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Annals of Clinical & Laboratory Science 40:10-14 (2010)
© 2010 Association of Clinical Scientists

Increased Serum Concentrations of Homocysteine and Lipoprotein (a) in Familial Mediterranean Fever

Saliha Karatay1, Kadir Yildirim1, Abdullah Uyanik2, Hulya Uzkeser1, Ahmet Kiziltunc3, Mahir Ugur1, Fatih Baygutalp1 and Hamit Acemoglu4
Departments of 1 Physical Medicine and Rehabilitation, 2 Nephrology, 3 Biochemistry, and 4 Medical Education, Medical Faculty, Ataturk University, Erzurum, Turkey

Address correspondence to Dr. Saliha Karatay, Department of Physical Medicine and Rehabilitation, Medical Faculty, Ataturk University, 25240 Erzurum, Turkey; tel 90 442 2361212/1625; fax 90 442 2361301; e-mail skaratay73{at}hotmail.com.

Serum homocysteine, folic acid, lipoprotein (a) (Lp(a)), fibrinogen, and C-reactive protein (CRP) concentrations and erythrocyte sedimentation rates (ESR) were measured in 52 patients with familial Mediterranean fever (FMF) during attack-free periods and in 30 healthy control subjects. Serum homocysteine levels were significantly higher in the FMF patients (median 17.8 µg/dl; range 5.6–80.8) than in controls (median 11.7; range 5.6–42.2; p = 0.013). Serum homocysteine levels were elevated above the upper reference limit (15 µg/dl) in 56% of the FMF patients compared to 27% of the controls (p = 0.011). Serum Lp(a) levels were significantly higher in the FMF patients (median 39.3 mg/dl; range 6.6–124.5) than in controls (median 27.2; range 11.1–78.1; p = 0.035). Serum Lp(a) levels were elevated above the upper reference limit (30 mg/dl) in 71% of the FMF patients compared to 47% of the controls (p = 0.028). The ESR, fibrinogen, CRP, and folic acid levels were similar in both groups. In conclusion, serum homocysteine and Lp(a) concentrations are often increased in FMF patients during attack-free periods. The elevated homocysteine and Lp(a) levels, which are markers of sub-clinical inflammation, may be mediators of atherosclerotic disease in FMF patients.

Keywords: familial Mediterranean fever, homocysteine, lipoprotein (a), folic acid, atherosclerosis






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