DETERMINACIÓN DE LAS PRINCIPALES PROTEÍNAS REGULADORAS DE LA COAGULACIÓN Y NIVELES DE HOMOCISTEÍNA EN ADULTOS MAYORES

Abstract

Homocysteine (Hcy) is an amino acid originated from the metabolism of methionine, which at high concentrations (15 mmol/L) is considered as atherogenic factor in various pathologies. There has been particular attention focused on hyperhomocysteinemia (HHC) in recent years; high frequency of HHC in the general population ranges from 5% to 10% and increases in older adults up to 40%. HHC causes endothelial damage and dysfunction by generating potent reactive oxygen species that lead to thrombosis as it enhances thrombin generation, reduces nitric oxide production and inhibits the activation of antithrombotic protein: protein C (PC), protein S (PS) and antithrombin (AT). The objective of this study was to determine the levels of Hcy and its association with PC, PS and AT levels in elderly people, as well as to correlate Hcy levels to antithrombotic proteins and associated pathologies. There were 115 participants aged from 50 to 98 attended at the Geriatric Rehabilitation Service INR and at the Research Laboratory on Hematopathology of the ENCB Morphology Department, IPN. All of them answered a questionnaire to obtain their general characteristics, associated pathologies and drug intake. The individuals, who were detected with pathologies, were considered as patients and those who did not have any, were considered as controls. In both groups (95 patients: 63 females, 32 males and 20 controls: 13 females, 7 males), the Hcy level in their blood was determined through automated immunoassay and the activity of PC, PS and AT was determined through chromogenic and coagulometric methods by using IL Diagnostics coagulation systems, ACL Elite Pro version. The participants were divided into groups according to their ages 50-59, 60-69, 70-79 and >80 year olds. The following results were obtained: 24% of the subjects showed HHC, with significant increase related to age. There was a significant variation related to gender and age for PC levels, and only to age for PS levels. A Correlation was obtained between PC-PS, PS-AT activity and PS-Hcy levels and association between hypertension (HTA) with Hcy and AT levels, chronic renal failure (CRF) with concentration of Hcy and PC as well as between cerebral vascular disease (CVD) and dyslipidemia with activity of PC. High homocysteine levels in peripheral blood significantly affect PS but not PC and AT, in 50 year old adults or older.