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W2076607556 abstract "Homocystein je intermediĂĄrnĂm produktem metabolismu methioninu. Jeho koncentrace v organismu je kontrolovĂĄna cestou remetylace a transsulfurace. Nedostatek Äi snĂĹženĂĄ funkce enzymĹŻ a kofaktorĹŻ v tÄchto procesech pak mĹŻĹže vyĂşstit v hyperhomocysteinemii. VzĂĄcnĂĄ vrozenĂĄ porucha homocystinurie se vyznaÄuje extrĂŠmnĂmi hodnotami homocysteinu a vede k arteriĂĄlnĂm i ĹžilnĂm trombĂłzĂĄm v mladĂŠm vÄku. Homocystein je tedy povaĹžovĂĄn za rizikovĂ˝ faktor cĂŠvnĂch nemocĂ.Hodnota homocysteinu je ovlivnÄna mnoha faktory, jak genetickĂ˝mi, tak i vlivem prostĹedĂ. MĂrnĂĄ hyperhomocysteinemie je pomÄrnÄ ÄastĂĄ. Role homocysteinu v ĹžilnĂ tromboembolickĂŠ nemoci (TEN) byla ponÄkud mĂŠnÄ studovĂĄna neĹž u tepennĂ˝ch onemocnÄnĂ a v souÄasnĂŠ dobÄ se jevĂ jako ponÄkud kontroverznĂ. In vitro lze prokĂĄzat mnohoÄetnĂŠ protrombotickĂŠ ĂşÄinky homocysteinu. VĂ˝sledky epidemiologickĂ˝ch studiĂ vĹĄak nejsou zcela jednoznaÄnĂŠ. VÄtĹĄina z nich prokazuje asociaci hyperhomocysteinemie s ĹžilnĂ TEN, ovĹĄem pomÄrnÄ slabou, a navĂc mnohem mĂŠnÄ vyjĂĄdĹenou ve studiĂch prospektivnĂch neĹž retrospektivnĂch. NenĂ zcela jasnĂŠ, je-li elevace homocysteinu pĹĂÄinou tromboembolickĂŠ pĹĂhody Äi naopak jejĂm dĹŻsledkem. Je takĂŠ moĹžnĂŠ, Ĺže hyperhomocysteinemie hraje roli v patogenezi ĹžilnĂ trombĂłzy jen jako pĹĂdatnĂ˝ rizikovĂ˝ faktor v pĹĂtomnosti jinĂ˝ch trombofiliĂ.ExistujĂ vĹĄak i data potvrzujĂcĂ hyperhomocysteinemii jako rizikovĂ˝ faktor recidivy TEN. NÄkolik menĹĄĂch studiĂ popsalo takĂŠ souvislost hyperhomocysteinemie s trombĂłzou v neobvyklĂŠ lokalizaci.Koncentraci homocysteinu lze snĂĹžit suplementacĂ vitaminĹŻ, pĹedevĹĄĂm kyseliny listovĂŠ a takĂŠ vitaminu B12. PĹĂznivĂ˝ efekt snĂĹženĂ hodnoty v primĂĄrnĂ i sekundĂĄrnĂ prevenci TEN vĹĄak dosud pĹesvÄdÄivÄ prokĂĄzĂĄn nebyl.V souÄasnĂŠ dobÄ tedy nenĂ dostatek dĹŻkazĹŻ podporujĂcĂch nutnost vyĹĄetĹovĂĄnĂ koncentrace homocysteinu u pacientĹŻ s ĹžilnĂ TEN ani potvrzujĂcĂch prospÄĹĄnost suplementace vitaminy v pĹĂpadÄ mĂrnĂŠ Äi stĹednĂ hyperhomocysteinemie. TakovĂĄto diagnostika a lĂŠÄba by proto mÄla bĂ˝t provĂĄdÄna jen v selektovanĂ˝ch pĹĂpadech." @default.
W2076607556 created "2016-06-24" @default.
W2076607556 creator A5047893736 @default.
W2076607556 date "2013-06-01" @default.
W2076607556 modified "2023-10-14" @default.
W2076607556 title "Homocysteine and venous thromboembolism- Is there any link?" @default.
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W2076607556 doi "https://doi.org/10.1016/j.crvasa.2013.01.007" @default.
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