Homocysteinaemia and Ovarectomy: the FirstExperience with Functional Monitoring

Overview

Objective:
Metabolic study on plasmatic levels of homocysteine (Hcy) in 30 women post ovarectomysuffering from benign diseases.Based on previous pilot study by 6 women patients after ovarectomy the Hcy level increase hasbeen supposed. Further objective was to detect possible change of homocysteinemia after applicationof estrogen replacement therapy (ERT). Hyperhomocysteinemia (HHC) – increased level offree amino acid homocysteine in blood – is considered on lipids independent risk factor in earlydevelopment of cardiovascular diseases. The deficiency of 5,10-methylatetetrahydrofolate reductase(mutation C677T) is suspected as the main reason for decreased remethylation of Hcy. Thegroup of women heterozygous for MTHFR mutation was compared with group of women patientswithout this mutation during the 8 weeks – monitoring after application of foliculostimulatinghormone (FSH), estradiol (E2) for folate, vitamine B12 and Hcy in plasma.Design: Basic study to get our own data about HHC in population of operated women before andafter ovarectomy and after ERT.Setting: Department of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University,Prague. Methods: Total homocysteine in plasma was estimated by chromatographic method with use offluorescence detection. The level of hormones in plasma was estimated by RIA test of DCL company.The mutation of gen for 5,10-MTHFR was estimated by genetic examination. Six blood takingwere performed within 8 weeks. The 1st before ovarectomy, further 1., 3., 7., 28. and 56. day afteroperation. Since the 28th day 50 micrograms of 17-beta estradiol have been substituted by weeklytransdermal system.Results: No homozygote for 5,10-MTHFR has been found in the group of operated women, only 5heterozygotes and 25 healthy homozygotes were found. Hcy values were similar in both groups.The patients were distributed into 2 groups according to their FSM level in the plasma (40 UI/Iwas stipulated as the limit). After ovarectomy the Hcy increased by both groups and after hormonaltreatment the Hcy decreased. The folate level in both groups corresponded with Hcy level, inB12 vitamine concentration no dependence has been proved (P

Key words:
homocysteine, homocysteinaemia, hyperhomocysteinaemia, ovarectomy, folikulostimulatinghormone, estradiol, vitamins