RRML - Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke

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Nr. 26(1)/2018 DOI:10.2478/rrlm-2018-0003

Research article

Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke

Abdullah Sivrikaya, Serefnur Ozturk, Hakan Ekmekci, Aslıhan Sağlam, Sedat Abusoglu, Ali Unlu

Correspondence should be addressed to: Sedat Abusoglu

Abstract:

Introduction: Sitosterolemia, defined as phytosterolemia, is a rare autosomal recessive disease characterized by elevated blood sterol levels. Our aim was to investigate serum plant sterols, methylmalonic acid, vitamin B12, oxidized-LDL and homocysteine levels in ischemic and hemorrhagic stroke patients and healthy subjects. Material and Methods: 50 healthy subjects (without a family history of coronary artery disease) and 89 patients hospitalized in the Selcuk University neurology clinic or intensive care unit with a diagnosis of stroke were included in this study. Serum plant sterols, homocysteine and methylmalonic acid, oxidized-LDL, total cholesterol, triglycerides, HDL-Cholesterol and vitamin B12 levels were analyzed by gas chromatography-mass spectrometry, liquid-chromatography tandem mass spectrometry, commercially available ELISA kit, spectrophotometry and chemiluminescence methods, respectively. Results: Urinary methylmalonic acid/creatinine ratio (p< 0.05), serum β-sitosterol levels and β-sitosterol/ cholesterol ratio were significantly higher (p <0.01) in patients compared to the control group. There was a significant positive correlation between the serum OxLDL- methylmalonic acid, serum homocysteine- urinary methylmalonic acid /creatinine ratio, serum methylmalonic acid - Urinary methylmalonic acid (p<0.05), serum homocysteine- urinary methylmalonic acid, urinary methylmalonic acid-methylmalonic acid/creatinine ratio, serum methylmalonic acid- methylmalonic acid/creatinine ratio, serum beta-sitosterol- beta-sitosterol /cholesterol, total cholesterol-HDL, total cholesterol-LDL (p <0.01) levels and negative correlation between vitamin B12- serum methylmalonic acid (p<0.05), cholesterol-stigmasterol/cholesterol, LDL- stigmasterol/cholesterol (p <0.01) levels in the patient group. Conclusion: Our findings presented that the serum sitosterol levels were significantly higher in stroke patients compared to controls.

Keywords: sterol, stroke, oxidized LDL, methylmalonic acid, creatinine

Received: 24.8.2017
Accepted: 5.12.2017
Published: 17.12.2017

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Sivrikaya A, Ozturk S, Ekmekci H, Sağlam A, Abusoglu S, Unlu A. Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke . Rev Romana Med Lab. 2018;26(1):51-8. DOI:10.2478/rrlm-2018-0003