Open Access Maced J Med Sci. 2017 Jun 15; 5(3):271-398. (published online June 15, 2017)
Table of Contents
Open Access Maced J Med Sci. 2017 Jun 15; 5(3):271-398. (published online June 15, 2017)
Basic Science
Jusuf NK, Putra IB, Kartayana J. The Correlation between Body Mass Index with the Occurrence of
Skin Tag. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):271-274.
https://doi.org/10.3889/oamjms.2017.061 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Zaki M, Hassan N, El-Bassyouni HT, Kamal S, Basha W, Azmy O, Amr K. Association of the
Pro12Ala Polymorphism with the Metabolic Parameters in Women with Polycystic Ovary
Syndrome. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):275-280.
https://doi.org/10.3889/oamjms.2017.088 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Zarrin M, Rahdar M, Poormohamadi F, Rezaei-Matehkolaei A. In Vitro Nematophagous Activity of
Predatory Fungi on Infective Nematodes Larval Stage of Strongyloidae Family. Open Access
Maced J Med Sci. 2017 Jun 15; 5(3):281-284. https://doi.org/10.3889/oamjms.2017.064 [Abstract] [FullText PDF] [OnlineFirst Full-Text PDF]
Clinical Science
Abbas W, Adam I, Rayis DA, Hassan NG, Lutfi MF. A Higher Rate of Iron Deficiency in Obese
Pregnant Sudanese Women. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):285-289.
https://doi.org/10.3889/oamjms.2017.059 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Arefizadeh R, Hariri SY, Moghadam AJ. Outcome of Cardiac Rehabilitation Following Off-Pump
Versus On-Pump Coronary Bypass Surgery. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):290-294. https://doi.org/10.3889/oamjms.2017.057 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]
Panovski MJ, Fildishevski IV, Ognjenovic LL, Dejanova-Ilijevska VI. New Surgical Technologies Could
Facilitate Surgical Hemostasis in Hemophilic Patients. Open Access Maced J Med Sci. 2017 Jun
15; 5(3):295-298. https://doi.org/10.3889/oamjms.2017.062 [Abstract] [Full-Text PDF] [OnlineFirst FullText PDF]
El Samahi MH, Ismail NA, Matter RM, Selim A, Ibrahim AA, Nabih W. Study of Visfatin Level in Type
1 Diabetic Children and Adolescents. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):299-304.
https://doi.org/10.3889/oamjms.2017.065 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Ghaffari J, Rokni GR, Kazeminejad A, Abedi H. Association among Thyroid Dysfunction, Asthma,
Allergic Rhinitis and Eczema in Children with Alopecia Areata. Open Access Maced J Med Sci.
2017 Jun 15; 5(3):305-309. https://doi.org/10.3889/oamjms.2017.050 [Abstract] [Full-Text PDF]
[OnlineFirst Full-Text PDF]
Farčić N, Barać I, Pačarić S, Lovrić I, Ilakovac V. Acute Postoperative Pain in Trauma Patients - The
Fifth Vital Sign. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):310-315.
https://doi.org/10.3889/oamjms.2017.067 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Özdaş S, Olt S, Şirik M. The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus.
Open Access Maced J Med Sci. 2017 Jun 15; 5(3):316-318. https://doi.org/10.3889/oamjms.2017.074
[Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Masoumi B, Heydari F, Hatamabadi H, Azizkhani R, Yoosefian Z, Zamani M. The Relationship
between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head
Trauma Admitted To Hospital. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):319-323.
https://doi.org/10.3889/oamjms.2017.071 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Grubovic RM, Georgievski B, Cevreska L, Genadieva-Stavric S, Grubovic MR. Analysis of Factors
that Influence Hematopoietic Recovery in Autologous Transplanted Patients with Hematopoietic
Stem Cells from Peripheral Blood. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):324-331.
https://doi.org/10.3889/oamjms.2017.039 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Hasibuan DRU, Putra IB, Jusuf NK. Correlation between Serum Homocysteine and Vitiligo Area
Scoring Index. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):332-334.
https://doi.org/10.3889/oamjms.2017.066 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Shahsavari R, Bagheri SM, Iraji H. Comparison of Diagnostic Value of Sonourethrography with
Retrograde Urethrography in Diagnosis of Anterior Urethral Stricture. Open Access Maced J Med
Sci. 2017 Jun 15; 5(3):335-339. https://doi.org/10.3889/oamjms.2017.073 [Abstract] [Full-Text PDF]
[OnlineFirst Full-Text PDF]
Case Report
Trajkovska I, Georgievski B, Cevreska L, Gacovski A, Hasan T, Nedeska-Minova N. Early and Late
Complications in Patients with Allogeneic Transplantation of Hematopoietic Stem Cell – Case
Report. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):340-343.
https://doi.org/10.3889/oamjms.2017.038 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]OAMJMS2017-038v.pdf
Rexhepi M, Trajkovska E, Ismaili H, Besimi F, Rufati N. Primary Fallopian Tube Carcinoma: A Case
Report and Literature Review. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):344-348.
https://doi.org/10.3889/oamjms.2017.044 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Stojmenski S, Merdzanovski I, Gavrilovski A, Pejkova S, Dzokic G, Tudzarova S. Treatment of
Decubitis Ulcer Stage IV in the Patient with Polytrauma and Vertical Share Pelvic Fracture,
Diagnosed Entherocollitis and Deep Wound Infection with Clostridium Difficile with Combined
Negative Pressure Wound Therapy (NPWT) and Faecal Management System: Case Report. Open
Access Maced J Med Sci. 2017 Jun 15; 5(3):349-351. https://doi.org/10.3889/oamjms.2017.060
[Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Expert Opinion
Tchernev G, Chokoeva AA. New Safety Margins for Melanoma Surgery: Nice Possibility for
Drinking of "Just That Cup of Coffee"? Open Access Maced J Med Sci. 2017 Jun 15; 5(3):352-358.
https://doi.org/10.3889/oamjms.2017.068 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Stomatology
Bahaa-Eldin K, Mostafa B, Nasry S, Reda A, Shoeib M. Maxillary Sinus Augmentation Using a
Titanium Mesh: A Randomized Clinical Trial. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):359-369. https://doi.org/10.3889/oamjms.2017.083 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]
Public Health
Edu BC, Agan TU, Monjok E, Makowiecka K. Effect of Free Maternal Health Care Program on
Health-seeking Behavior of Women during Pregnancy, Intrapartum and Postpartum Periods in
Cross River State of Nigeria: A Mixed Method Study. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):370-382. https://doi.org/10.3889/oamjms.2017.075 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]
Starc J, Erjavec K. Impact of the Dimensions of Diversity on the Quality of Nursing Care: The
Case of Slovenia. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):383-390.
https://doi.org/10.3889/oamjms.2017.086 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Review Article
Ekmekçi H, Kaptan H. Vagus Nerve Stimulation. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):391-394. https://doi.org/10.3889/oamjms.2017.056 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]
Letter to the Editor
Chokoeva A, Sokolova R, Lotti T, Wollina U, Gianfaldoni S, Lotti J, França K, Tchernev G. Congenital
Progressive Mutilating Hemangioma. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):395-396.
https://doi.org/10.3889/oamjms.2017.098 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Chokoeva AA, Tchernev G. Wolf’s Panniculitis. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):397-398.
https://doi.org/10.3889/oamjms.2017.069 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Editors-in-Chief:
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Dr Mirko Spiroski is the founder and Editor-in-Chief of the Macedonian Journal of Medical Sciences. He is
a graduate of the Skopje Faculty of Medicine (1972), where he later obtained his MSc (1978), and PhD
(1989) degrees. He is the founder and first Director of the Institute of Immunobiology and Human Genetics
at the Faculty of Medicine in Skopje and acts as a tutor of the Medical Scientific Club "Acad. Dimitar
Arsov". He introduced several subjects in the curricula at the Faculties of Medicine (Immunology and
Human genetics), Natural Sciences (Immunochemistry with basic immunology, Biochemistry-3,
Immunogenetics), Physical Education (Genetics in sport), and in the Master of Sciences postgraduate
program in Public Health (Public health genetics). His research interest is immunology, but he has also
published in the fields of molecular anthropology and human genetics. He was Secretary general and
Deputy Editor-in-Chief of the journal Godishen zbornik na Medicinski Fakultet Skopje, and Editor-in-Chief
of the Macedonian Journal of Medicine.
Doncho M. Donev, MD, PhD - EDITOR-IN-CHIEF FOR PUBLIC HEALTH
Institute of Social Medicine, Medical Faculty, Ss Cyril and Methodius University of Skopje, 50 Divizija 16,
1109 Skopje, Republic of Macedonia. Tel.: +389 2 3298-580, Fax: +389 2 3298 582, Mobile: +389
70244760.
dmdonev@gmail.com
Dr. Donev received his MD at the St. Cyril and Methodius University Medical School, Skopje, Macedonia,
in 1973, where he completed his specialization in social medicine in 1981. From 1983 to 1985 he had his
postgraduate studies of social medicine in Sarajevo, Bosnia and Herzegovina, and later on received his
PhD in 1993 at the Skopje Medical School. He realized his postdoctoral studies in public health (Hubert H.
Humphrey Fellowship Program) at Emory University School of Public Health in Atlanta, GA, USA, in the
academic year 1993/94. Since 2003 he has been Regular/ full-time Professor of Social Medicine at the
Skopje University School of Medicine. His professional and research interest include broad scope of
activities related to prevention and control of non-communicable diseases and other priority health
problems, health status and needs for health care of the vulnerable population groups, organization of
health systems and health care reforms, health economics and quality of health care, health education,
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Senior Lecturer/Honorary Consultant in Old Age Psychiatry, Newcastle University.
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Elizabeta Mukaetova-Ladinska graduated at the Medical School in Skopje, Macedonia, where she
completed her clinical training in neuropsychiatry and obtained a Masters degree in Clinical Psychiatry.
Following her move to the UK, she obtained a PhD in Psychiatry at the University of Cambridge and
completed higher specialist training in Old Age Psychiatry. She joined the Institute for Ageing and Health,
University of Newcastle, in 2000, and since 2005 has worked within the Liaison Service for Older Adults in
Newcastle. Her research interests are the molecular pathology of dementia, ageing and
neurodevelopmental disorders, and clinical phenomenology of mental health problems in the acutely
medically ill older adults. She is an Associate Editor of Age and Ageing, and serves on the Editorial Board
of several Geriatric Medicine journals (http://www.ncl.ac.uk/iah/staff/profile/elizabeta.mukaetova-ladi).
Borislav D Dimitrov, MD, MSc, PhD - DEPUTY EDITOR IN CHIEF
Associate Professor in Medical Statistics, Faculty of Medicine, University of Southampton
(www.southampton.ac.uk); & Senior Statistician/Honorary Consultant, University Hospital Southampton
NHS Foundation Trust, Southampton, UK (www.uhs.nhs.uk/ClinicalResearchinSouthampton/Ourresearch/Respiratory-research/NIHR-SRBU/NIHR-Southampton-Respiratory-Biomedical-ResearchUnit.aspx). Joint position with the Southampton Statistical Sciences Research Institute (S3RI), University
of Southampton (www.southampton.ac.uk/s3ri).
b.dimitrov@soton.ac.uk
Borislav Dimitrov graduated at the Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria. He
completed his MSc in Pollution & Environmental Control, University of Manchester, Manchester, UK (1994)
and his specialty in Public Health (Social Medicine & Health Management, SMHM), Medical University,
Plovdiv, Bulgaria (1998). He received his DM/PhD in Public Health (Social Medicine & Health
Management) at the Medical University, Plovdiv, Bulgaria (2006). He started as an Assistant Professor in
Public Health (Social Medicine & Health Management), at the Trakia University of Stara Zagora and the
Medical University in Plovdiv, Bulgaria (1991-2005), continued as Senior Scientist in Biostatistics &
Clinical Epidemiology at the Mario Negri Institute for Pharmacological Research, Italy (2000-2008), Senior
Health Outcomes Manager, IMS Health, London, UK (2008), and Senior Research Fellow/Programme
Manager & Coordinator, HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland,
Dublin, Ireland. In 2012 he was appointed as a Senior Lecturer in Medical Statistics at the Faculty of
Medicine, and from 2014 – as an Associate Professor, a joint position with the Southampton Statistical
Sciences Research Institute (S3RI).
Marko Spasov, MD, PhD candidate - DEPUTY EDITOR-IN-CHIEF
General Surgeon at University Clinic of Traumatology, Orthoapedics, Anesthesia, Reanimation, Intensive
Care and Emergency Department; Medical Faculty, Skopje.
marspasov@yahoo.com
Marko Spasov graduated at the Medical School in Skopje, Macedonia. From 2008 he worked as a medical
doctor at Emergency Department in Skopje. In 2012 he completed his clinical training in General Surgery
and since then he works as a General Surgeon at the same institution. At the present, he is attending The
School of Doctoral Studies at Ss. Cyril and Methodius University of Skopje in the field of Clinical Medicine.
His research interest is the skeletal trauma in athletes and pathophysiology of bone healing process.
Sasho Stoleski, MD, MSc - DEPUTY EDITOR-IN-CHIEF
Institute for Occupational Health of Republic of Macedonia - Skopje, WHO Collaborating Center, GA2LEN
Collaborating Center, II Makedonska brigada 43, 1000 Skopje, Macedonia. Phone: +389 70 778 543, +389
71 314 435.
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Sasho Stoleski graduated at the Medical Faculty in Skopje in 2002 and obtained a Master degree in 2009.
He is actively engaged in the educational process of the students of medicine, nurses, physiotherapists,
and logopedists. Since 2003, he is employed in the Institute of occupational Health of Republic of
Macedonia, WHO CC in the Center for respiratory functional diagnostics. He became assistant professor
in the Chair of Occupational Medicine within the Medical Faculty in Skopje in 2010. He has finished his
specialization in Occupational Medicine in 2008. Actively involved in the research, expert’s and scientific
work of the Institute of occupational health, dealing with actual challenges in occupational medicine,
principles of functional diagnostics of respiratory system, occupational pulmology and allergology,
industrial toxicology, ecology of work, and workplace risk assessment. He started his sub-specialization in
pulmology and allergology and PhD studies in the field of occupational medicine in 2012. He is a National
Secretary of International Commission on Occupational Health (ICOH), and member of Macedonian
Society of Occupational Health, Macedonian Respiratory Society, Macedonian Society of Basic, Clinical
Immunology and Allergology, European Respiratory Society, European Academy of Allergy and Clinical
Immunology. Author and co-author of more than 80 titles published in domestic and international journals.
Ivo Spiroski - MANUSCRIPT EDITION AND ELECTRONIC PUBLISHING
Ivo Spiroski. Engineer of Design, ID Design 2012/DOOEL Skopje, Naroden Front 13/45, 1000 Skopje,
Republic of Macedonia. http://www.iddesign.mk/ Tel.: +389 23109851; +389 71 205072.
ivospiroski@gmail.com
Ivo Spiroski graduated in 2010 at the University "Ss Cyril and Methodius", Faculty of Design and
Technologies of Furniture and Interior. At the present he is attending Master of Sciences at the same
Faculty in the field of Furniture and Interior Design. Two years (1999-2001) he was Director of the
company Medis, Skopje. Mold design specialisation in Taipei, Taiwan (2002). He was founder and Editorin-chief of the journal Igrach (Player). Founder and Director of ID Design 2012/DOOEL Skopje, Republic of
Macedonia.
Katarina Stavric, MD - EVIDENCE BASED MEDICINE
Children Hospital Skopje, Macedonia, Vodnjanska 17, University "Ss Cyril and Methodius", Skopje,
Republic of Macedonia. Phone +389-91-3147-714 ; 070-365038.
kstavric@hotmail.com
Dr Katarina Stavric, graduated in 1987 at University of Skopje “Ss Cyril and Methodius”, Medical Faculty
Skopje, Macedonia. From 1990 she works as a medical doctor at University’s Children Hospital, Medical
Faculty – Skopje, and from 1997 as Pediatrician, at Department of Immunology. In 2002, she obtained his
MSc degree. In 2006 she was inaugurated with title of primaries from the Ministry of health. From 1999
she works as a teaching assistant of pediatrics. The objectives of her interest are clinical immunology and
allergy, as well as education of medical professions. She has performed professional visits of several
paediatric clinics and educational workshops as a part of her continual professional education. She
published numerous professional papers in national and international medical journals and 3 books. She
was involved as a researcher in two national projects, and 3 international projects from the domain of
immunology and allergy. She was also involved in several working groups of Project in improving the
health education preparing curriculum for Primary health care, Faculty of pediatric nurses and state exam.
From 2005 she becomes a member of the Educational board in Macedonian association of doctor
responsible for the continual medical education of doctors.
ID Design 2012/DOOEL Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2017 Jun 15; 5(3):332-334.
https://doi.org/10.3889/oamjms.2017.066
eISSN: 1857-9655
Clinical Science
Correlation between Serum Homocysteine and Vitiligo Area
Scoring Index
*
Dina R. U. Hasibuan , Imam B. Putra, Nelva K. Jusuf
Dermatovenereology, Faculty of Medicine, University of Sumatera Utara, Medan, North Sumatera, Indonesia
Abstract
Citation: Hasibuan DRU, Putra IB, Jusuf NK. Correlation
between Serum Homocysteine and Vitiligo Area Scoring
Index. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):332-334. https://doi.org/10.3889/oamjms.2017.066
Keywords: Vitiligo; serum homocysteine; pathogenesis.
*Correspondence:
Dina
R.
U.
Hasibuan.
Dermatovenereology, Faculty of Medicine, University of
Sumatera Utara, Medan, North Sumatera, Indonesia. Email: dina.afif.almahdaly@gmail.com
Received:
02-Mar-2017;
Revised:
11-Apr-2017;
Accepted: 18-Apr-2017; Online first: 11-Jun-2017
Copyright: © 2017 Dina R. U. Hasibuan, Imam B. Putra,
Nelva K. Jusuf. This is an open-access article distributed
under the terms of the Creative Commons AttributionNonCommercial 4.0 International License (CC BY-NC
4.0).
Funding: This research did not receive any financial
support.
Competing Interests: The authors have declared that no
competing interests exist.
BACKGROUND: Vitiligo is a chronic skin disorder. White macules caused by melanocyte destruction is a
characteristic finding that cosmetically disturbing. Until recently, pathogenesis of vitiligo is still unclear. The role of
homocysteine in vitiligo is mentioned in previous studies thus it is probable that it can be a biomarker to determine
vitiligo severity.
AIM: To determine correlation between serum homocysteine and vitiligo area Scoring Index (VASI)
SUBJECT AND METHOD: This was a cross-sectional analytic study which involved 30 vitiligo patients that were
diagnosed by clinical and Wood’s lamp examinations then VASI score was determined and same numbers of
control. We conducted blood sampling and measurement of serum homocysteine level to the patients.
RESULTS: There is no significant correlation between serum homocysteine and VASI score (p = 0.133, r =
0.281), family history (p = 0.706), and duration of vitiligo (p = 0.993, r = 0.002). There is no significant difference
between serum homocysteine in vitiligo patients and controls (p = 0.905). There is a correlation between serum
homocysteine with gender (p = 0.001) and age (p = 0.036; r = 0.385) in vitiligo patient.
CONCLUSION: There is no significant correlation between serum homocysteine and VASI score, family history,
and duration of vitiligo. There is no significant difference between serum homocysteine in vitiligo patients and
controls. There is a correlation between serum homocysteine with gender and age in vitiligo patient.
Introduction
Subjects and Methods
Vitiligo is a skin depigmentation disorder with
the characteristic as a white macule caused by
melanocyte destruction. Aetiology of vitiligo is still
unknown. But there are several hypotheses like
genetic, autoimmune and biochemistry [1-3]. This
hypothesis was thought to simultaneously work
together and caused vitiligo. Genetic predisposition
can trigger autoimmune process, and with the addition
of oxidative stress, elevation can result in the
destruction of melanocyte, therefore, inducing white
macule in vitiligo subjects [4].
This was a cross-sectional analytic study
involving 30 vitiligo patients and 30 controls who were
18 years old or above and submitted to the outpatient
dermatology and venereology clinic in Haji Adam
Malik General hospital, Medan, North Sumatera,
Indonesia. This study conducted from June until
October 2016. Each subject signed informed consent
were included in this study. Exclusion criteria were
consumption of vitamin B6, B12, and folic acid within
the last 6 months, breastfeeding, pregnancy, and
vitiligo treatment during the last 6 months. Ethical
clearance was given by Health Research Ethical
Committee, Faculty of Medicine, University of
Sumatera Utara.
One compound thought to be involved in this
hypothesis is homocysteine [5]. Homocysteinemediated melanocyte destruction via production of
interleukin-6 (IL-6), activating nuclear factor-kappa B
(NF-ĸB) and increased oxidative stress [6].
All subjects with vitiligo were diagnosed by
clinical and Wood’s lamp examinations. VASI score
was determined by calculating body part involved and
depigmentation severity. VASI was calculated using a
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Hasibuan et al. Correlation between Serum Homocysteine and Vitiligo Area Scoring Index
______________________________________________________________________________________________________________________________
formula that includes contributions from all body
regions (possible range, 0–100). VASI = ∑ Hand Units
of all body sites × Residual Depigmentation. One
hand unit, which encompasses the palm plus the volar
surface of all the digits, is approximately 1% of the
total body surface area. It is used as a guide to
estimate the baseline percentage of vitiligo
involvement in each body region. The body was
divided into separate regions: upper extremities
(excluding hands), hands, trunk, lower extremities
(excluding feet), feet and head and neck. The axillary
region was included with the upper extremities while
the buttocks and inguinal areas were included with the
lower extremities.
The extent of residual depigmentation was
expressed by the following percentages: 0, 10%, 25%,
50%, 75%, 90%, or 100%. At 100% depigmentation;
no pigment was present, at 90%; specks of pigment
were present, at 75%; the depigmented area
exceeded the pigmented area, at 50%; the
depigmented and pigmented areas were equal, at
25%; the pigmented area exceeded the depigmented
area, at 10%; only specks of depigmentation were
present.
Fasting blood sample from subjects then
processed into the serum. Homocysteine level was
®
measured from serum by using ADVIA Centaur HCY .
The results were analysed with SPSS version
19. Quantitative data were analysed using mean and
SD. The Student t-test was used to compare the
means of different groups. Spearman test was used to
determine relationships. P values less than 0.05 were
considered significant.
Results
There is no significant correlation between
serum homocysteine and VASI score (p = 0.133, r =
0.281), family history (p = 0.706), and duration of
vitiligo (p = 0.993, r = 0.002).
Table 1: Serum homocysteine level in vitiligo subjects and
controls
Subjects
Vitiligo
Control
Male
Female
Positive family history
Negative family history
Mean (µmol/L)
10.66
10.58
13.02
9.81
11.07
10.56
Serum homocysteine level
Standard Deviation
(µmol/L)
2.89
2.01
1.48
2.81
2.16
3.08
p
0.905
0.001
0.706
There is a correlation between serum
homocysteine with gender (p = 0.001) and age (p =
0.036; r = 0.385) in vitiligo patient. There is no
significant difference between serum homocysteine in
vitiligo patients and controls (p = 0.905).
Table 2: Correlation between the serum homocysteine with
VASI score and other variables
Serum homocysteine with VASI score
Serum homocysteine with age of vitiligo subjects
Serum homocysteine serum with duration of disease
p
0.133
0.036
0.993
r
0.281
0.385
0.002
Discussion
In this study we didn’t find any significant
correlation between serum homocysteine level and
VASI score (p > 0.05; r = 0.281). This is in agreement
with another study in Dr M. Djamil Padang, which
conducted a study with 17 samples (r = 0.061; p >
0.05) [7].
A similar finding by Zaki et al. in Egypt also
didn’t find any significant relation between serum
homocysteine level and VASI score (p > 0.05). Zaki et
al. reveal this study used VASI score instead of rules
of nine like in other studies. VASI score evaluates
vitiligo lesion both quantitatively and qualitatively [8].
This result was in disagreement with ElDawela and Abou-elf touch who conducted a study
with 70 samples and found a correlation between
VASI score and homocysteine serum (r = 0.835, p =
0.001) with mean VASI score was 9.5 ± 19.5 [9].
Similar findings found by Agarwal et al in India with 50
vitiligo subjects (r = 0.567; p = 0.000). In this study
VASI score ≥ 30 significantly higher than VASI score
Open Access Maced J Med Sci. 2017 Jun 15; 5(3):271-398. (published online June 15, 2017)
Basic Science
Jusuf NK, Putra IB, Kartayana J. The Correlation between Body Mass Index with the Occurrence of
Skin Tag. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):271-274.
https://doi.org/10.3889/oamjms.2017.061 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Zaki M, Hassan N, El-Bassyouni HT, Kamal S, Basha W, Azmy O, Amr K. Association of the
Pro12Ala Polymorphism with the Metabolic Parameters in Women with Polycystic Ovary
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Zarrin M, Rahdar M, Poormohamadi F, Rezaei-Matehkolaei A. In Vitro Nematophagous Activity of
Predatory Fungi on Infective Nematodes Larval Stage of Strongyloidae Family. Open Access
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Clinical Science
Abbas W, Adam I, Rayis DA, Hassan NG, Lutfi MF. A Higher Rate of Iron Deficiency in Obese
Pregnant Sudanese Women. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):285-289.
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Arefizadeh R, Hariri SY, Moghadam AJ. Outcome of Cardiac Rehabilitation Following Off-Pump
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Panovski MJ, Fildishevski IV, Ognjenovic LL, Dejanova-Ilijevska VI. New Surgical Technologies Could
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15; 5(3):295-298. https://doi.org/10.3889/oamjms.2017.062 [Abstract] [Full-Text PDF] [OnlineFirst FullText PDF]
El Samahi MH, Ismail NA, Matter RM, Selim A, Ibrahim AA, Nabih W. Study of Visfatin Level in Type
1 Diabetic Children and Adolescents. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):299-304.
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Ghaffari J, Rokni GR, Kazeminejad A, Abedi H. Association among Thyroid Dysfunction, Asthma,
Allergic Rhinitis and Eczema in Children with Alopecia Areata. Open Access Maced J Med Sci.
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Farčić N, Barać I, Pačarić S, Lovrić I, Ilakovac V. Acute Postoperative Pain in Trauma Patients - The
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Özdaş S, Olt S, Şirik M. The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus.
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[Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Masoumi B, Heydari F, Hatamabadi H, Azizkhani R, Yoosefian Z, Zamani M. The Relationship
between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head
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https://doi.org/10.3889/oamjms.2017.071 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Grubovic RM, Georgievski B, Cevreska L, Genadieva-Stavric S, Grubovic MR. Analysis of Factors
that Influence Hematopoietic Recovery in Autologous Transplanted Patients with Hematopoietic
Stem Cells from Peripheral Blood. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):324-331.
https://doi.org/10.3889/oamjms.2017.039 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Hasibuan DRU, Putra IB, Jusuf NK. Correlation between Serum Homocysteine and Vitiligo Area
Scoring Index. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):332-334.
https://doi.org/10.3889/oamjms.2017.066 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Shahsavari R, Bagheri SM, Iraji H. Comparison of Diagnostic Value of Sonourethrography with
Retrograde Urethrography in Diagnosis of Anterior Urethral Stricture. Open Access Maced J Med
Sci. 2017 Jun 15; 5(3):335-339. https://doi.org/10.3889/oamjms.2017.073 [Abstract] [Full-Text PDF]
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Case Report
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Complications in Patients with Allogeneic Transplantation of Hematopoietic Stem Cell – Case
Report. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):340-343.
https://doi.org/10.3889/oamjms.2017.038 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
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Rexhepi M, Trajkovska E, Ismaili H, Besimi F, Rufati N. Primary Fallopian Tube Carcinoma: A Case
Report and Literature Review. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):344-348.
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Stojmenski S, Merdzanovski I, Gavrilovski A, Pejkova S, Dzokic G, Tudzarova S. Treatment of
Decubitis Ulcer Stage IV in the Patient with Polytrauma and Vertical Share Pelvic Fracture,
Diagnosed Entherocollitis and Deep Wound Infection with Clostridium Difficile with Combined
Negative Pressure Wound Therapy (NPWT) and Faecal Management System: Case Report. Open
Access Maced J Med Sci. 2017 Jun 15; 5(3):349-351. https://doi.org/10.3889/oamjms.2017.060
[Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Expert Opinion
Tchernev G, Chokoeva AA. New Safety Margins for Melanoma Surgery: Nice Possibility for
Drinking of "Just That Cup of Coffee"? Open Access Maced J Med Sci. 2017 Jun 15; 5(3):352-358.
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Stomatology
Bahaa-Eldin K, Mostafa B, Nasry S, Reda A, Shoeib M. Maxillary Sinus Augmentation Using a
Titanium Mesh: A Randomized Clinical Trial. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):359-369. https://doi.org/10.3889/oamjms.2017.083 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]
Public Health
Edu BC, Agan TU, Monjok E, Makowiecka K. Effect of Free Maternal Health Care Program on
Health-seeking Behavior of Women during Pregnancy, Intrapartum and Postpartum Periods in
Cross River State of Nigeria: A Mixed Method Study. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):370-382. https://doi.org/10.3889/oamjms.2017.075 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
PDF]
Starc J, Erjavec K. Impact of the Dimensions of Diversity on the Quality of Nursing Care: The
Case of Slovenia. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):383-390.
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Review Article
Ekmekçi H, Kaptan H. Vagus Nerve Stimulation. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):391-394. https://doi.org/10.3889/oamjms.2017.056 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text
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Letter to the Editor
Chokoeva A, Sokolova R, Lotti T, Wollina U, Gianfaldoni S, Lotti J, França K, Tchernev G. Congenital
Progressive Mutilating Hemangioma. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):395-396.
https://doi.org/10.3889/oamjms.2017.098 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Chokoeva AA, Tchernev G. Wolf’s Panniculitis. Open Access Maced J Med Sci. 2017 Jun 15; 5(3):397-398.
https://doi.org/10.3889/oamjms.2017.069 [Abstract] [Full-Text PDF] [OnlineFirst Full-Text PDF]
Editors-in-Chief:
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Dr Mirko Spiroski is the founder and Editor-in-Chief of the Macedonian Journal of Medical Sciences. He is
a graduate of the Skopje Faculty of Medicine (1972), where he later obtained his MSc (1978), and PhD
(1989) degrees. He is the founder and first Director of the Institute of Immunobiology and Human Genetics
at the Faculty of Medicine in Skopje and acts as a tutor of the Medical Scientific Club "Acad. Dimitar
Arsov". He introduced several subjects in the curricula at the Faculties of Medicine (Immunology and
Human genetics), Natural Sciences (Immunochemistry with basic immunology, Biochemistry-3,
Immunogenetics), Physical Education (Genetics in sport), and in the Master of Sciences postgraduate
program in Public Health (Public health genetics). His research interest is immunology, but he has also
published in the fields of molecular anthropology and human genetics. He was Secretary general and
Deputy Editor-in-Chief of the journal Godishen zbornik na Medicinski Fakultet Skopje, and Editor-in-Chief
of the Macedonian Journal of Medicine.
Doncho M. Donev, MD, PhD - EDITOR-IN-CHIEF FOR PUBLIC HEALTH
Institute of Social Medicine, Medical Faculty, Ss Cyril and Methodius University of Skopje, 50 Divizija 16,
1109 Skopje, Republic of Macedonia. Tel.: +389 2 3298-580, Fax: +389 2 3298 582, Mobile: +389
70244760.
dmdonev@gmail.com
Dr. Donev received his MD at the St. Cyril and Methodius University Medical School, Skopje, Macedonia,
in 1973, where he completed his specialization in social medicine in 1981. From 1983 to 1985 he had his
postgraduate studies of social medicine in Sarajevo, Bosnia and Herzegovina, and later on received his
PhD in 1993 at the Skopje Medical School. He realized his postdoctoral studies in public health (Hubert H.
Humphrey Fellowship Program) at Emory University School of Public Health in Atlanta, GA, USA, in the
academic year 1993/94. Since 2003 he has been Regular/ full-time Professor of Social Medicine at the
Skopje University School of Medicine. His professional and research interest include broad scope of
activities related to prevention and control of non-communicable diseases and other priority health
problems, health status and needs for health care of the vulnerable population groups, organization of
health systems and health care reforms, health economics and quality of health care, health education,
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Senior Lecturer/Honorary Consultant in Old Age Psychiatry, Newcastle University.
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completed her clinical training in neuropsychiatry and obtained a Masters degree in Clinical Psychiatry.
Following her move to the UK, she obtained a PhD in Psychiatry at the University of Cambridge and
completed higher specialist training in Old Age Psychiatry. She joined the Institute for Ageing and Health,
University of Newcastle, in 2000, and since 2005 has worked within the Liaison Service for Older Adults in
Newcastle. Her research interests are the molecular pathology of dementia, ageing and
neurodevelopmental disorders, and clinical phenomenology of mental health problems in the acutely
medically ill older adults. She is an Associate Editor of Age and Ageing, and serves on the Editorial Board
of several Geriatric Medicine journals (http://www.ncl.ac.uk/iah/staff/profile/elizabeta.mukaetova-ladi).
Borislav D Dimitrov, MD, MSc, PhD - DEPUTY EDITOR IN CHIEF
Associate Professor in Medical Statistics, Faculty of Medicine, University of Southampton
(www.southampton.ac.uk); & Senior Statistician/Honorary Consultant, University Hospital Southampton
NHS Foundation Trust, Southampton, UK (www.uhs.nhs.uk/ClinicalResearchinSouthampton/Ourresearch/Respiratory-research/NIHR-SRBU/NIHR-Southampton-Respiratory-Biomedical-ResearchUnit.aspx). Joint position with the Southampton Statistical Sciences Research Institute (S3RI), University
of Southampton (www.southampton.ac.uk/s3ri).
b.dimitrov@soton.ac.uk
Borislav Dimitrov graduated at the Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria. He
completed his MSc in Pollution & Environmental Control, University of Manchester, Manchester, UK (1994)
and his specialty in Public Health (Social Medicine & Health Management, SMHM), Medical University,
Plovdiv, Bulgaria (1998). He received his DM/PhD in Public Health (Social Medicine & Health
Management) at the Medical University, Plovdiv, Bulgaria (2006). He started as an Assistant Professor in
Public Health (Social Medicine & Health Management), at the Trakia University of Stara Zagora and the
Medical University in Plovdiv, Bulgaria (1991-2005), continued as Senior Scientist in Biostatistics &
Clinical Epidemiology at the Mario Negri Institute for Pharmacological Research, Italy (2000-2008), Senior
Health Outcomes Manager, IMS Health, London, UK (2008), and Senior Research Fellow/Programme
Manager & Coordinator, HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland,
Dublin, Ireland. In 2012 he was appointed as a Senior Lecturer in Medical Statistics at the Faculty of
Medicine, and from 2014 – as an Associate Professor, a joint position with the Southampton Statistical
Sciences Research Institute (S3RI).
Marko Spasov, MD, PhD candidate - DEPUTY EDITOR-IN-CHIEF
General Surgeon at University Clinic of Traumatology, Orthoapedics, Anesthesia, Reanimation, Intensive
Care and Emergency Department; Medical Faculty, Skopje.
marspasov@yahoo.com
Marko Spasov graduated at the Medical School in Skopje, Macedonia. From 2008 he worked as a medical
doctor at Emergency Department in Skopje. In 2012 he completed his clinical training in General Surgery
and since then he works as a General Surgeon at the same institution. At the present, he is attending The
School of Doctoral Studies at Ss. Cyril and Methodius University of Skopje in the field of Clinical Medicine.
His research interest is the skeletal trauma in athletes and pathophysiology of bone healing process.
Sasho Stoleski, MD, MSc - DEPUTY EDITOR-IN-CHIEF
Institute for Occupational Health of Republic of Macedonia - Skopje, WHO Collaborating Center, GA2LEN
Collaborating Center, II Makedonska brigada 43, 1000 Skopje, Macedonia. Phone: +389 70 778 543, +389
71 314 435.
sstoleski@yahoo.com
Sasho Stoleski graduated at the Medical Faculty in Skopje in 2002 and obtained a Master degree in 2009.
He is actively engaged in the educational process of the students of medicine, nurses, physiotherapists,
and logopedists. Since 2003, he is employed in the Institute of occupational Health of Republic of
Macedonia, WHO CC in the Center for respiratory functional diagnostics. He became assistant professor
in the Chair of Occupational Medicine within the Medical Faculty in Skopje in 2010. He has finished his
specialization in Occupational Medicine in 2008. Actively involved in the research, expert’s and scientific
work of the Institute of occupational health, dealing with actual challenges in occupational medicine,
principles of functional diagnostics of respiratory system, occupational pulmology and allergology,
industrial toxicology, ecology of work, and workplace risk assessment. He started his sub-specialization in
pulmology and allergology and PhD studies in the field of occupational medicine in 2012. He is a National
Secretary of International Commission on Occupational Health (ICOH), and member of Macedonian
Society of Occupational Health, Macedonian Respiratory Society, Macedonian Society of Basic, Clinical
Immunology and Allergology, European Respiratory Society, European Academy of Allergy and Clinical
Immunology. Author and co-author of more than 80 titles published in domestic and international journals.
Ivo Spiroski - MANUSCRIPT EDITION AND ELECTRONIC PUBLISHING
Ivo Spiroski. Engineer of Design, ID Design 2012/DOOEL Skopje, Naroden Front 13/45, 1000 Skopje,
Republic of Macedonia. http://www.iddesign.mk/ Tel.: +389 23109851; +389 71 205072.
ivospiroski@gmail.com
Ivo Spiroski graduated in 2010 at the University "Ss Cyril and Methodius", Faculty of Design and
Technologies of Furniture and Interior. At the present he is attending Master of Sciences at the same
Faculty in the field of Furniture and Interior Design. Two years (1999-2001) he was Director of the
company Medis, Skopje. Mold design specialisation in Taipei, Taiwan (2002). He was founder and Editorin-chief of the journal Igrach (Player). Founder and Director of ID Design 2012/DOOEL Skopje, Republic of
Macedonia.
Katarina Stavric, MD - EVIDENCE BASED MEDICINE
Children Hospital Skopje, Macedonia, Vodnjanska 17, University "Ss Cyril and Methodius", Skopje,
Republic of Macedonia. Phone +389-91-3147-714 ; 070-365038.
kstavric@hotmail.com
Dr Katarina Stavric, graduated in 1987 at University of Skopje “Ss Cyril and Methodius”, Medical Faculty
Skopje, Macedonia. From 1990 she works as a medical doctor at University’s Children Hospital, Medical
Faculty – Skopje, and from 1997 as Pediatrician, at Department of Immunology. In 2002, she obtained his
MSc degree. In 2006 she was inaugurated with title of primaries from the Ministry of health. From 1999
she works as a teaching assistant of pediatrics. The objectives of her interest are clinical immunology and
allergy, as well as education of medical professions. She has performed professional visits of several
paediatric clinics and educational workshops as a part of her continual professional education. She
published numerous professional papers in national and international medical journals and 3 books. She
was involved as a researcher in two national projects, and 3 international projects from the domain of
immunology and allergy. She was also involved in several working groups of Project in improving the
health education preparing curriculum for Primary health care, Faculty of pediatric nurses and state exam.
From 2005 she becomes a member of the Educational board in Macedonian association of doctor
responsible for the continual medical education of doctors.
ID Design 2012/DOOEL Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2017 Jun 15; 5(3):332-334.
https://doi.org/10.3889/oamjms.2017.066
eISSN: 1857-9655
Clinical Science
Correlation between Serum Homocysteine and Vitiligo Area
Scoring Index
*
Dina R. U. Hasibuan , Imam B. Putra, Nelva K. Jusuf
Dermatovenereology, Faculty of Medicine, University of Sumatera Utara, Medan, North Sumatera, Indonesia
Abstract
Citation: Hasibuan DRU, Putra IB, Jusuf NK. Correlation
between Serum Homocysteine and Vitiligo Area Scoring
Index. Open Access Maced J Med Sci. 2017 Jun 15;
5(3):332-334. https://doi.org/10.3889/oamjms.2017.066
Keywords: Vitiligo; serum homocysteine; pathogenesis.
*Correspondence:
Dina
R.
U.
Hasibuan.
Dermatovenereology, Faculty of Medicine, University of
Sumatera Utara, Medan, North Sumatera, Indonesia. Email: dina.afif.almahdaly@gmail.com
Received:
02-Mar-2017;
Revised:
11-Apr-2017;
Accepted: 18-Apr-2017; Online first: 11-Jun-2017
Copyright: © 2017 Dina R. U. Hasibuan, Imam B. Putra,
Nelva K. Jusuf. This is an open-access article distributed
under the terms of the Creative Commons AttributionNonCommercial 4.0 International License (CC BY-NC
4.0).
Funding: This research did not receive any financial
support.
Competing Interests: The authors have declared that no
competing interests exist.
BACKGROUND: Vitiligo is a chronic skin disorder. White macules caused by melanocyte destruction is a
characteristic finding that cosmetically disturbing. Until recently, pathogenesis of vitiligo is still unclear. The role of
homocysteine in vitiligo is mentioned in previous studies thus it is probable that it can be a biomarker to determine
vitiligo severity.
AIM: To determine correlation between serum homocysteine and vitiligo area Scoring Index (VASI)
SUBJECT AND METHOD: This was a cross-sectional analytic study which involved 30 vitiligo patients that were
diagnosed by clinical and Wood’s lamp examinations then VASI score was determined and same numbers of
control. We conducted blood sampling and measurement of serum homocysteine level to the patients.
RESULTS: There is no significant correlation between serum homocysteine and VASI score (p = 0.133, r =
0.281), family history (p = 0.706), and duration of vitiligo (p = 0.993, r = 0.002). There is no significant difference
between serum homocysteine in vitiligo patients and controls (p = 0.905). There is a correlation between serum
homocysteine with gender (p = 0.001) and age (p = 0.036; r = 0.385) in vitiligo patient.
CONCLUSION: There is no significant correlation between serum homocysteine and VASI score, family history,
and duration of vitiligo. There is no significant difference between serum homocysteine in vitiligo patients and
controls. There is a correlation between serum homocysteine with gender and age in vitiligo patient.
Introduction
Subjects and Methods
Vitiligo is a skin depigmentation disorder with
the characteristic as a white macule caused by
melanocyte destruction. Aetiology of vitiligo is still
unknown. But there are several hypotheses like
genetic, autoimmune and biochemistry [1-3]. This
hypothesis was thought to simultaneously work
together and caused vitiligo. Genetic predisposition
can trigger autoimmune process, and with the addition
of oxidative stress, elevation can result in the
destruction of melanocyte, therefore, inducing white
macule in vitiligo subjects [4].
This was a cross-sectional analytic study
involving 30 vitiligo patients and 30 controls who were
18 years old or above and submitted to the outpatient
dermatology and venereology clinic in Haji Adam
Malik General hospital, Medan, North Sumatera,
Indonesia. This study conducted from June until
October 2016. Each subject signed informed consent
were included in this study. Exclusion criteria were
consumption of vitamin B6, B12, and folic acid within
the last 6 months, breastfeeding, pregnancy, and
vitiligo treatment during the last 6 months. Ethical
clearance was given by Health Research Ethical
Committee, Faculty of Medicine, University of
Sumatera Utara.
One compound thought to be involved in this
hypothesis is homocysteine [5]. Homocysteinemediated melanocyte destruction via production of
interleukin-6 (IL-6), activating nuclear factor-kappa B
(NF-ĸB) and increased oxidative stress [6].
All subjects with vitiligo were diagnosed by
clinical and Wood’s lamp examinations. VASI score
was determined by calculating body part involved and
depigmentation severity. VASI was calculated using a
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Hasibuan et al. Correlation between Serum Homocysteine and Vitiligo Area Scoring Index
______________________________________________________________________________________________________________________________
formula that includes contributions from all body
regions (possible range, 0–100). VASI = ∑ Hand Units
of all body sites × Residual Depigmentation. One
hand unit, which encompasses the palm plus the volar
surface of all the digits, is approximately 1% of the
total body surface area. It is used as a guide to
estimate the baseline percentage of vitiligo
involvement in each body region. The body was
divided into separate regions: upper extremities
(excluding hands), hands, trunk, lower extremities
(excluding feet), feet and head and neck. The axillary
region was included with the upper extremities while
the buttocks and inguinal areas were included with the
lower extremities.
The extent of residual depigmentation was
expressed by the following percentages: 0, 10%, 25%,
50%, 75%, 90%, or 100%. At 100% depigmentation;
no pigment was present, at 90%; specks of pigment
were present, at 75%; the depigmented area
exceeded the pigmented area, at 50%; the
depigmented and pigmented areas were equal, at
25%; the pigmented area exceeded the depigmented
area, at 10%; only specks of depigmentation were
present.
Fasting blood sample from subjects then
processed into the serum. Homocysteine level was
®
measured from serum by using ADVIA Centaur HCY .
The results were analysed with SPSS version
19. Quantitative data were analysed using mean and
SD. The Student t-test was used to compare the
means of different groups. Spearman test was used to
determine relationships. P values less than 0.05 were
considered significant.
Results
There is no significant correlation between
serum homocysteine and VASI score (p = 0.133, r =
0.281), family history (p = 0.706), and duration of
vitiligo (p = 0.993, r = 0.002).
Table 1: Serum homocysteine level in vitiligo subjects and
controls
Subjects
Vitiligo
Control
Male
Female
Positive family history
Negative family history
Mean (µmol/L)
10.66
10.58
13.02
9.81
11.07
10.56
Serum homocysteine level
Standard Deviation
(µmol/L)
2.89
2.01
1.48
2.81
2.16
3.08
p
0.905
0.001
0.706
There is a correlation between serum
homocysteine with gender (p = 0.001) and age (p =
0.036; r = 0.385) in vitiligo patient. There is no
significant difference between serum homocysteine in
vitiligo patients and controls (p = 0.905).
Table 2: Correlation between the serum homocysteine with
VASI score and other variables
Serum homocysteine with VASI score
Serum homocysteine with age of vitiligo subjects
Serum homocysteine serum with duration of disease
p
0.133
0.036
0.993
r
0.281
0.385
0.002
Discussion
In this study we didn’t find any significant
correlation between serum homocysteine level and
VASI score (p > 0.05; r = 0.281). This is in agreement
with another study in Dr M. Djamil Padang, which
conducted a study with 17 samples (r = 0.061; p >
0.05) [7].
A similar finding by Zaki et al. in Egypt also
didn’t find any significant relation between serum
homocysteine level and VASI score (p > 0.05). Zaki et
al. reveal this study used VASI score instead of rules
of nine like in other studies. VASI score evaluates
vitiligo lesion both quantitatively and qualitatively [8].
This result was in disagreement with ElDawela and Abou-elf touch who conducted a study
with 70 samples and found a correlation between
VASI score and homocysteine serum (r = 0.835, p =
0.001) with mean VASI score was 9.5 ± 19.5 [9].
Similar findings found by Agarwal et al in India with 50
vitiligo subjects (r = 0.567; p = 0.000). In this study
VASI score ≥ 30 significantly higher than VASI score