Homocheck Tablet: A Diagnostic Tool for Homocysteine Measurement
Homocheck tablet is used for measuring total plasma homocysteine levels to assess cardiovascular risk and monitor patients with hyperhomocysteinemia. This diagnostic test helps identify elevated homocysteine levels, which are associated with increased risk of cardiovascular diseases, stroke, and other health conditions.
Purpose and Clinical Significance
Homocheck serves as a diagnostic tool for:
- Detecting hyperhomocysteinemia (elevated homocysteine levels >15 μmol/L) 1
- Assessing cardiovascular risk in patients with or without established disease 1
- Monitoring patients with metabolic disorders related to homocysteine metabolism
- Evaluating nutritional deficiencies that affect homocysteine levels (folate, vitamin B12, vitamin B6)
Clinical Applications
Cardiovascular Disease Risk Assessment
- Elevated homocysteine levels (>15 μmol/L) are associated with increased risk of premature vascular occlusion 1
- Values between 10-15 μmol/L may confer a graded risk for cardiovascular events 1
- Homocysteine testing is particularly valuable in patients with:
- Unexplained atherosclerotic disease
- Family history of premature cardiovascular disease
- Presence of other cardiovascular risk factors
Metabolic Disorders Evaluation
- Homocheck can help identify patients with non-alcoholic fatty liver disease (NAFLD), which is associated with metabolic syndrome and insulin resistance 1
- Homocysteine levels correlate with insulin resistance and can be used alongside HOMA-IR in non-diabetic patients 1
Nutritional Deficiency Screening
- Elevated homocysteine may indicate deficiencies in:
- Folate
- Vitamin B12 (cobalamin)
- Vitamin B6 (pyridoxine)
Interpretation of Results
- Normal range: 5-15 μmol/L in fasting subjects 1, 2
- Hyperhomocysteinemia: >15 μmol/L 1
- A single elevated value should be confirmed with a repeat test after fasting for ≥8 hours 1
Clinical Management Based on Results
If elevated homocysteine levels are detected:
Further diagnostic workup:
- Measure serum and erythrocyte folate
- Check serum cobalamin (B12)
- Assess serum and/or urine methylmalonic acid levels 1
Treatment options:
- Folate supplementation (0.5-5.0 mg/day) can reduce fasting homocysteine levels by 25-30% 1
- Vitamin B12 supplementation (0.02-1 mg/day) provides an additional 7% reduction 1
- Vitamin B6 helps reduce post-methionine loading homocysteinemia 1
- B complex vitamins might be considered for prevention of ischemic stroke in patients with hyperhomocysteinemia (Class IIb; Level of Evidence B) 1
Important Considerations
- Homocysteine levels in whole blood increase at room temperature due to continuous production from blood cells
- To avoid artificial increases, blood samples should be centrifuged within 1 hour of collection or placed on ice 2
- Supplementation with folate alone can mask B12 deficiency by correcting hematologic findings while allowing neurological damage to progress 1
- Homocysteine levels are affected by renal function, age, and certain medications (e.g., methotrexate) 3
Limitations
- The test measures total homocysteine but doesn't differentiate between different forms (free vs. protein-bound)
- Results should be interpreted in the context of the patient's overall clinical picture
- A single measurement may not reflect long-term status
Homocheck provides valuable diagnostic information for cardiovascular risk assessment and nutritional status evaluation, particularly in patients with risk factors for atherosclerotic disease or suspected B vitamin deficiencies.