No Evidence for Hyperhomocysteinemia or Increased Prevalence of Genetic Polymorphisms in the Homocysteine Pathway in Patients with Moderate Juvenile Idiopathic Arthritis

MARTINA HUEMER, CHRISTIAN HUEMER, HANNO ULMER, JULIA CRONE, MANUELA FÖDINGER, JUTTA FALGER, and MICHAELA SAILER-HÖCK

ABSTRACT.

Objective. Elevated plasma total homocysteine (tHcy) concentrations are associated with premature cardiovascular disease. We assessed tHcy, folate, vitamin B₁₂ (Vit B₁₂), vitamin B₆ (Vit B₆), and genetic polymorphisms potentially enhancing tHcy in patients with juvenile idiopathic arthritis (JIA) and healthy controls.

Methods. Open study of 56 consecutive patients with JIA and 62 controls.

Results. tHcy concentrations were normal in JIA patients (mean 6.5 ± 2 µmol/l) and controls (mean 7.5 ± 2.2 µmol/l). Folate concentrations were significantly higher in JIA patients (40.2 ± 67.9 ng/ml) compared to controls (13.6 ± 8.2 ng/ml). The prevalence of genetic polymorphisms coding for key enzymes in the homocysteine pathway did not differ between patients and controls. Erythrocyte sedimentation rate (ESR) showed significant inverse correlations with circulating Vit B₆ and tHcy concentrations.

Conclusion. No evidence for hyperhomocysteinemia or evidence for a specific genetic predisposition for hyperhomocysteinemia was present in patients with JIA. Elevated ESR is not associated with hyperhomocysteinemia. (J Rheumatol 2005;32:170-4)

Key Indexing Terms:

PREMATURE CARDIOVASCULAR DISEASE
THROMBOSIS
HYPERCOAGULABILITY
JUVENILE RHEUMATOID ARTHRITIS
JUVENILE IDIOPATHIC ARTHRITIS

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From the Department of Pediatrics, Landeskrankenhaus Feldkirch, Feldkirch, Austria.

M. Huemer, MD, Department of Pediatrics, Landeskrankenhaus Feldkirch; C. Huemer, MD, Department of Pediatrics, Landeskrankenhaus Bregenz; H. Ulmer, Institute of Biostatistics, University of Innsbruck; J. Crone, MD; J. Falger, MD, Department of Pediatrics, University of Vienna; M. Födinger, MD, Department of Laboratory Medicine, University of Vienna; M. Sailer-Höck, MD, Department of Pediatrics, University of Innsbruck.

Address reprint requests to Dr. M. Huemer, Department of Pediatrics, Landeskrankenhaus Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria. E-mail: m333.huemer@aon.at

Submitted December 11, 2003; revision accepted August 27, 2004.

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