Ann Med. 2026 Dec;58(1):2719236. doi: 10.1080/07853890.2026.2719236. Epub 2026 Aug 21.
ABSTRACT
OBJECTIVES: This retrospective study explored the associations of plasma homocysteine (Hcy), cysteine (Cys) and methionine (Met) levels with 90-day prognosis in intracerebral hemorrhage (ICH) patients and evaluated their predictive value for ICH prognosis.
METHODS: A total of 212 ICH patients and 215 age- and sex-matched healthy controls were enrolled. ICH patients were categorized into favorable and unfavorable prognostic groups based on their 90-day prognosis. Plasma Hcy, Cys and Met levels were compared between groups. Multivariate logistic regression and ROC curve analyses were used to assess their prognostic correlations and predictive efficacy. Restricted Cubic Spline (RCS) analysis explored the nonlinear relationship between Met and prognosis. The predictive model was internally validated and compared with classic ICH prognostic scoring systems.
RESULTS: ICH patients had significantly higher Hcy, Cys and Met levels than healthy controls. Unfavorable prognosis patients presented higher Hcy and Cys levels but lower Met levels. High Hcy (OR = 1.235, 95%CI 1.137-1.342) and Cys (OR = 1.017, 95%CI 1.008-1.025) were independent risk factors for poor prognosis. Met exerted a dual nonlinear effect and played a protective role at levels <32.88 μmol/L (OR = 0.924, 95%CI 0.860-0.992). The combined three biomarkers yielded the optimal predictive performance (AUC = 0.819), superior to all single and pairwise biomarker combinations.
CONCLUSION: Elevated Hcy, Cys and Met levels are observed in ICH patients. High Hcy and Cys predict unfavorable prognosis. Met exhibited concentration-dependent correlational trends, lower odds of adverse outcomes were observed for Met <32.88 μmol/L. Combined detection of the three biomarkers yielded the highest predictive accuracy in internal single-center validation, pending external prospective verification before clinical translation.
PMID:42626963 | DOI:10.1080/07853890.2026.2719236