Alfonso FRY, Denis AR, Santana PS

Language: Spanish
References: 0
Page: 487-498
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ABSTRACT

Rationale: Serum homocystein (Hcy) has become important as a marker of cardiovascular risk (CVR). Correct interpretation of CVR in a given subject depends upon contrasting obtained Hcy values with those expected in the reference population. There are not Hcy reference values defined for Cuba, and use has to be made of foreing, imported standards. Objective: To establish the Hcy reference intervals for Cuban subjects with low atherosclerotic risk. Study location: Clinical Laboratory Service, “Hermanos Ameijeiras” Clinical Surgical Hospital (Havana City, Cuba). Study serie: Two-hundred and eighty-one blood donors (Males: 56.6%; Average age: 27.3 ± 10.3 years), assisted at the hospital Blood Bank between July 2015 and March 2017. Low atherosclerotic risk was assured by means of a questionnaire about health history, current medical treatments, and life styles. Twenty mL of venous blood were withdrawn from each subject by antecubital venipuncture after an overnight fasting. Hcy was determined in the sera resulting samples with an automatized enzymatic method. Methods: Ninety-five percent reference intervals (RI) for original (“naive IR”) and logarithmically-transformed (“log IR”) Hcy values were constructed. Ninety-five percent RI were also constructed for Hcy values obtained after BoxCox transformation (“BoxCox IR”). Fiiting of Hcy values obtained in each step to the normal distribution was assessed by means of the Kolmogorov-Smirnov (KS) test. Results: Hcy average values were 7.4 ± 3.3 μmol.L-1 (Minimum: 1.7 μmol.L-1 vs. Maximum: 18.4 μmol.L-1). Hcy values were sex- independent: Males: 7.1 ± 3.3 μmol.L-1 vs. Females: 7.7 ± 3.3 μmol.L-1 ( = +0.6; t-Student = 1.57; p > 0.05). Hcy values diminished with subject’s age (r2 = 0.2386; p < 0.05). Hcy 95% RI were as follows: “Naïve IR”: 0.9 – 14.9 μmol.L-1 (ZKS = 2.092; p < 0.05); “Log IR”: 2.7 – 16.6 μmol.L-1 (ZKS = 0.950; p > 0.05); and “BoxCox IR”: 1.6 – 15.6 μmol.L-1 (ZKS = 1.061; p < 0.05); respectively. Non-parametric 95% IR for Hcy (based upon percentiles of the ordered original values) were as 2.7 – 14.7 μmol.L-1. Conclusions: Non-normality of original Hcy data should be taken into account for the construction of 95% IR to be adequate for assessing CVR present in a given subject.