Homocysteine, Folate, and Vitamin B12 Interplay in Patients with Ischaemic Stroke in Plateau State

The biochemical triad of elevated homocysteine, folate deficiency, and low vitamin B12 has been implicated in stroke pathogenesis through mechanisms involving endothelial damage and thrombogenesis. This study examines the interplay between serum homocysteine, folate, and vitamin B12 in patients with ischaemic stroke at a neurology unit in Plateau State, North Central Nigeria. A case-control study was conducted, enrolling 90 first-ever ischaemic stroke patients and 90 age- and sex-matched stroke-free hospital controls. Serum homocysteine was measured by HPLC with fluorescence detection, and folate and vitamin B12 were assayed by electrochemiluminescence immunoassay. Structural neuroimaging findings, stroke severity assessed by the NIH Stroke Scale, and traditional cardiovascular risk factors were documented. Mediation analysis was applied to determine whether folate and B12 deficiency explain the association between hyperhomocysteinaemia and stroke. Dietary B vitamin intake was assessed by a validated food frequency questionnaire. The study provides the first detailed characterisation of the homocysteine-B vitamin axis in ischaemic stroke patients in North Central Nigeria. Keywords: homocysteine, ischaemic stroke, folate, vitamin B12, Plateau State.