Homocysteine In Alcoholics

While Ine promrombotic and aterogenetic role of homocysteine is well estab-lished, thè effects of alcohol abuse on homocysteine metabolism are stili a debated matter. In this study, a series of 61 chronic alcoholics (69% male, 31% female, aged 21-69 years) on early alcohol withdrawal were enrolled; thè diag-nosis was made aecording to thè DSM-IV TR criteria. Subjects affected by dis-orders affecting homocysteine metabolism were excluded. Ali thè patients drank alcoholic beverages till thè day before thè blood was drawn. Plasma homocysteine and cysteine were assessed by using high-pressure liquid chro¬matography. Gene MTHFR polymorphism was assessed by DNA extraction, PCR, and Hinf digestìon. HDL, LDL, total-, LDL- and HDL-cholesterol, triglycerides, and biochemical markers of alcohol abuse were assessed by routine methods. In our series, homocysteine was not increased (10.6 ' 9.9), vvhile cysteine was increased (227,2 ± 52.0). The markers of alcohol abuse, Iriglycerides, total cholesteroì, and LDL-cholesterol were increased. MTHFT polymorphism was not differertt from generai populatioil. A negative correla-tion (P < 0.005) between homocysteine and LDL was found. Cysteine was correlated to years of at-risk drinking (P < 0.006). Our series was split into two subsets, alcoholics with or without cardiovascular diseases: in thè cardiovascular disease subset, cysteine was higher (P < 0.05). The negative correlatìon between homocysteine and LDL-cholesterol seems ver»' surprising, but may be related to imemalization of LDL into atherosclerosis plaques in subjects with homocysteine-reiated atheroscierosis. The findings about homo¬cysteine and cysteine may be related to homocysteine metabolism: homocys¬teine may be converted to tnethionine, if folle acid is present, or to cysteine (ria trans-sulphuration) if vitamin B6 is present, As in chronic aleoholics aeid folio deficit is more severe than vitamin B6 deficit, trans-sulphuration is increased. Thus, aecording to our data, in chronic alcoholics thè cardiovascular disease risk factor is not homocysteine, but cysteine. Indeed, just as thè increase in cysteine values is related to years of at-risk drinking, thè deficit of folle acid in aleoholics also seems to be related to years of at risk drinking.