86 age and sex-matched persons without ischemic stroke, who visited our Pathobiology Laboratory for blood sampling. Baseline demographic data (age and sex) and conventional cardiovascular risk factors, including diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLP), smoking, and previous coronary diseases, were recorded for the patients and controls. All the patients and controls gave their written informed consent, and the Medical Research Ethics Committee of Shiraz University of Medical Sciences approved the study (approval number: 2817). Sample Collection Fasting blood samples were obtained from all the patients within 5 days of ischemic stroke Inhibitors,research,lifescience,medical and were immediately chilled on ice. Serum samples were collected within 30 minutes and were thereafter stored at -80ºC. The axis homocysteine enzyme immunoassay (EIA) (Axis-Shield Diagnostics Ltd., United Kingdom) was used for the quantitative analysis of total L-homocysteine in serum. Vitamin B12 Inhibitors,research,lifescience,medical and folate were measured using the SimulTRAC-SNB Radioassay Kit (DRG Instruments GmbH, Germany). Exclusion Criteria for Cases and Controls The exclusion criteria were concomitant history of previous ischemic strokes, cerebral Inhibitors,research,lifescience,medical venous infarcts, ischemic heart disease, peripheral vascular disease, hypothyroidism, epilepsy, renal impairment, pregnancy, postpartum state, consumption of oral contraceptives or drugs that
might affect serum vitamin B12, folate, and Hcy levels, brain mass or any malignancy, history of migraine, and vitamin B12 and Inhibitors,research,lifescience,medical folate deficiencies. Stroke Subtypes According
to the TOAST criteria, stroke subtypes were classified into large artery, cardioembolic, small artery/lacunar strokes, and strokes of other undetermined etiologies.2,25 All the patients were subtyped using a modified TOAST criterion.12 Patients with Inhibitors,research,lifescience,medical incomplete data because of early death or other causes were gathered in the last group. Statistical Analysis All the analyses were done using SPSS (version 13) software (SPSS, Inc.). Student’s t test was used for the quantitative variables. Chi-square test was used to analyze the qualitative findings. Odds ratios (OR) and 95% confidence intervals were calculated and a P value smaller than 0.05 was considered statistically significant. Age, sex, DM, and smoking were matched in both cases and controls (table 1). HTN and HLP Annual Review of Biochemistry were controlled by stratifying two levels. Binary logistic regression analysis was used to calculate Hcy in the stroke subgroups and controls. Additionally, the analysis of variance (ANOVA) was employed to compare the mean values of B12, folate, and Hcy. Table 1 Demographic data, risk factors, and serum Hcy, vitamin B12, and folate 4-mu nmr levels in the cases and controls Results One hundred seventy-one consecutive patients and 86 age and sex-matched controls from the same geographic area were selected.