Mechanisms of altered fatty acid and phospholipid levels in hyperhomocysteinemia

Hyperhomocysteinemia (HHcy) is a risk factor for several health conditions including cardiovascular disease. Endothelial dysfunction is a key feature of HHcy but the underlying molecular mechanisms are not fully understood. Evidence has accumulated to support a role for alterations in lipid metabolism in the pathology of HHcy. Homocysteine is linked to lipid metabolism through the methionine cycle and the synthesis of phosphatidylcholine. Liver phosphatidylcholine is required for the synthesis and secretion of hepatic lipoproteins and therefore plays an indirect role in the delivery of fatty acids to the vascular endothelium and other extrahepatic tissues. In this review, we present current information on the affect of HHcy on phospholipid and fatty acid metabolism and speculate on the potential role this may play in the pathology of HHcy.