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Test Code 603

Test Details

Homocysteine

Homocysteine is a thiol-containing amino acid formed from methionine. Values >15 µmol/L have been associated with increased risk of cardiovascular disease.1

Methodology

Enzymatic

Patient Preparation

None

Preferred Specimen

1.0 mL EDTA plasma (0.5 mL minimum) collected in plasma separator tube (Pearl Top). Centrifuge blood samples immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept refrigerated and centrifuged within an hour, or kept on ice for up to 6 hours prior to centrifugation.

Alternate Specimen

Dried Blood collected on an AdvanceDx 100 card

Transport Temperature

Refrigerated (ship on frozen cold packs)

Stability

Refrigerated: 2 weeks

References:

  1. Clarke R, Halsey J, Lewington S, et al. Eff ects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality. Arch Intern Med. 2010;170(18):1622-1630.
Lab Values

Lab Values

Homocysteine

  • Optimal: <10 µmol/L
  • Borderline: 10–14 µmol/L
  • Increased Risk: >14 µmol/L
Test Details
Clinical Significance

Clinical Significance

Homocysteine

Hyperhomocysteinemia is a risk factor for:1

  • Ischemic heart disease
  • Fatal and non-fatal myocardial infarction and sudden cardiac death
  • Premature coronary artery disease
  • Extracranial carotid-artery stenosis
  • Venous thrombosis
  • Stroke
  • Peripheral vascular disease

References:

  1. Clarke R, Halsey J, Lewington S, et al. Eff ects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality. Arch Intern Med. 2010;170(18):1622-1630.
Lab Values
Treatment Options

Treatment Options

Homocysteine

Treatment of hyperhomocysteinemia for high risk values >15 µmol/L:

  • Control all standard cardiovascular disease factors:
    • Blood glucose: <125 mg/dL
    • HbA1c: <6.5%
    • Systolic blood pressure: <130 mmHg
    • LDL-C: <100 mg/dL
  • Folate (800 µg/day),vitamin B12 (0.5 mg/day) and vitamin B6 (20 mg/day),and recheck values in 6 months

Treatment of borderline values between 10-15 µmol/L:

  • Daily multivitamin tablet containing the recommended daily allowances of folate (400 µg/day), vitamin B12 (2.4 µg/day) and vitamin B6 (1.5 mg/day)
Clinical Significance