Association between plasma homocysteine, vitamin B12, and folic acid levels with thrombotic diseases in Syrian patients

OBJECTIVE: This study aimed to investigate the relationship between plasma homocysteine, vitamin B12, and folic acid in Syrian patients with thrombotic diseases. METHODS: We conducted a case-control study on patients with hyperhomocysteinemia associated with a thrombotic disease at the National University Hospital of Damascus, Syria, comprising 133 thrombosis patients (84 males, 49 females; aged 20-80 years) and 39 matched healthy controls. Vitamin B12 and folic acid profiles were analyzed, and homocysteine ≥15 μmol/l was considered as hyperhomocysteinemia. RESULTS: Patients with thrombosis exhibited significantly higher levels of homocysteine compared to controls (38.93 ± 19.91 μmol/l versus 8.13 ± 2.42 μmol/l, respectively, P < 0.001). Additionally, they had lower levels of vitamin B12, with values of 159.19 ± 57.66 pg/ml compared to 521.26 ± 58.08 pg/ml in controls (P < 0.001), and they had lower levels of folic acid compared to controls (5.14 ± 4.07 ng/ml versus 11.33 ± 2.17 ng/ml, respectively, P < 0.001). Moreover, hyperhomocysteinemia was the single vascular risk factor retrieved in 21.1% (28/133) of patients, with no other identified conventional risk factors. CONCLUSION: This study concludes that hyperhomocysteinemia is considered a strong and independent risk factor for thrombotic diseases and is strongly associated with vitamin B12 and folic acid deficiencies.