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Giuseppe Agosta

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BC: Articoli scritti da U. Russo

Determinazione dell’omocisteina plasmatica: indicazioni per la richiesta
Determination of plasma homocysteine: recommendations for test requesting
D. Szőke  |  A. Dolci  |  U. Russo  |  M. Panteghini  | 
<p>High plasma homocysteine&nbsp;concentrations can be caused by various factors, including low blood concentrations of B-complex vitamins.&nbsp;Hyperhomocysteinemia is widely believed to be associated with an increased risk of atherosclerotic disease; recent&nbsp;emerging evidence made, however, doubtful its role as cardiovascular risk factor. The aim of this document was to&nbsp;examine the appropriateness of homocysteine requesting in our clinical setting. Clinical guidelines, meta-analyses&nbsp;and systematic reviews were used as source of high level evidence. During the last two decades, the role of&nbsp;hyperhomocysteinemia was examined in a number of clinical conditions; however, the analysis of available data&nbsp;made us clear that determination of plasma homocysteine has only limited clinical role. Test requesting results to be&nbsp;appropriate only in case of suspected homocystinuria (an inherited disorder of the metabolism of the amino acid&nbsp;methionine), in patients with previous venous or arterial thromboembolism and in patients with severe (&gt;100 &mu;mol/L)&nbsp;[and possibly moderate (&gt;30 &mu;mol/L)] hyperhomocysteinemia treated with B-complex vitamins. Determination of&nbsp;plasma homocysteine is not recommended as a primary prevention tool for cardiovascular disease in the general&nbsp;population.</p>
Biochimica Clinica ; 38(3) 234-237
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