Turkish Neurosurgery 2021 , Vol 31 , Num 2
Hyperhomocysteinemia Independently Associated with Adult Moyamoya Disease: Hospital Based Study of 237 Patients
Ying ZHANG1,Xian FU2,Xiangfan ZENG1,Jie XU1,Hongying LIU1,Xuelong LI1,Qingchun GAO1
1Guangzhou Medical University, The Second Affiliated Hospital, Department of Neurology and Institute of Neuroscience, Guangzhou, China
2Shenzhen Baoan District Songgang People?s Hospital, Department of Neurology, Shenzhen, China
DOI : 10.5137/1019-5149.JTN.29244-20.2 AIM: To clarify the risk factors for adult moyamoya disease (MMD) in patients from South China.

MATERIAL and METHODS: We prospectively studied adult patients who were diagnosed angiographically with MMD. The demographic profiles, medical history and clinical characteristics were compared between adult MMD and non-MMD stroke patients. Logistic regression analysis was used to determine the risk factors associated with adult MMD.

RESULTS: A total of 35 adult MMD patients and 202 adults patients with non-MMD stroke were included. Of the 35 MMD patients, bilateral MMD occurred in 48.6% and bypass surgery was performed in 28.6%; these figures were significantly lower than those reported in patients from Korea and the United States (p<0.05). After adjusting for baseline demographics and potential confounders, multivariate logistic regression analysis was conducted, which showed that the plasma homocysteine level (odds ratio [OR]: 1.10; 95% confidence interval [CI]: 1.06?1.14) and occupation as a technological worker (OR: 4.23; 95% CI: 1.65?10.89) were independently associated with adult MMD.

CONCLUSION: Hyperhomocysteinemia and type of occupation were found to be independent risk factors for adult MMD in patients from South China. However, there is still a need for further research to clarify the pathogenesis of MMD. Given the lack of understanding about the risk factors and prevention measures for MMD, we suggest bypass surgery be used for MMD treatment in clinical practice in China to achieve more desirable effects in the management of the disease. Keywords : Moyamoya disease, Angiography, Digital subtraction, Hyperhomocysteinemia, Adult

Corresponding author : Xian FU, fuxian2011@163.com