Total homocysteine in pediatric patients.

Determination of plasma total homocysteine (tHcy; the sum of all forms of thiol derivatives that form homocysteine by reduction) (1) is essential for diagnosis and follow-up of homocystinuric patients (2) and for detection of moderate hyperhomocysteinemia, a risk factor for coronary, cerebral, and peripheral vascular disease (3). In childhood, moderate hyperhomocysteinemia may result from several genetic, nutritional (4), and iatrogenic factors (1), renal failure (5), HIV (6), and cancer (1). Plasma tHcy in children may be a useful biochemical marker for a genetic risk of premature atherosclerosis (1). Various methods to measure tHcy have been described during the last decade, but HPLC with fluorescence detection is the most common (4)(7). Age- and sex-specific reference intervals for adults have been reported (4), considering even vitamin status (8), but data for children are sparse and inconsistent [ 9 , 10] , and no evidence is available in Mediterranean countries, where dietary vitamin content differs from that in Northern Europe or North America. Our goal was to establish reference values for a pediatric population in our geographical area with our working conditions so that we could compare the values in further studies with those of children at risk for moderate hyperhomocysteinemia. Specimens were collected from …