Author/Editor		Skitek, Milan
Title		Homocistein v luči novih spoznanj
Translated title		Homocystein in the spotlight of the new conceptions
Type		članek
Source		Farm Vestn
Vol. and No.		Letnik 52, št. Poseb št
Publication year		2002
Volume		str. 331-5
Language		slo
Abstract		Homocysteine research has emerged among the many dynamic fields in expanding insight of atherosclerosis. Since the mid-eighties, many studies have documented that a moderately elevated plasma (serum) homocysteine level is an independent risk factor for atherosclerosic diseases (myocardial infarction, stroke or peripheral vascular disease). In the recent past, growing understanding of the function of homocysteine with methodological considerations and standardisation of the preanalytical phase moved testing of homocysteine into the reality of every day routine practice. Professional organisations, associations and peer-reviewed literature already offer basic guidelines not only for performing the test, but also the recommendations about whom and when to test. Measurement of total homocysteine is valuable tool in patients with a history of atherothrombotic vessel diseases, in identifying individuals with cobalamin or folate deficiency, in patients with diabetes or hyperlipidemia, in renal patients, in obese subjects, in elderly people, in post-menopausal women, in early pregnancy and diagnosing homocystinuria. International standardisation and calibration of measurement of total homocysteine currently do not yet exist and interlaboratory variation are not yet satisfactory. Laboratories should monitor method performance by participation in an external quality assurance programmes (schemes).
Summary		Razvoj novih spoznanj v procesu ateroskleroze je uvrstil določanje homocisteina med relevantne pokazatelje tega širokega področja patogeneze. Že od sredine osemdesetih let prejšnega stoletja se pojavljajo dokumentirane raziskave o zmerni hiperhomocisteinemiji kot neodvisnem dejavniku tveganja za razvoj žilne bolezni vključno z miokardnim infarktom, ishemičnim insultom in okluzivno boleznijo perifernih arterij. Nova znanja o vlogi homocisteina in razvoj novih metod določanja celokupnega (vezanega na beljakovine in prostega) homocisteina s standardizacijo predanalitske faze so v zadnjem času približali to določanje bolnikom v vsakdanji praksi. Znanstvene organizacije, strokovna združenja in sodobna literatura že imajo priporočila tako za analitiko kot tudi za pogoje določanja (komu in kdaj?). Določanje celokupnega homocisteina v serumu ali plazmi je smiselno pri bolnikih s tveganjem za določene bolezni ali stanja (srčnožilne in ledvične bolezni, diabetes, hiperlipemije itd.), pri pomanjkanju folatov, B 12 in B6, ter za določitev diagnoze homocistinurije. Mednarodni sistem standardizacije in kalibracije številnih metod določanja homocisteina še ne obstoja, zato so razlike med metodami še relativno velike. Sodelovanje laboratorijev v nacionalnih in mednarodnih programih za presojo kakovosti je nujno za preverjanje zanesljivosti različnih analitičnih metod in za razvoj standardizacije.
Descriptors		ATHEROSCLEROSIS HOMOCYSTEINE