocysteine (SAH), the metabolic precursor of homocysteine (Hcy) as a risk predictor for cerebral venous thrombosis (CVT).MethodWe estimated fasting plasma concentrations of total homocysteine (tHcy), SAH and S-adenosylmethionine (SAM), in 185 CVT patients and 248 healthy controls, by reverse-phase high performance liquid chromatography coupled with coulometric electrochemical detection.ResultsFasting tHcy, SAH and SAM were significantly higher in patients compared with controls. Increased tHcy and SAH concentrations were associated with 4.54-fold (95% CI, 2.74–7.53) and 35.77-fold (95% CI, 19.45–65.79) increase in risk for CVT, respectively. Receiver operating characteristic (ROC) curve analysis showed that the area under curve, sensitivity and specificity was higher for SAH compared to tHcy. Further, discriminant analysis to distinguish between tHcy and SAH showed that SAH had a significantly higher percentage classification, with lower Wilk's lambda and higher χ2, compared to tHcy.ConclusionIncreased plasma SAH may be a more sensitive risk marker for CVT than plasma tHcy.