Assessment of serum Homocysteine levels in congenital heart disease and with rubella infection: A hospital- based case-control study in North Indian population

Objective Circulating homocysteine and Rubella infection are independent risk factors for congenital heart disease (CHD). The primary objective of the study was to assess the association of serum homocysteine levels in cases of CHD and healthy controls and the secondary objective was to assess the association of serum homocysteine levels with rubella infection among CHD cases. Methods This case-control study was conducted in King George’s Medical University, Lucknow. Total 245 echo-graphically confirmed cases of CHD and age-gender matched 245 healthy controls of aged 0–11 months were recruited from the outpatient clinic and wards of paediatric and cardiology department and controls were recruited from immunization clinic of the hospital. Samples were tested for rubella specific IgM and IgG antibody and homocysteine levels using enzyme-linked-immunosorbent-assay. Results From July 2022 - December 2023, 245 cases of CHD and 245 healthy controls were recruited. The mean (SD) age of the cases were 4.40 ± 3.34 months and controls were 4.33 ± 3.63. In cases, 70.20% males were recruited while 68.57% in controls. The mean serum homocysteine levels (µmol/L) in CHD cases were 15.70 ± 7.6 while in controls 9.51 ± 3.1 (p = < 0.0001). Within CHD cases, 7.8% (19/245) were found seropositive for rubella infection. The crude odd ratio of homocysteine levels against seropositive rubella infection was 1.08 (95% CI 1.02–1.14) as compare to seronegative. Conclusion Levels of serum homocysteine in cases of CHD were significantly higher as compared to controls, whereas among CHD cases, those who had rubella seropositive showed significantly higher serum homocysteine levels.