scholarly journals Influence of Vitamin-optimized Plasma Homocysteine Cutoff Values on the Prevalence of Hyperhomocysteinemia in Healthy Adults

2001 ◽  
Vol 47 (6) ◽  
pp. 1001-1007 ◽  
Author(s):  
M Rebecca Fokkema ◽  
Jacomijn M Weijer ◽  
D A Janneke Dijck-Brouwer ◽  
Jasper J van Doormaal ◽  
Frits A J Muskiet

Abstract Background: Hyperhomocysteinemia is a cardiovascular disease (CVD) risk factor. We determined plasma homocysteine (Hcy) reference values at optimized vitamin status and investigated their influence on the prevalence of hyperhomocysteinemia in healthy adults. Results were compared with those obtained using European Concerted Action Project (ECAP) cutoff values. Methods: Healthy adults (n = 101) received folic acid (5 mg/day) and vitamin B12 (1 mg/day) for 2 weeks and the same dosages of folic acid and vitamin B12 plus vitamin B6 (1 mg · kg−1 · day−1) during the following 2 weeks. Hcy concentrations, both fasting and 6-h post-methionine load, were determined at baseline and after 4 weeks. Results: Baseline (4 weeks) fasting and 6-h postload Hcy reference values were 4.7–14.6 (4.1–9.3) and 18.8–49.7 (12.9–35.1) μmol/L, respectively. Mean fasting and 6-h postload Hcy decreased after 4 weeks of vitamin supplementation by 3.5 μmol/L (33.5%) and 8.5 μmol/L (26.3%), respectively. The percentages of subjects exhibiting significant decreases in fasting Hcy following vitamin supplementation were 88% (all subjects), 92% (non-vitamin users), and 72% (vitamin users). The prevalences of hyperhomocysteinemia with use of ECAP cutoff values were 29% for all groups, 29% for men, 27% for premenopausal women, and 53% for postmenopausal women. With vitamin-optimized cutoff values, prevalences were 58%, 58%, 76%, and 89%, respectively. Use of vitamin-optimized cutoff values increased the diagnostic value of fasting Hcy and decreased that of a 6-h postload Hcy compared with use of ECAP cutoff values. Conclusions: Use of vitamin-optimized cutoff values gives rise to high hyperhomocysteinemia pretest probabilities in the general population and, therefore, precludes any meaningful role for Hcy testing. Future demonstration of a beneficial effect of decreasing Hcy on CVD risk would justify use of vitamin-optimized cutoff values for assessment of CVD risk.

Medicina ◽  
2013 ◽  
Vol 49 (5) ◽  
pp. 34 ◽  
Author(s):  
Fatih Türkcü ◽  
Özlem Köz ◽  
Alper Yarangümeli ◽  
Veysi Öner ◽  
Gülcan Kural

Objective. The aim of this study was to evaluate the levels of plasma homocysteine (Hcy), vitamin B12, and folic acid in patients with pseudoexfoliation glaucoma (PEXG), pseudoexfoliation syndrome (PEXS), PEXS plus normotensive glaucoma (NTG).Material and Methods. In total, 24 patients with PEXG, 35 patients with PEXS, 18 patients with PEXS plus NTG, and 35 control subjects were enrolled into study. Their Hcy levels were measured by high performance liquid chromatography (HPLC); the levels of vitamin B12 and folic acid were measured by a competitive electrochemiluminescence immunoassay.Results. Higher plasma Hcy levels and lower folic acid and vitamin B12 levels were found in all 3 patients’ groups compared with the control group (all P<0.001, expect for folic acid in the PEXG group, P=0.03). Although plasma Hcy levels in the PEXG and PEXS groups were similar, the PEXS plus NTG group had significantly higher Hcy levels compared with these groups (P=0.019 and P=0.032, respectively).Conclusions. Our study showed that there was an association between hyperhomocysteinemia and PEXS either with or without glaucoma. The patients with PEXS plus NTG had higher plasma Hcy levels than the patients with PEXS or PEXG and the healthy controls. The treatment of hyperhomocysteinemia by taking low-cost vitamin B12 and folic acid preparations may prevent additional vascular problems.


Author(s):  
Indrani Mukhopadhyay ◽  
V. Pruthviraj ◽  
Rao P. S. ◽  
Manash Biswas

Background: Recurrent pregnancy loss (RPL) affects about 5% of women. High levels of homocysteine, termed hyperhomocysteinemia, have been implicated in a number of pathologic processes in the venous and arterial vascular systems. Hyperhomocysteinemia in pregnant women has been associated with deep venous thrombosis, recurrent miscarriage, abruption placentae, preeclampsia, neural tube defects, and fetal growth restriction. This study aims at determining association between hyperhomocysteinemia and recurrent pregnancy loss and also association of folic acid (vitamin B 9) and vitamin B 12 with hyperhomocysteinemia (HHCY), in reducing its levels in the body and thus preventing obstetric complications.Methods: A prospective study of pregnant mothers booked at our hospital over a period of two years with history of unexplained RPL were included in the study and their serum homocysteine levels were assessed. Hyperhomocysteinemia (>12 micromol/l) patients were treated with folic acid and vitamin B12 supplements and homocysteine levels were assessed again, post treatment.Results: Out of the 100 patients who were assessed, 32% of RPL patients had hyperhomocysteinemia. Folic acid and VitB12 supplementation reduced homocysteine levels and this was found to be statistically significant.Conclusions: Hyperhomocysteinemia is associated with RPL. Vitamin supplementation to those with hyperhomocysteinemia, decreases homocysteine levels.


2006 ◽  
Vol 52 (6) ◽  
pp. 1205-1206 ◽  
Author(s):  
Jonathan Golledge ◽  
Leonie Jones ◽  
Lisa Oliver ◽  
Francis Quigley ◽  
Mirko Karan

The Lancet ◽  
2002 ◽  
Vol 360 (9327) ◽  
pp. 172-173
Author(s):  
Joe McPartlin ◽  
Helene McNulty ◽  
Eoin Quinlivan ◽  
Mary Ward ◽  
John Scott

Author(s):  
Rima Obeid ◽  
Wolfgang Herrmann

AbstractStudies linking hyperhomocysteinemia (HHCY) and B-vitamin deficiency to some health aspects in children have been accumulating. Low B-vitamin status inearly life, even as early as the time of conception, may endanger the potential for new life and may negatively influence the health of the offspring. Early abortion, pregnancy complications and poor pregnancy outcomes have been linked to elevated concentrations of total plasma homocysteine (tHcy) and low folate or vitamin B


2014 ◽  
Vol 29 ◽  
pp. 1
Author(s):  
B. Misiak ◽  
D. Frydecka ◽  
R. Slezak ◽  
P. Piotrowski ◽  
A. Kiejna

2008 ◽  
Vol 18 (2) ◽  
pp. 226-232 ◽  
Author(s):  
E. Aydin ◽  
H.D. Demir ◽  
H. Ozyurt ◽  
I. Etikan

Purpose The aim of this study was to assess the association of macular edema (ME) with plasma homocysteine, vitamin B6, vitamin B12, and folic acid levels in patients with Type 2 diabetes. Methods Sixty-five diabetic subjects with no retinopathy and nonproliferative diabetic retinopathy (NPDR) (no DR, without ME, with ME: 16, 25, 24, respectively), 28 with proliferative diabetic retinopathy (PDR) (with and without ME: 14, 14, respectively), and 19 healthy subjects as control were recruited in this cross-sectional study Plasma homocysteine, vitamin B12, vitamin B6, and folate levels were determined after 8-hour of fasting for all subjects. The levels of serum homocysteine and vitamin B6 were measured using high performance liquid chromatography (HPLC) with fluorescence detection, and the levels of serum vitamin B12 and folic acid were measured by electrochemiluminescence immunoassay. Results When diabetic groups with ME were compared with diabetic groups without ME for homocysteine, vitamin B12, vitamin B6, and folic acid, the only significant difference was detected in homocysteine levels (p=0.001). There was no significant difference between NPDR with ME group compared with NPDR without ME group and no DR group for plasma homocysteine, vitamin B12, vitamin B6, and folic acid (p=0.200, p=0.660; p=0.999, p=0.678; p=1.0, p=0.248; p=1.0, p=0.982, respectively). On the other hand, when PDR with ME group was compared with PDR without ME group, there was only significant difference in homocysteine levels (p=0.023). Conclusions Mild to moderate elevation of homocysteine may explain the role of vascular dysregulation and endothelial dysfunction in patients with DR. The present study suggests hyperhomocysteinemia may be one of the crucial risk factors for development of ME.


The Lancet ◽  
2002 ◽  
Vol 360 (9327) ◽  
pp. 171-172 ◽  
Author(s):  
PAL Ashfield-Watt ◽  
SJ Moat ◽  
RG Newcombe ◽  
IFW McDowell

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