1
|
Ji Y, Luo H, Li H, Lin Z, Luo W. Determination of plasma homocysteine with a UHPLC-MS/MS method: Application to analyze the correlation between plasma homocysteine and whole blood 5-methyltetrahydrofolate in healthy volunteers. Biomed Chromatogr 2020; 34:e4845. [PMID: 32267542 DOI: 10.1002/bmc.4845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/27/2020] [Accepted: 04/04/2020] [Indexed: 02/05/2023]
Abstract
An ultra-high performance liquid chromatography tandem mass spectrometry method was developed for determination of homocysteine (HCY) in human plasma. The HCY was derivatized with 2-chloro-1-methylquinolinium tetrafluoroborate and isolated using solid-phase extraction. Derivatization, isolation and detection procedures were optimized. Satisfactory linearity was obtained with determination coefficients (r2 ) >0.999. The intra- and inter-day precisions were in the interval of 1.2-5.1% and accuracy was within ±7%. Mean recoveries were close to 100%. The limit of detection and the limit of quantification were 0.46 and 1.38 μmol/L, respectively. The method was then applied to investigate the relationship between plasma HCY and whole blood 5-methyltetrahydrofolate levels in healthy volunteers. The results revealed that the plasma level of HCY was significantly negatively correlated to whole blood 5-methyltetrahydrofolate in volunteers.
Collapse
Affiliation(s)
- Yubin Ji
- Bio-analytical Laboratory, Shantou University Medical College, Shantou, China
| | - Hongjun Luo
- Bio-analytical Laboratory, Shantou University Medical College, Shantou, China
| | - Hui Li
- Bio-analytical Laboratory, Shantou University Medical College, Shantou, China
| | - Zhexuan Lin
- Bio-analytical Laboratory, Shantou University Medical College, Shantou, China
| | - Wenhong Luo
- Bio-analytical Laboratory, Shantou University Medical College, Shantou, China
| |
Collapse
|
2
|
Ingenbleek Y. Plasma Transthyretin as A Biomarker of Sarcopenia in Elderly Subjects. Nutrients 2019; 11:E895. [PMID: 31010086 PMCID: PMC6521094 DOI: 10.3390/nu11040895] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/13/2019] [Accepted: 04/16/2019] [Indexed: 01/19/2023] Open
Abstract
Skeletal muscle (SM) mass, the chief component of the structural compartment belonging to lean body mass (LBM), undergoes sarcopenia with increasing age. Decreased SM in elderly persons is a naturally occurring process that may be accelerated by acute or chronic nutritional deficiencies and/or inflammatory disorders, declining processes associated with harmful complications. A recently published position paper by European experts has provided an overall survey on the definition and diagnosis of sarcopenia in elderly persons. The present review describes the additional contributory role played by the noninvasive transthyretin (TTR) micromethod. The body mass index (BMI) formula is currently used in clinical studies as a criterion of good health to detect, prevent, and follow up on the downward trend of muscle mass. The recent upsurge of sarcopenic obesity with its multiple subclasses has led to a confused stratification of SM and fat stores, prompting workers to eliminate BMI from screening programs. As a result, investigators are now focusing on indices of protein status that participate in SM growth, maturation, and catabolism that might serve to identify sarcopenia trajectories. Plasma TTR is clearly superior to all other hepatic biomarkers, showing the same evolutionary patterns as those displayed in health and disease by both visceral and structural LBM compartments. As a result, this TTR parameter maintains positive correlations with muscle mass downsizing in elderly persons. The liver synthesis of TTR is downregulated in protein-depleted states and suppressed in cytokine-induced inflammatory disorders. TTR integrates the centrally-mediated regulatory mechanisms governing the balance between protein accretion and protein breakdown, emerging as the ultimate indicator of LBM resources. This review proposes the adoption of a gray zone defined by cut-off values ranging from 200 mg/L to 100 mg/L between which TTR plasma values may fluctuate and predict either the best or the worst outcome. The best outcome occurs when appropriate dietary, medicinal and surgical decisions are undertaken, resuming TTR synthesis which manifests rising trends towards pre-stress levels. The worst occurs when all therapeutic means fail to succeed, leading inevitably to complete exhaustion of LBM and SM metabolic resources with an ensuing fatal outcome. Some patients may remain unresponsive in the middle of the gray area, combining steady clinical states with persistent stagnant TTR values. Using the serial measurement of plasma TTR values, these last patients should be treated with the most aggressive and appropriate therapeutic strategies to ensure the best outcome.
Collapse
Affiliation(s)
- Yves Ingenbleek
- Laboratory of Nutrition, Faculty of Pharmacy, University Louis Pasteur, F-67401 Strasbourg, France.
| |
Collapse
|
3
|
Szczuko M, Ziętek M, Kulpa D, Seidler T. Riboflavin - properties, occurrence and its use in medicine. Pteridines 2019. [DOI: 10.1515/pteridines-2019-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Abstract
Riboflavin is built on an isoalloxazin ring, which contains three sixcarbon rings: benzoic, pyrazine and pyrimidine. Riboflavin is synthesized by some bacteria, but among humans and animals, the only source of flavin coenzymes (FAD, FMN) is exogenous riboflavin. Riboflavin transport in enterocytes takes place via three translocators encoded by the SLC52 gene. Deficiency of dietary riboflavin has wide ranging implications for the efficacy of other vitamins, the mechanism of cellular respiration, lactic acid metabolism, hemoglobin, nucleotides and amino acid synthesis. In studies it was found that, pharmacologic daily doses (100 mg) have the potential to react with light, which can have adverse cellular effects. Extrene caution should be exercised when using riboflavin as phototherapy in premature newborns. At the cellular level, riboflavin deficiency leads to increased oxidative stress and causes disorders in the glutathione recycling process. Risk factors for developing riboflavin deficinecy include pregnancy, malnutrition (including anorexia and other eating disorders, vegitarianism, veganism and alcoholism. Furthermore, elderly people and atheletes are also at risk of developing this deficiency. Widespread use of riboflavin in medicine, cancer therapy, treatment of neurodegenerative diseases, corneal ectasia and viral infections has resulted in the recent increased interest in this flavina.
Collapse
Affiliation(s)
- Małgorzata Szczuko
- Department of Biochemistry and Human Nutrition , Pomeranian Medical University in Szczecin , Poland
| | - Maciej Ziętek
- Clinic of Perinatology, Obstetrics and Gynecology Pomeranian Medical University in Szczecin , Poland
| | - Danuta Kulpa
- Department of Genetics, Plant Breeding and Biotechnology , West Pomeranian University of Technology in Szczecin , Poland
| | - Teresa Seidler
- Department of Human Nutrition , West Pomeranian University of Technology in Szczecin , Poland
| |
Collapse
|
4
|
Pelozo LL, Silva-Neto RD, Corona SAM, Palma-Dibb RG, Souza-Gabriel AE. Dentin pretreatment with Er:YAG laser and sodium ascorbate to improve the bond strength of glass fiber post. Lasers Med Sci 2018; 34:47-54. [DOI: 10.1007/s10103-018-2579-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/29/2018] [Indexed: 12/13/2022]
|
5
|
Ingenbleek Y. Lean Body Mass Harbors Sensing Mechanisms that Allow Safeguarding of Methionine Homeostasis. Nutrients 2017; 9:nu9091035. [PMID: 28930162 PMCID: PMC5622795 DOI: 10.3390/nu9091035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/14/2017] [Accepted: 09/16/2017] [Indexed: 01/16/2023] Open
Abstract
Protein-depleted states generate allosteric inhibition of liver cystathionine β-synthase (CBS), which governs the first enzymatic step of the transsulfuration cascade, resulting in upstream accretion of homocysteine (Hcy) in body fluids. A similar Hcy increase may arise from normal hepatocytes undergoing experimentally-induced impairment of betaine-homocysteine methyltransferase (BHTM) activity or from components of lean body mass (LBM) submitted to any inflammatory disorder. LBM comprises a composite agglomeration of extrarenal tissues characterized by naturally occurring BHTM inactivity. As a result of cellular injury, LBM releases high concentrations of Hcy into the extracellular space, contrasting with the disruption of normal remethylation pathways. Hyperhomocysteinemia acts as a biomarker, reflecting the severity of insult and operating as an alarm signal. Elevated Hcy levels constitute a precursor pool recognized by a CBS coding region that reacts to meet increased methionine requirements in LBM tissues, using its enhanced production in hepatocytes. Preservation of methionine homeostasis benefits from its high metabolic priority and survival value.
Collapse
Affiliation(s)
- Yves Ingenbleek
- Laboratory of Nutrition, Faculty of Pharmacy, University Louis Pasteur, F-67401 Strasbourg, France.
| |
Collapse
|
6
|
Verly-Jr E, Steluti J, Fisberg RM, Marchioni DML. A quantile regression approach can reveal the effect of fruit and vegetable consumption on plasma homocysteine levels. PLoS One 2014; 9:e111619. [PMID: 25365261 PMCID: PMC4218785 DOI: 10.1371/journal.pone.0111619] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/06/2014] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION A reduction in homocysteine concentration due to the use of supplemental folic acid is well recognized, although evidence of the same effect for natural folate sources, such as fruits and vegetables (FV), is lacking. The traditional statistical analysis approaches do not provide further information. As an alternative, quantile regression allows for the exploration of the effects of covariates through percentiles of the conditional distribution of the dependent variable. OBJECTIVE To investigate how the associations of FV intake with plasma total homocysteine (tHcy) differ through percentiles in the distribution using quantile regression. MATERIALS AND METHODS A cross-sectional population-based survey was conducted among 499 residents of Sao Paulo City, Brazil. The participants provided food intake and fasting blood samples. Fruit and vegetable intake was predicted by adjusting for day-to-day variation using a proper measurement error model. We performed a quantile regression to verify the association between tHcy and the predicted FV intake. The predicted values of tHcy for each percentile model were calculated considering an increase of 200 g in the FV intake for each percentile. RESULTS The results showed that tHcy was inversely associated with FV intake when assessed by linear regression whereas, the association was different when using quantile regression. The relationship with FV consumption was inverse and significant for almost all percentiles of tHcy. The coefficients increased as the percentile of tHcy increased. A simulated increase of 200 g in the FV intake could decrease the tHcy levels in the overall percentiles, but the higher percentiles of tHcy benefited more. CONCLUSIONS This study confirms that the effect of FV intake on lowering the tHcy levels is dependent on the level of tHcy using an innovative statistical approach. From a public health point of view, encouraging people to increase FV intake would benefit people with high levels of tHcy.
Collapse
Affiliation(s)
- Eliseu Verly-Jr
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Josiane Steluti
- Department of Nutrition, School of Public Health, Sao Paulo University, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, Sao Paulo University, São Paulo, Brazil
| | | |
Collapse
|
7
|
Baszczuk A, Musialik K, Kopczyński J, Thielemann A, Kopczyński Z, Kęsy L, Dopierała G. Hyperhomocysteinemia, lipid and lipoprotein disturbances in patients with primary hypertension. Adv Med Sci 2014; 59:68-73. [PMID: 24797978 DOI: 10.1016/j.advms.2013.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 08/12/2013] [Indexed: 02/06/2023]
Abstract
PURPOSES The main aim of the study was to answer two questions: what are the concentrations of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apo A-I (apolipoprotein A-I), apo B (apolipoprotein B) and Lp(a) (lipoprotein(a)) in serum of patients with primary hypertension and with hyperhomocysteinemia? Is there any correlation between the concentration of homocysteine in blood serum and investigated lipid and lipoprotein parameters in patients with primary hypertension? MATERIAL/METHODS We investigated 42 patients with primary hypertension, aged 22-57. The control group consisted of 20 healthy volunteers. The concentration of homocysteine in serum was evaluated using immunochemical method (FPIA - Fluorescence Polarization Immunoassay). The concentration of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides in blood serum were estimated using enzymatic method. Apo A-I, apo B and lipoprotein(a) were assessed using nephelometric method. RESULTS The analysis of the results revealed statistically significant lower concentrations of HDL-cholesterol and apo A-I in blood serum of patients with primary hypertension and hyperhomocysteinemia than in the population with hypertension and normohomocysteinemia. Negative correlation between homocysteine and HDL-cholesterol as well as apo A-I has been revealed. CONCLUSION Quantitative analysis of the concentration of lipids and lipoproteins in blood serum in patients with primary hypertension and hyperhomocysteinemia may suggest that this type of human population might be more susceptible to atherosclerosis than those with primary hypertension and normal values of homocysteine.
Collapse
Affiliation(s)
- Aleksandra Baszczuk
- Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland.
| | - Katarzyna Musialik
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Jarosław Kopczyński
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Thielemann
- Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Zygmunt Kopczyński
- Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Lena Kęsy
- Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Gabriela Dopierała
- Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
8
|
Yoshimatsu H, Yonezawa A, Yao Y, Sugano K, Nakagawa S, Omura T, Matsubara K. Functional involvement of RFVT3/SLC52A3 in intestinal riboflavin absorption. Am J Physiol Gastrointest Liver Physiol 2014; 306:G102-10. [PMID: 24264046 DOI: 10.1152/ajpgi.00349.2013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Riboflavin, also known as vitamin B2, is transported across the biological membrane into various organs by transport systems. Riboflavin transporter RFVT3 is expressed in the small intestine and has been suggested to localize in the apical membranes of the intestinal epithelial cells. In this study, we investigated the functional involvement of RFVT3 in riboflavin absorption using intestinal epithelial T84 cells and mouse small intestine. T84 cells expressed RFVT3 and conserved unidirectional riboflavin transport corresponding to intestinal absorption. Apical [(3)H]riboflavin uptake was pH-dependent in T84 cells. This uptake was not affected by Na(+) depletion at apical pH 6.0, although it was significantly decreased at apical pH 7.4. The [(3)H]riboflavin uptake from the apical side of T84 cells was prominently inhibited by the RFVT3 selective inhibitor methylene blue and significantly decreased by transfection of RFVT3-small-interfering RNA. In the gastrointestinal tract, RFVT3 was expressed in the jejunum and ileum. Mouse jejunal and ileal permeabilities of [(3)H]riboflavin were measured by the in situ closed-loop method and were significantly reduced by methylene blue. These results strongly suggest that RFVT3 would functionally be involved in riboflavin absorption in the apical membranes of intestinal epithelial cells.
Collapse
Affiliation(s)
- Hiroki Yoshimatsu
- Dept. of Clinical Pharmacology and Therapeutics, Kyoto Univ. Hospital, Sakyo-ku, Kyoto 606-8507, Japan.
| | | | | | | | | | | | | |
Collapse
|
9
|
Nienaber-Rousseau C. Dietary strategies to treat hyperhomocysteinaemia based on the biochemistry of homocysteine: a review. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2014. [DOI: 10.1080/16070658.2014.11734495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Bemeur C. Neurological complications post-liver transplantation: impact of nutritional status. Metab Brain Dis 2013; 28:293-300. [PMID: 23129292 DOI: 10.1007/s11011-012-9352-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 10/22/2012] [Indexed: 12/11/2022]
Abstract
Nutritional status is significantly altered in patients with end-stage liver disease (cirrhosis). Malnutrition is a common complication of cirrhosis and is known to be associated with a greater risk of post-operative complications and mortality, especially following liver transplantation. Neurological complications occur frequently after transplant and the nature and extent of these complications may relate to nutritional deficits such as protein-calorie malnutrition as well as vitamin and micronutrient deficiencies. A consensus document from the International Society on Hepatic Encephalopathy and Nitrogen metabolism (ISHEN) has been established in order to address these concerns. Careful assessment of nutritional status followed by prompt treatment of nutritional deficits has the potential to impact on transplant outcome and, in particular, on post-transplant neurological disorders in patients with cirrhosis.
Collapse
Affiliation(s)
- Chantal Bemeur
- Department of Nutrition, University of Montreal, Montreal, Québec, Canada.
| |
Collapse
|
11
|
Pfeiffer CM, Sternberg MR, Schleicher RL, Rybak ME. Dietary supplement use and smoking are important correlates of biomarkers of water-soluble vitamin status after adjusting for sociodemographic and lifestyle variables in a representative sample of U.S. adults. J Nutr 2013; 143:957S-65S. [PMID: 23576641 PMCID: PMC4822996 DOI: 10.3945/jn.112.173021] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Biochemical indicators of water-soluble vitamin (WSV) status were measured in a nationally representative sample of the U.S. population in NHANES 2003-2006. To examine whether demographic differentials in nutritional status were related to and confounded by certain variables, we assessed the association of sociodemographic (age, sex, race-ethnicity, education, income) and lifestyle (dietary supplement use, smoking, alcohol consumption, BMI, physical activity) variables with biomarkers of WSV status in adults (aged ≥ 20 y): serum and RBC folate, serum pyridoxal-5'-phosphate (PLP), serum 4-pyridoxic acid, serum total cobalamin (vitamin B-12), plasma total homocysteine (tHcy), plasma methylmalonic acid (MMA), and serum ascorbic acid. Age (except for PLP) and smoking (except for MMA) were generally the strongest significant correlates of these biomarkers (|r| ≤ 0.43) and together with supplement use explained more of the variability compared with the other covariates in bivariate analysis. In multiple regression models, sociodemographic and lifestyle variables together explained from 7 (vitamin B-12) to 29% (tHcy) of the biomarker variability. We observed significant associations for most biomarkers (≥ 6 of 8) with age, sex, race-ethnicity, supplement use, smoking, and BMI and for some biomarkers with PIR (5 of 8), education (1 of 8), alcohol consumption (4 of 8), and physical activity (5 of 8). We noted large estimated percentage changes in biomarker concentrations between race-ethnic groups (from -24 to 20%), between supplement users and nonusers (from -12 to 104%), and between smokers and nonsmokers (from -28 to 8%). In summary, age, sex, and race-ethnic differentials in biomarker concentrations remained significant after adjusting for sociodemographic and lifestyle variables. Supplement use and smoking were important correlates of biomarkers of WSV status.
Collapse
Affiliation(s)
- Christine M. Pfeiffer
- To whom correspondence should be addressed: Christine M. Pfeiffer, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Mail Stop F55, Atlanta, GA 30341, Phone: 770-488-7926, Fax: 770-488-4139,
| | | | | | | |
Collapse
|
12
|
Haynes BMH, Pfeiffer CM, Sternberg MR, Schleicher RL. Selected physiologic variables are weakly to moderately associated with 29 biomarkers of diet and nutrition, NHANES 2003-2006. J Nutr 2013; 143:1001S-10S. [PMID: 23596168 PMCID: PMC4811331 DOI: 10.3945/jn.112.172882] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The physiologic status of an individual may influence biomarkers of nutritional status. To help researchers with planning studies and interpreting data, we assessed the associations between common physiologic variables (fasting, inflammation, renal function, and pregnancy) and 29 biomarkers of diet and nutrition measured in blood or urine in a representative sample of the adult U.S. population (aged ≥ 20 y; pregnancy variable and iron indicators limited to women aged 20-49 y) participating in NHANES 2003-2006. We compared simple linear regression (model 1) with multiple linear regression [model 2, controlling for age, sex, race-ethnicity, smoking, supplement use, and the physiologic factors (and urine creatinine for urine biomarkers)] and report significant findings from model 2. Not being fasted was positively associated with most water-soluble vitamins (WSVs) and related metabolites (RMs). Some WSV, fat-soluble vitamin (FSV) and micronutrient (MN), and phytoestrogen concentrations were lower in the presence of inflammation (C-reactive protein ≥ 5 mg/L), whereas fatty acids and most iron indicators were higher. Most WSVs and RMs were higher when renal function was impaired [estimated glomerular filtration rate <60 mL/(min · 1.73 m(2))]. Most WSV, FSV and MN, and fatty acid concentrations were higher in pregnant compared with nonpregnant women, but vitamins A and B-12 and most iron indicators were lower. The estimated changes in biomarker concentrations with different physiologic status were mostly small to moderate (≤ 25%) and generally similar between models; renal function, however, showed several large differences for WSV and RM concentrations. This descriptive analysis of associations between physiologic variables and a large number of nutritional biomarkers showed that controlling for demographic variables, smoking, and supplement use generally did not change the interpretation of bivariate results. The analysis serves as a useful basis for more complex future research.
Collapse
Affiliation(s)
- Bridgette M. H. Haynes
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Christine M. Pfeiffer
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Maya R. Sternberg
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Rosemary L. Schleicher
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| |
Collapse
|
13
|
Folic acid and vitamin B(12) supplementation lowers plasma homocysteine but has no effect on serum bone turnover markers in elderly women: a randomized, double-blind, placebo-controlled trial. Nutr Res 2013; 33:211-9. [PMID: 23507227 DOI: 10.1016/j.nutres.2013.01.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 12/05/2012] [Accepted: 01/02/2013] [Indexed: 11/24/2022]
Abstract
An elevated homocysteine level is a newly recognized risk factor for osteoporosis. Older individuals may have elevated homocysteine levels due to inadequate folate intake and/or lower absorption of vitamin B(12). The aim of this study was to determine whether there is an impact of folic acid and vitamin B(12) supplementation on homocysteine levels and, subsequently, on bone turnover markers in older women with mildly to moderately elevated homocysteine levels. It is hypothesized that supplementation with folic acid and vitamin B(12) will improve homocysteine levels and, in turn, positively modify bone turnover markers in this population. This randomized, double-blind, placebo-controlled trial included 31 women (65 to 93 years) with homocysteine levels greater than 10 μmol/L. Participants were randomly assigned to receive either a daily folic acid (800 μg) and vitamin B(12) (1000 μg) (n = 17) or a matching placebo (n = 14) for 4 months. The results showed significantly lower homocysteine concentrations in the vitamin group compared to the placebo group (10.6 vs 18.5 μmol/L, P = .007). No significant difference in serum alkaline phosphatase or C-terminal cross-linking telopeptide of type I collagen was found between the vitamin and placebo groups before or after supplementation. The use of folic acid and vitamin B(12) as a dietary supplement to improve homocysteine levels could be beneficial for older women, but additional research must be conducted in a larger population and for a longer period to determine if there is an impact of supplementation on bone turnover markers or other indicators of bone health.
Collapse
|
14
|
Nienaber-Rousseau C, Pisa PT, Venter CS, Ellis SM, Kruger A, Moss SJ, Melse-Boonstra A, Towers GW. Nutritional Genetics: The Case of Alcohol and the MTHFR C677T Polymorphism in Relation to Homocysteine in a Black South African Population. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2013; 6:61-72. [DOI: 10.1159/000348839] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 02/08/2013] [Indexed: 01/07/2023]
|
15
|
Agarwal M, Mehta PK, Dwyer JH, Dwyer KM, Shircore AM, Nordstrom CK, Sun P, Paul-Labrador M, Yang Y, Merz CNB. Differing Relations to Early Atherosclerosis between Vitamin C from Supplements vs. Food in the Los Angeles Atherosclerosis Study: A Prospective Cohort Study. Open Cardiovasc Med J 2012; 6:113-21. [PMID: 23002405 PMCID: PMC3447163 DOI: 10.2174/1874192401206010113] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 07/26/2012] [Accepted: 08/06/2012] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To determine the relationship of vitamin c intake from supplements vs food on early atherosclerosis detected by carotid intima media thickness (IMT). BACKGROUND Oxidative stress and endothelial dysfunction play a critical role in the pathogenesis of atherosclerosis. Dietary vitamin C appears to have anti-oxidant properties and beneficial relations to endothelial function, yet vitamin C taken as a vitamin supplement does not appear to protect from cardiovascular events. The impact of vitamin c intake from supplements vs food on progression of atherosclerosis is unknown. METHODS We examined 3-year progression of carotid IMT in a randomly sampled cohort of 573 healthy women and men aged 40-60 years. Progression of carotid IMT was determined bilaterally with B-mode ultrasound at 3 examinations (1.5-year intervals). Intake of dietary vitamin C was measured by six, 24-hour recall interviews. Intake of vitamin C from vitamin supplements was measured by questionnaire in quartiles of supplement intake and no supplement. Vitamin C wasmeasured in plasma as ascorbic acid. RESULTS Carotid IMT progressed 10.0±16.5 μm/year (mean±SD) among all those with follow-up (n=500; 87%). For those who took vitamin C supplements, carotid IMT progression increased with dose (p-trend=0.0009). Among persons in the highest quartile (857-5000 mg/day) of vitamin C supplement intake compared to those not consuming any vitamin C supplements, carotid IMT progression increased three-fold (20.3±2.6 versus 7.6±1.8 μm/year (mean±SD); p<0.001). The adverse association of vitamin C supplement intake with carotid IMT was two-fold greater in the upper tertile of serum cholesterol compared to the lower two tertiles (p=0.01). In contrast to the adverse association of vitamin C supplements, vitamin C intake from food had a weak protective relationship on carotid IMT progression (reduced progression -5.0±1.9 μm/year; p=0.008). CONCLUSIONS Vitamin C supplementation is associated with accelerated early atherosclerosis measured by carotid IMT compared to a protective association with vitamin C from food. Theadverse association of vitamin C supplementation may be greater in patients with higher serum cholesterol levels. The current results provide a potential mechanistic understanding for the observed differences between Vitamin C in supplements vs food in prior studies. Given these observations,vitamin C supplementation does not appear to be currently advisable for prevention or treatment of atherosclerosis.
Collapse
Affiliation(s)
- Megha Agarwal
- Women’s Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Puja K Mehta
- Women’s Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James H Dwyer
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
- Deceased This work was supported by grants from the NHLBI (National Heart, Lung, and Blood Institute, USA; grants R01 HL49910 and R01 073108-01), TRDRP (Tobacco-Related Disease Research Program, USA; grant 7RT-0034) and a GCRC grant MO1-RR00425 from the National Center for Research Resources, and grants from the Gustavus and Louis Pfeiffer Research Foundation, Denville, New Jersey, the Women’s Guild of Cedars-Sinai Medical Center, Los Angeles, California, the Edythe L. Broad Women’s Heart Research Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, and the Barbra Streisand Women’s Cardiovascular Research and Education Program, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Kathleen M Dwyer
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Anne M Shircore
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | | | - Ping Sun
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Maura Paul-Labrador
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
- Deceased This work was supported by grants from the NHLBI (National Heart, Lung, and Blood Institute, USA; grants R01 HL49910 and R01 073108-01), TRDRP (Tobacco-Related Disease Research Program, USA; grant 7RT-0034) and a GCRC grant MO1-RR00425 from the National Center for Research Resources, and grants from the Gustavus and Louis Pfeiffer Research Foundation, Denville, New Jersey, the Women’s Guild of Cedars-Sinai Medical Center, Los Angeles, California, the Edythe L. Broad Women’s Heart Research Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, and the Barbra Streisand Women’s Cardiovascular Research and Education Program, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Yuching Yang
- Women’s Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - C. Noel Bairey Merz
- Women’s Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| |
Collapse
|
16
|
Abstract
OBJECTIVES To investigate whether biological markers of health differ among older adults with visual impairment compared to those with normal vision. DESIGN We use data from the National Health and Nutrition Examination Survey (1999 - 2006) to investigate clinically defined at-risk levels for 10 biological markers. SETTING Survey participants were non-institutionalized. PARTICIPANTS Nationally representative (U.S.) sample of older adults age 65 and older, categorized as having blindness (20/200 or worse), low vision (20/40 to 20/100) or normal vision (better than 20/40). INTERVENTION Separate binary logistic regressions (one for each biomarker, with two at-risk cut points for BMI: obese and underweight) were computed to determine the odds of having at-risk levels of each biomarker. MEASUREMENTS Biomarkers included: systolic and diastolic blood pressure, high-density lipoprotein, low-density lipoprotein (LDL) cholesterol, total cholesterol, glycated hemoglobin, body mass index (BMI), fasting triglycerides, C-reactive protein, and plasma homocysteine. RESULTS Older adults who were blind were more likely to have high-risk levels of LDL cholesterol, homocysteine, and to be underweight (BMI>18.5). Similarly, older adults with LV were more likely to have high-risk levels of homocysteine compared to older adults with normal vision. CONCLUSION As several of the high-risk biomarkers associated with visual impairment were diet-related, our results suggest the importance of nutrition and diet programs aimed towards educating older people who are visually impaired.
Collapse
Affiliation(s)
- B A Steinman
- University of Southern California, Southern California, USA
| | | |
Collapse
|
17
|
Yun JM, Singh S, Jialal R, Rockwood J, Jialal I, Devaraj S. A Randomized Placebo-Controlled Crossover trial of Aloe Vera on Bioavailability of Vitamins C and B12, Blood Glucose, and Lipid Profile in Healthy Human Subjects. J Diet Suppl 2010; 7:145-53. [DOI: 10.3109/19390211003781693] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
18
|
Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of People Aged 65 Years and Over. Br J Nutr 2010; 104:893-9. [PMID: 20398433 DOI: 10.1017/s0007114510001236] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Predictive power, for total and vascular mortality, of selected indices measured at baseline in the British National Diet and Nutrition Survey (community-living subset) of People Aged 65 Years and Over was tested. Mortality status and its primary and underlying causes were recorded for 1100 (mean age 76.7 (sd 7.5) years, 50.2% females) respondents from the baseline survey in 1994-5 until September 2008. Follow-up data analyses focussed especially on known predictors of vascular disease risk, together with intakes and status indices of selected nutrients known to affect, or to be affected by, these predictors. Total mortality was significantly predicted by hazard ratios of baseline plasma concentrations (per sd) of total homocysteine (tHcy) (95% CI) 1.19 (1.11, 1.27), pyridoxal phosphate 0.90 (0.81, 1.00), pyridoxic acid 1.10 (1.03, 1.19), alpha1-antichymotrypsin 1.21 (1.13, 1.29), fibrinogen 1.14 (1.05, 1.23), creatinine 1.20 (1.10, 1.31) and glycosylated Hb 1.23 (1.14, 1.32), and by dietary intakes of energy 0.87 (0.80, 0.96) and protein 0.86 (0.77, 0.97). Prediction patterns and significance were similar for primary-cause vascular mortality. The traditional risk predictors plasma total and HDL cholesterol were not significant mortality predictors in this age group, nor were the known tHcy-regulating nutrients, folate and vitamin B12 (intakes and status indices). Model adjustment for known risk predictors resulted in the loss of significance for some of the afore-mentioned indices; however, tHcy 1.34 (1.04, 1.73) remained a significant predictor for vascular mortality. Thus, total and primary vascular mortality is predicted by energy and protein intakes, and by biochemical indices including tHcy, independent of serum folate or vitamin B12.
Collapse
|
19
|
Abstract
High blood pressure (BP) and elevated homocysteine are reported as independent risk factors for CVD and stroke in particular. The main genetic determinant of homocysteine concentrations is homozygosity (TT genotype) for the C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene, typically found in approximately 10% of Western populations. The B-vitamins folate, vitamin B12and vitamin B6are the main nutritional determinants of homocysteine, with riboflavin more recently identified as a potent modulator specifically in individuals with the TT genotype. Although observational studies have reported associations between homocysteine and BP, B-vitamin intervention studies have shown little or no BP response despite decreases in homocysteine. Such studies, however, have not considered the MTHFR C677T polymorphism, which has been shown to be associated with BP. It has been shown for the first time that riboflavin is an important determinant of BP specifically in individuals with the TT genotype. Research generally suggests that 24 h ambulatory BP monitoring provides a more accurate measure of BP than casual measurements and its use in future studies may also provide important insights into the relationship between the MTHFR polymorphism and BP. Further research is also required to investigate the association between specific B-vitamins and BP in individuals with different MTHFR genotypes in order to confirm whether any genetic predisposition to hypertension is correctable by B-vitamin intervention. The present review will investigate the evidence linking the MTHFR C677T polymorphism to BP and the potential modulating role of B-vitamins.
Collapse
|
20
|
Ingenbleek Y. Why should plasma transthyretin become a routine screening tool in elderly persons? J Nutr Health Aging 2009; 13:640-2. [PMID: 19621200 DOI: 10.1007/s12603-009-0175-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
21
|
Ingenbleek Y. Why should plasma transthyretin become a routine screening tool in elderly persons? J Nutr Health Aging 2009. [DOI: 10.1007/s12603-009-0137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
High-dose short-term folate administration modifies ambulatory blood pressure in postmenopausal women. A placebo-controlled study. Eur J Clin Nutr 2009; 63:1266-8. [DOI: 10.1038/ejcn.2009.58] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
23
|
Association between vitamin B12-containing supplement consumption and prevalence of biochemically defined B12 deficiency in adults in NHANES III (third national health and nutrition examination survey). Public Health Nutr 2009; 13:25-31. [PMID: 19519972 DOI: 10.1017/s1368980009990279] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore the association between vitamin B(12) (B(12))-containing supplement use, low B(12) concentrations and biochemically defined B(12) deficiency in US adults. DESIGN A cross-sectional study with adjustment for survey design. Prevalence ratios for two age groups (18-50 and >50 years) were estimated using unconditional logistic models. Outcome measures included prevalence of low serum B(12) concentration (<148 pmol/l) and biochemical B(12) deficiency (serum B(12)< 148 pmol/l with concomitant homocysteine > 10 mumol/l). SETTING A population survey of health and nutritional measures. SUBJECTS Subjects were non-institutionalized adults, aged 18 years and older, who participated in Phase 2 of NHANES III (Third National Health and Nutrition Examination Survey). RESULTS Low B(12) concentrations were less prevalent among persons consuming B(12)-containing supplements (P = 0.001) with an adjusted prevalence ratio of 0.6 (95 % CI 0.3, 1.0). Biochemical B(12) deficiency showed a similar trend (P = 0.0002), with an adjusted prevalence ratio of 0.3 (95 % CI 0.1, 0.8). Prevalence ratios were similar in adults >50 years of age, although the prevalence of low B(12) and biochemical deficiency was proportionally higher. CONCLUSIONS Consumption of B(12)-containing supplements was associated with at least 50 % lower prevalence of both low serum B(12) and biochemical B12 deficiency in a nationally representative sample of US adults, suggesting increased consumption of B(12) from supplements or from fortified foods may reduce the prevalence of B(12) deficiency. Additionally, the current Recommended Daily Allowance for B(12) of 2.4 microg may be insufficient for those aged >50 years.
Collapse
|
24
|
van den Kommer TN, Dik MG, Comijs HC, Jonker C, Deeg DJH. Homocysteine and inflammation: predictors of cognitive decline in older persons? Neurobiol Aging 2008; 31:1700-9. [PMID: 19004529 DOI: 10.1016/j.neurobiolaging.2008.09.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 09/19/2008] [Accepted: 09/25/2008] [Indexed: 01/01/2023]
Abstract
The aim of the current study was to examine the association between homocysteine and 6-year cognitive decline, and the modifying role of the inflammatory markers Interleukin-6 (IL-6), C-reactive protein (CRP) and alpha-1-antichymotrypsin (ACT). Data were collected within the Longitudinal Aging Study Amsterdam (ages >or=65 years) and analyzed using multiple longitudinal regression models (N=1257 of whom N=1076 had longitudinal data). Cognition was measured with the Mini-Mental State Examination (general cognition), Auditory Verbal Learning Test (memory), Coding Task (information processing speed) and Raven Coloured Progressive Matrices (fluid intelligence). Higher homocysteine at baseline was negatively associated with prolonged lower cognitive functioning and a faster rate of decline in information processing speed and fluid intelligence. The negative association between higher homocysteine and immediate recall was strongest in persons with a high level of IL-6. Only in the highest tertile of CRP, higher homocysteine was negatively associated with retention. In the middle tertile of ACT, higher homocysteine was associated with lower information processing speed and faster decline. Both in the lower and middle tertile of CRP, higher homocysteine was associated with a faster rate of decline in information processing speed. The results implicate that a combination of both risk factors may be used as a marker for cognitive impairment.
Collapse
Affiliation(s)
- T N van den Kommer
- Longitudinal Aging Study Amsterdam and EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | | | | | | | | |
Collapse
|
25
|
Bekaert B, Cooper ML, Green FR, McNulty H, Pentieva K, Scott JM, Molloy AM, Rayman MP. Effect of selenium status and supplementation with high-selenium yeast on plasma homocysteine and B vitamin concentrations in the UK elderly. Mol Nutr Food Res 2008; 52:1324-33. [DOI: 10.1002/mnfr.200700353] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
26
|
Stea TH, Mansoor MA, Wandel M, Uglem S, Frølich W. Changes in predictors and status of homocysteine in young male adults after a dietary intervention with vegetables, fruits and bread. Eur J Nutr 2008; 47:201-9. [PMID: 18521531 DOI: 10.1007/s00394-008-0714-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Accepted: 05/21/2008] [Indexed: 12/31/2022]
Abstract
BACKGROUND Elevated plasma total homocysteine (p-tHcy) is associated with increased risk of cardiovascular disease, and an inverse association has been shown between the dietary intake of B-vitamins, B-vitamin profile and the concentration of p-tHcy. AIM OF THE STUDY The main objective of this investigation was to study the effect of a dietary intervention focusing on an increased intake of vegetables, fruits and bread. The effect of the dietary intervention was determined by the changes in plasma concentrations of tHcy, cysteine (cys), riboflavin, flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN) and serum concentrations of folate and vitamin B(12). METHOD An intervention study with duration of 5 months, including 541 male recruits from the Norwegian National Guard, Vaernes and a control group, including 209 male recruits from the Norwegian Army, Heggelia. RESULTS The dietary intervention resulted in decreased concentration of p-tHcy (-10%, P = 0.002), p-cys (-6%, P < 0.001) and FMN (-11%, P = 0.310) and increased concentration of riboflavin (+23%, P < 0.001) and FAD (+10%, P = 0.008) in the intervention group compared with the control group. The change in p-tHcy concentration was positively related to the change in the concentration of p-cys (P < 0.001) and FMN (P = 0.035) and inversely related to the change in concentration of folate (P = 0.021). CONCLUSIONS A dietary intervention program focusing on an increased intake of vegetables, fruits and bread showed a favourable effect on the concentration of p-tHcy and its metabolites. Our findings suggest that the changes in the concentration of p-cys, folate and FMN seem to be predictors of changes in the p-tHcy concentration.
Collapse
Affiliation(s)
- Tonje Holte Stea
- Norwegian School of Hotel Management, University of Stavanger, 4036 Stavanger, Norway.
| | | | | | | | | |
Collapse
|
27
|
Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene, intakes of folate and related B vitamins and colorectal cancer: a case-control study in a population with relatively low folate intake. Br J Nutr 2007; 99:379-89. [PMID: 18053312 DOI: 10.1017/s0007114507801073] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Folate is key in one-carbon metabolism, disruption of which can interfere with DNA synthesis, repair, and methylation. Efficient one-carbon metabolism requires other B vitamins and the optimal activity of enzymes including 5,10-methylenetetrahydrofolate reductase (MTHFR). We report a population-based case-control study of folate intake, related dietary factors and MTHFR polymorphisms (C677T, A1298C) and colorectal cancer in a population with relatively high colorectal cancer incidence and relatively low folate intake. A total of 264 cases with histologically confirmed incident colorectal cancer and 408 controls participated. There was no clear trend in risk with reported intakes of total, or dietary, folate, riboflavin, vitamin B12 or vitamin B6, nor were there interactions between folate intake and the other B vitamins or alcohol. For C677T, risk decreased with increasing variant alleles (multivariate OR for CT v. CC = 0.77 (95 % CI 0.52, 1.16); OR for TT v. CC = 0.62 (95 % CI 0.31, 1.24)), which, although not statistically significant, was consistent with previous studies. For A1298C, compared with AA subjects, CC subjects had modest, non-significant, reduced risk (multivariate OR = 0.81 (95 % CI 0.45, 1.49)). There were significant interactions between total folate and C677T (P = 0.029) and A1298C (P = 0.025), and total vitamin B6 and both polymorphisms (C677T, P = 0.016; A1298C, P = 0.033), although the patterns observed differed from previous studies. Seen against the setting of low folate intake, the results suggest that the role of folate metabolism in colorectal cancer aetiology may be more complex than previously thought. Investigation of particular folate vitamers (for example, tetrahydrofolate, 5,10-methylenetetrahydrofolate) may help clarify carcinogenesis pathways.
Collapse
|
28
|
Ravaglia G, Forti P, Maioli F, Chiappelli M, Montesi F, Tumini E, Mariani E, Licastro F, Patterson C. Blood inflammatory markers and risk of dementia: The Conselice Study of Brain Aging. Neurobiol Aging 2007; 28:1810-20. [PMID: 17011077 DOI: 10.1016/j.neurobiolaging.2006.08.012] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Revised: 07/26/2006] [Accepted: 08/31/2006] [Indexed: 11/24/2022]
Abstract
Incidence studies of blood inflammatory markers as predictors of dementia in older age are few and did not take into account hyperhomocysteinemia, although this condition is associated with both inflammation and increased risk of dementia. We investigated the relationships of baseline serum C-reactive protein (CRP), serum interleukin 6 (IL6), plasma alpha-1-antichymotrypsin, and hyperhomocysteinemia (defined as plasma total homocysteine>15 micromol/L) with risk of incident Alzheimer's disease (AD) and vascular dementia (VaD) in a dementia-free Italian population-based elderly cohort (n=804, 53.2% women, mean age 74 years) with 4 years of follow-up. No inflammatory marker, alone or in combination, predicted AD risk whereas the combination of high CRP and high IL6 was associated with risk of VaD (HR, 2.56; 95%CI, 1.21-5.50) independently of socio-demographic confounders, traditional risk factors and hyperhomocysteinemia. By contrast, in the same model, hyperhomocysteinemia was independently associated with AD (HR, 1.91; 95%CI, 1.02-3.56) but not VaD risk. Blood inflammatory markers are associated with increased VaD risk but do not predict AD, which seems selectively associated with hyperhomocysteinemia.
Collapse
Affiliation(s)
- Giovanni Ravaglia
- Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S. Orsola-Malpighi, Via Massarenti, 9, 40138 Bologna, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Plasma pyridoxal phosphate and pyridoxic acid and their relationship to plasma homocysteine in a representative sample of British men and women aged 65 years and over. Br J Nutr 2007. [DOI: 10.1017/s0007114599000380] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Concentrations of pyridoxal phosphate and pyridoxic acid were measured in fasting plasma samples from British men and women aged 65 years and over, participating in a National Diet and Nutrition Survey during 1994–5, selected to be representative of the population of mainland Britain. In this population, the concentration of pyridoxal phosphate declined, whereas pyridoxic acid rose, with increasing age and frailty; however, both status indicators were strongly and directly (with a positive coefficient) correlated with estimates of vitamin B6intake. This was little affected by the inclusion of food energy and protein intakes in the model. Forty-eight percent of the participants living in the community and 75% of those living in institutions had plasma pyridoxal phosphate concentrations below a range considered normal from other studies. In a univariate regression model, plasma pyridoxal phosphate concentrations were inversely correlated with plasma homocysteine concentrations, consistent with the hypothesis that vitamin B6status may influence plasma homocysteine levels, and hence vascular disease risk. However, this relationship was partly attenuated in a multiple regression model including age, sex, domicile and biochemical status indices, including those of folate and vitamin B12. There was evidence that plasma pyridoxal phosphate was sensitive to metabolic conditions associated with inflammation and the acute-phase reaction, and that plasma pyridoxic acid was sensitive to renal function. Thus, neither index is an ideal predictor of vitamin B6status in older people, unless these confounding factors are allowed for. Since poor vitamin B6status may have health implications, e.g. for immune function, cognition, and for essential intermediary metabolic pathways in older people, it needs to be investigated as a possible public health problem.
Collapse
|
30
|
Nusier MK, El-Dwairi QA. Effects of Vitamin B12 and Folic Acid on Hyperhomocysteinemia in Patients with Acute Myocardial Infarction. ACTA ACUST UNITED AC 2007. [DOI: 10.1248/jhs.53.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Mohamad Khakid Nusier
- Department of Biochemistry and Molecular Biology, Jordan University of Science and Technology School of Medicine
| | - Qasim Abdel El-Dwairi
- Department of Anatomy, Jordan University of Science and Technology School of Medicine
| |
Collapse
|
31
|
Beeri MS, Uribarri J, Schmeidler J, Lally R, Wang J, Grossman HT, Langhoff E, Rosendorff C, Silverman JM. NORMAL HOMOCYSTEINE LEVELS IN WELL-FUNCTIONING OLDEST-OLD INDIVIDUALS DESPITE LOW KIDNEY FUNCTION. J Am Geriatr Soc 2006; 54:1623-5. [PMID: 17038088 PMCID: PMC3163093 DOI: 10.1111/j.1532-5415.2006.00903.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
32
|
Molero AE, Altimari CC, Duran DA, Garcia E, Pino-Ramirez G, Maestre GE. Total plasma homocysteine values among elderly subjects: findings from the Maracaibo Aging Study. Clin Biochem 2006; 39:1007-15. [PMID: 16959233 DOI: 10.1016/j.clinbiochem.2006.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Revised: 07/16/2006] [Accepted: 07/27/2006] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The present study generated baseline data for total homocysteine (tHcy) in elderly Caribbeans of Hispanic ancestry, residing in Venezuela, their country of origin. DESIGN AND METHODS 2106 participants in the Maracaibo Aging Study (MAS), older than 55 years, underwent standardized clinical and laboratory assessments, including measurement of plasma tHcy levels, folate, and vitamin B12 in fasting samples. RESULTS tHcy concentration in the healthy, normative group ranged from 4.1 to 31.8 micromol/L, with a median of 11.5+/-4.7 micromol/L. tHcy level increased with age, was significantly higher in men than in women, and exhibited inverse correlations with folate and vitamin B12. CONCLUSIONS tHcy levels of the MAS participants were generally higher than levels previously reported for community-dwelling elderly populations from other countries. The normative centile curves for tHcy can be used in disease risk analysis for this population, and possibly for other Hispanic populations residing in the Caribbean.
Collapse
Affiliation(s)
- Aldrin E Molero
- Laboratory of Neurosciences, Institute for Biological Research, Faculty of Medicine, University of Zulia, Apdo. Postal 10.636, Maracaibo, Venezuela
| | | | | | | | | | | |
Collapse
|
33
|
Troughton JA, Woodside JV, Young IS, Arveiler D, Amouyel P, Ferrières J, Ducimetière P, Patterson CC, Kee F, Yarnell JWG, Evans A. Homocysteine and coronary heart disease risk in the PRIME study. Atherosclerosis 2006; 191:90-7. [PMID: 16774755 DOI: 10.1016/j.atherosclerosis.2006.05.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Revised: 04/20/2006] [Accepted: 05/03/2006] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Despite recent meta-analyses suggesting that homocysteine is an independent predictor of coronary heart disease (CHD), there is debate regarding whether elevated homocysteine may be deleterious only in the presence of other risk factors, with which it acts synergistically to exert a multiplicative effect on CHD risk, emerging only as a CHD predictor in patients with pre-existing risk factors. The Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study is a multicentre prospective study of 10593 men from France and Northern Ireland, investigating cardiovascular risk factors. We investigated: (1) whether higher homocysteine is associated with increased CHD risk in the PRIME case-control cohort; (2) whether homocysteine interacts synergistically with pre-existing CHD risk factors. METHODS Homocysteine was measured in 323 participants who had developed CHD at 5-year follow-up and in 638 matched controls. RESULTS There was no significant difference in homocysteine between cases and controls (p=0.18). Homocysteine was significantly higher in current smokers (geometric mean mumol/l (interquartile range mumol/l) 9.45 (7.43, 11.75)) compared with non-smokers (8.90 (7.32, 10.70); p=0.007). There was a significant interaction between homocysteine, smoking and CHD risk (chi2=10.29, d.f.=2, p=0.006). CONCLUSIONS These findings suggest that elevated homocysteine is significantly associated with CHD risk in current smokers.
Collapse
Affiliation(s)
- J A Troughton
- Faculty of Medicine, Queen's University Belfast, Belfast, Northern Ireland, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Ceperković Z. The role of increased levels of homocysteine in the development of cardiovascular diseases. ACTA ACUST UNITED AC 2006; 59:143-7. [PMID: 17066586 DOI: 10.2298/mpns0604143c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction. Homocysteine is a sulphur amino acid produced by demethylation of the essential amino acid methionine. Dysfunction of certain enzymes or insufficient intake of nutrients may cause increase of intracellular homocysteine, which is then exported into plasma. Etiopathogenesis of cardiovascular diseases accompanied with higher level of homocysteine. McCully's theory suggests that high levels of homocysteine are associated with cardiovascular diseases, arteriosclerosis and endothelial dysfunction. Harmful effects of homocysteine are associated with LDL cholesterol oxidation, increased production of collagen, lower availability of nitric oxide as well as prothrombotic activity. Reduction of homocysteine levels. The most recent researches show that hyperhomocysteinemia is responsible for about 10% of total risk of cardiovascular diseases. Vitamin BJ2 plays a major role in the remethylation of homocysteine. Reducing the homocysteine concentration in blood by 3 mol/l (with daily intake of 0.8 mg of folic acid) reduces the risk of ishemic heart diseases by 16%, vein thrombosis by 25%, and stroke by 24%. A six-month therapy with folic acid (Img/d), vitamin B12 (400g/d) and vitamin B6 (10mg/d), reduces the frequency of cardiovascular occurrences after successful PTCA. Plasma homocysteine concentration over 12/1 doubles the risk of myocardial infarction. Conclusion. A lack of folates, vitamin B6 and vitamin B12 increases the level of homocysteine and thus increases the risk of cardiovascular diseases. Changes in lifestyle and diet, as well as intake of food supplements, are of great importance in reducing homocysteine levels in plasma and therefore in reducing the occurrence and acceleration of arteriosclerosis. .
Collapse
|
35
|
Zhang ZW, Farthing MJG. The roles of vitamin C in Helicobacter pylori associated gastric carcinogenesis. ACTA ACUST UNITED AC 2005; 6:53-8. [PMID: 15904421 DOI: 10.1111/j.1443-9573.2005.00194.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Ascorbic acid, as one of the important water-soluble vitamins, is essential for a range of physiological functions, including the syntheses of collagen, carnitine and neurotransmitters. It is also an important dietary antioxidant against oxidative stress. Current information suggests that vitamin C might be protective against the development of gastric cancer. Chronic infection with Helicobacter pylori is recognized to be a significant cause of gastric adenocarcinoma. Inflammation induced by H. pylori infection in the stomach not only causes significantly enhanced consumption of vitamin C, but also reduces secretion of the vitamin into the gastric lumen. Most of the evidence relating to vitamin C and H. pylori infection derives from clinical studies and experiments directly examining the effect of vitamin C on H. pylori-associated gastric carcinogenesis and remains limited. Furthermore, results from recent studies suggest that vitamin C might also increase the risk of cancer through its pro-oxidant activity and protect against oxidative stress in cancer cells through its antioxidant action. In this article we review recent publications on vitamin C research and assess the potential roles of vitamin C in H. pylori associated gastric carcinogenesis. The possible adverse effects of the vitamin C are also discussed.
Collapse
|
36
|
Gori AM, Corsi AM, Fedi S, Gazzini A, Sofi F, Bartali B, Bandinelli S, Gensini GF, Abbate R, Ferrucci L. A proinflammatory state is associated with hyperhomocysteinemia in the elderly. Am J Clin Nutr 2005. [DOI: 10.1093/ajcn/82.2.335] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Anna Maria Gori
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Anna Maria Corsi
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Sandra Fedi
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Alessandra Gazzini
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Francesco Sofi
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Benedetta Bartali
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Stefania Bandinelli
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Gian Franco Gensini
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Rosanna Abbate
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| | - Luigi Ferrucci
- From the Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy (AMG, SF, AG, FS, GFG, and RA); the Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging, Florence, Italy (AMC and
| |
Collapse
|
37
|
Gori AM, Corsi AM, Fedi S, Gazzini A, Sofi F, Bartali B, Bandinelli S, Gensini GF, Abbate R, Ferrucci L. A proinflammatory state is associated with hyperhomocysteinemia in the elderly. Am J Clin Nutr 2005; 82:335-41. [PMID: 16087976 DOI: 10.1093/ajcn.82.2.335] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The mechanism by which high circulating homocysteine concentrations are a risk factor for atherothrombosis is incompletely understood. A proinflammatory state is related to atherosclerosis, and recent studies suggest that acute phase reactants correlate with circulating concentrations of homocysteine. OBJECTIVE We determined whether high concentrations of inflammatory markers are associated with hyperhomocysteinemia independently of dietary vitamin intakes, vitamin concentrations, and cardiovascular disease risk factors in a large, representative sample of the general population. DESIGN Five hundred eighty-six men and 734 women were randomly selected from the inhabitants of 2 small towns near Florence, Italy. RESULTS After adjustment for multiple potential confounders, interleukin 1 receptor antagonist (IL-1ra) and interleukin 6 (IL-6) concentrations were significantly (P < 0.001) associated with plasma homocysteine concentrations in older (>65 y) populations. Compared with participants in the lowest IL-6 tertile, those in the highest tertile had a higher risk of having homocysteine concentrations that were high (>30 micromol/L; odds ratio: 2.6; 95% CI: 1.1, 5.6; P = 0.024) or in the intermediate range 15-30 micromol/L (odds ratio: 1.6; 95% CI: 1.2, 2.2; P = 0.0014). Sedentary state, intakes of vitamin B-6 and folic acid, and serum folate, vitamin B-12, vitamin B-6, and alpha-tocopherol concentrations were significant independent correlates of homocysteine. CONCLUSIONS High circulating concentrations of IL-1ra and IL-6 are independent correlates of hyperhomocysteinemia and may explain, at least in part, the association between homocysteine and atherosclerosis.
Collapse
Affiliation(s)
- Anna Maria Gori
- Department of Medical and Surgical Critical Area, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Florence, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Fakhrzadeh H, Ghotbi S, Pourebrahim R, Heshmat R, Nouri M, Shafaee A, Larijani B. Plasma homocysteine concentration and blood pressure in healthy Iranian adults: the Tehran Homocysteine Survey (2003–2004). J Hum Hypertens 2005; 19:869-76. [PMID: 16049520 DOI: 10.1038/sj.jhh.1001911] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hypertension is a modifiable risk factor for cardiovascular disease, but its aetiology has not been fully elucidated. Recently, attention has been focused on the direct relations of plasma homocysteine (Hcy) to blood pressure (BP). The purpose of this study was to determine the relationship of Hcy with BP and other cardiovascular disease risk factors. This population-based study was a part of the Cardiovascular Risk Factors Survey and has been designed and conducted based on the methodology of the MONICA/WHO Project. A total of 1214 people aged 25-64 years were recruited using cluster sampling and assessed regarding standardized methods. BP was measured in seated position after a 10-min rest period. Blood samples were gathered and analysed according to standard methods. Variables were assessed in 1191 participants (416 men; 775 women). Mean age was higher in hypertensives compared to normotensives (P < 0.001). Mean Hcy was higher in hypertensives, but significant only in men (P < 0.031). Concurrent effects of Hcy, folate and vitamin B12 on hypertension indicated that Hcy acts as a risk factor and folate and vitamin B12 as protective factors; however, after adjustment, just vitamin B12 remained as a protective factor. Although we detected a simple correlation of Hcy with BP in Iranian adults, this relationship was no longer significant after applying an adjustment. In light of our observations, it is likely that the increased Hcy levels reported in hypertensive persons are concomitant rather than a precursor of hypertension.
Collapse
Affiliation(s)
- H Fakhrzadeh
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | | | |
Collapse
|
39
|
Stahl Z, Belmaker RH, Friger M, Levine J. Nutritional and life style determinants of plasma homocysteine in schizophrenia patients. Eur Neuropsychopharmacol 2005; 15:291-5. [PMID: 15820418 DOI: 10.1016/j.euroneuro.2004.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Revised: 12/29/2004] [Accepted: 12/30/2004] [Indexed: 11/17/2022]
Abstract
Recently, homocysteine levels have been reported to be elevated in young male schizophrenic patients. Since smoking, obesity, low folate or low vitamin B12 and various medications can increase homocysteine levels, we studied these variables and other clinical variables in 258 schizophrenic patients. A multiple linear regression for plasma homocysteine was performed on variables that were significantly related to plasma homocysteine. Variables predicting homocysteine levels in schizophrenic patients include gender, plasma folate levels, plasma vitamin B12 levels, mean red blood cell corpuscular volume and diastolic blood pressure. Only 24% of the variance in male patients was explained by the model. The reason for elevated plasma homocysteine in some schizophrenic populations remains unclear.
Collapse
Affiliation(s)
- Z Stahl
- Stanley Research Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel
| | | | | | | |
Collapse
|
40
|
Iqbal MP, Ishaq M, Kazmi KA, Yousuf FA, Mehboobali N, Ali SA, Khan AH, Waqar MA. Role of vitamins B6, B12 and folic acid on hyperhomocysteinemia in a Pakistani population of patients with acute myocardial infarction. Nutr Metab Cardiovasc Dis 2005; 15:100-108. [PMID: 15871858 DOI: 10.1016/j.numecd.2004.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Accepted: 05/27/2004] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Pakistani people belong to an ethnic group which has the highest rate of coronary artery disease (CAD). We investigated the possible correlation between deficiency of vitamins B6, B12 or folic acid and hyperhomocysteinemia in Pakistani patients with acute myocardial infarction (AMI). A case-control study was carried out involving 224 AMI patients (age 30-70 years; 55 females and 169 males) and 126 normal healthy subjects (age 31-70 years; 35 females and 91 males). METHODS AND RESULTS Fasting venous blood was obtained from cases and controls. Serum was analyzed for folic acid and B12 using radioassays. Plasma was analyzed for pyridoxal phosphate (PLP; coenzymic form of B6) using a radioenzymatic assay and for total homocysteine using a fluorescence polarization immunoassay. Mean serum B12 concentration in AMI patients was found to be significantly lower than the mean for controls (241+/-185 pg/ml vs 608+/-341 pg/ml; p < 0.001). Mean serum folate level in patients was also found to be lower than controls (3.35+/-3.78 ng/ml vs 4.93+/-2.93 ng/ml), however, the differences were not statistically significant. Similarly, mean PLP concentration in plasma of cases (19.4+/-24.4 nmol/l) was lower than the concentration in controls (23.2+/-17.6 nmol/l), but the difference was not statistically significant. Mean plasma homocysteine level in AMI cases (18+/-8.36 micromol/l) was higher than the mean level in controls (16.4+/-4.9 micromol/l), but not to a significant extent. However, this mean homocysteine concentration in normal healthy subjects was among the highest reported in the literature and was significantly more than mean values reported in most Eastern and Western studies. Compared to controls, there was significantly greater deficiency of folate (32.5% vs 67.1%), B12 (3.2% vs 63.4%) and PLP (49.2% vs 74.1%) in AMI patients. Deficiencies of folate, B12 and PLP were defined as serum folate levels less than 3.5 ng/ml, serum levels of B12 less than 200 pg/ml and plasma PLP levels less than 20 nmol/l. Mean plasma homocysteine levels in smokers were found to be significantly higher in both cases and controls. Similarly, mean serum folate levels in smokers (compared to nonsmokers) were significantly lower in both cases and controls. CONCLUSIONS Substantial nutritional deficiencies of these three vitamins along with mild hyperhomocysteinemia, perhaps through an interplay with the classical cardiovascular risk factors (highly prevalent in this population), could be further aggravating the risk of CAD in the Pakistani population.
Collapse
Affiliation(s)
- M P Iqbal
- Department of Biological & Biomedical Sciences, The Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Biesalski HK. Meat as a component of a healthy diet - are there any risks or benefits if meat is avoided in the diet? Meat Sci 2005; 70:509-24. [PMID: 22063749 DOI: 10.1016/j.meatsci.2004.07.017] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Revised: 07/15/2004] [Accepted: 07/15/2004] [Indexed: 01/10/2023]
Abstract
Meat is frequently associated with a "negative" health image due to its "high" fat content and in the case of red meat is seen as a cancer-promoting food. Therefore, a low meat intake, especially red meat is recommended to avoid the risk of cancer, obesity and metabolic syndrome. However, this discussion overlooks the fact, that meat is an important source for some of micronutrients such as iron, selenium, vitamins A, B12 and folic acid. These micronutrients are either not present in plant derived food or have poor bioavailability. In addition, meat as a protein rich and carbohydrate "low" product contributes to a low glycemic index which is assumed to be "beneficial" with respect to overweight, the development of diabetes and cancer (insulin resistance hypothesis). Taken together meat is an important nutrient for human health and development. As an essential part of a mixed diet, meat ensures adequate delivery of essential micronutrients and amino acids and is involved in regulatory processes of energy metabolism.
Collapse
Affiliation(s)
- H-K Biesalski
- Universität Hohenheim, Institut für Biologische Chemie und Ernährungswissenschaft, Garbenstrasse 30 70593 Stuttgart, Germany
| |
Collapse
|
42
|
Papoutsakis C, Yiannakouris N, Manios Y, Papaconstantinou E, Magkos F, Schulpis KH, Zampelas A, Matalas AL. Plasma homocysteine concentrations in Greek children are influenced by an interaction between the methylenetetrahydrofolate reductase C677T genotype and folate status. J Nutr 2005; 135:383-8. [PMID: 15735067 DOI: 10.1093/jn/135.3.383] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Risk factors established at young ages may set the stage for later cardiovascular disease (CVD). Elevated total homocysteine (tHcy) in blood is an emerging risk factor for CVD, yet few studies have been conducted in children, especially in the Mediterranean. We described plasma tHcy concentrations in a group of healthy Greek children and examined its relation with physiologic, metabolic, and genetic variables. Fasting blood samples were collected from 186 students, 11.6 +/- 0.4 years old, and tHcy, folate, vitamin B-12, and routine biochemistry variables in plasma were measured. The methylenetetrahydrolate reductase (MTHFR) C677T genotype was determined and anthropometric and dietary data were obtained. The distribution of tHcy was positively skewed with a median of 7.9 micromol/L (mean: 8.2 +/- 2.3 micromol/L; range: 4.4-22.2 micromol/L). tHcy was inversely related to plasma folate (r = -0.34, P < 0.0001), vitamin B-12 (r = -0.20, P = 0.008), and glucose (r = -0.15, P = 0.045). An interaction between the MTHFR genotype and plasma folate on tHcy was detected (P = 0.047). Specifically, the homozygous mutant TT genotype was associated with higher tHcy only in children with lower plasma folate (< 19.9 nmol/L), (P = 0.012). In our sample of healthy Greek children, plasma tHcy concentrations were higher than values reported in children of Northern European descent and were associated with folate, vitamin B-12, and glucose in plasma. The results also show that, similar to adults, plasma folate concentration is important in determining the contribution of the MTHFR C677T mutation to tHcy concentrations in children.
Collapse
Affiliation(s)
- Constantina Papoutsakis
- Laboratory of Nutrition and Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Adunsky A, Arinzon Z, Fidelman Z, Krasniansky I, Arad M, Gepstein R. Plasma homocysteine levels and cognitive status in long-term stay geriatric patients: a cross-sectional study. Arch Gerontol Geriatr 2005; 40:129-38. [PMID: 15680497 DOI: 10.1016/j.archger.2004.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Revised: 07/20/2004] [Accepted: 07/22/2004] [Indexed: 11/26/2022]
Abstract
Many studies have established an association of total plasma homocysteine (Hcys) levels and the risk for dementia and Alzheimer disease. However, little is known on the relation between Hcys and cognitive status in long-term stay geriatric patients. This cross-sectional study was conducted in a long-stay geriatric center and included 186 eligible patients, staying for more than 6 months in the facility. We looked for patients' clinico-demographic data, as well as for laboratory data and cognitive status, evaluated by the mini-mental state examination (MMSE). Patients were divided into three groups according to Hcys levels and analyzed in order to explore potential association with cognitive levels, considering clinically important cofounders. Cognitive state of patients of the highest Hcys tertile was significantly impaired, compared with other groups (p < 0.0001) and characterized by a worse nutritional status. Pearson's correlation coefficient for Hcys and MMSE resulted -0.251 (p = 0.0005). The linear regression model for MMSE showed that homocysteine is significantly associated with MMSE: mean MMSE score of patients with homocysteine >13.7 was significantly lower than the mean MMSE of patients with homocysteine < or = 8.5, after controlling for all other parameters in the regression equation (beta = -2.7685, p = 0.007). We conclude that in our sample of patients, Hcys was associated with cognitive impairment. Hcys levels >13.7 micromol/l remained a significant independent parameter associated with the severity of cognitive impairment, after controlling for other confounders. A better understanding of the mechanisms underlying such interrelations may have research and interventional implications.
Collapse
Affiliation(s)
- Abraham Adunsky
- Division of Medicine for the Elderly, Sheba Medical Center, Tel Hashomer 52621, Israel.
| | | | | | | | | | | |
Collapse
|
44
|
de Bree A, van der Put NMJ, Mennen LI, Verschuren WMM, Blom HJ, Galan P, Bates CJ, Herrmann W, Ullrich M, Dierkes J, Westphal S, Bouter LM, Heine RJ, Stehouwer CDA, Dekker JM, Nijpels GN, Araújo F, Cunha-Ribeiro LM, Refsum H, Vollset S, Nygard O, Ueland PM. Prevalences of hyperhomocysteinemia, unfavorable cholesterol profile and hypertension in European populations. Eur J Clin Nutr 2005; 59:480-8. [PMID: 15674310 DOI: 10.1038/sj.ejcn.1602097] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hyperhomocysteinemia (HHCY) is a risk factor for cardiovascular diseases (CVD). HHCY may interact with hypertension (HTEN) and an unfavorable cholesterol profile (UNFAVCHOL) to alter the risk of CVD. OBJECTIVES To estimate the prevalences of HHCY (1) isolated and (2) in combination with UNFAVCHOL and/or HTEN in different age categories. To provide information that may improve the screening and treatment of subjects at risk of CVD. DESIGN Cross-sectional data on 12,541 men and 12,948 women aged 20 + y were used from nine European studies. RESULTS The prevalence of isolated HHCY was 8.5% in subjects aged 20-40 y, 4.7% in subjects aged 40-60 y and 5.9% in subjects aged over 60 y. When combining all age groups, 5.3% had isolated HHCY and an additional 5.6% had HHCY in combination with HTEN and/or UNFAVCHOL. The combinations of risk factors increased with age and, except for HHCY&UNFAVCHOL, were more prevalent than predicted by chance. Of the young subjects (20-40 y), 24% suffered from one or more of the investigated CVD risk factors. This figure was 75.1% in the old subjects (60+ years). CONCLUSIONS A substantial number of subjects in selected European populations have HHCY (10.9%). In half of these cases, subjects suffer also from other CVD risk factors like UNFAVCHOL and HTEN. Older people in particular tend to have more than one risk factor. Healthcare professionals should be aware of this when screening and treating older people not only for the conventional CVD risk factors like UNFAVCHOL and HTEN but also HHCY, as this can easily be reduced through increased intake of folic acid via supplement or foods fortified with folic acid.
Collapse
Affiliation(s)
- A de Bree
- Unilever Health Institute, Unilever Research and Development Vlaardingen, Olivier van Noortlaan 120, 3133 AT Vlaardingen, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Han YH, Yon M, Hyun TH. Folate intake estimated with an updated database and its association to blood folate and homocysteine in Korean college students. Eur J Clin Nutr 2004; 59:246-54. [PMID: 15483632 DOI: 10.1038/sj.ejcn.1602065] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To measure folate content in cooked foods commonly consumed in Korea for evaluating its relation to folate nutriture of college students. DESIGN Folate content in 32 raw and cooked foods was measured by microbiological assay after trienzyme extraction. These values and the previously published values of 110 raw foods commonly consumed in Korea were used to update the currently available food tables to estimate dietary folate intake of 106 students based on a 3-day 24-h recall. The association of folate intake with blood folate and homocysteine concentrations was evaluated. SETTING Cheongju, Korea. SUBJECTS Healthy college students aged 18 to 27 y old (44 males and 62 females). RESULTS The average folate loss in 32 foods caused by cooking was 29%. The mean daily dietary folate intakes estimated with an updated database were 406 and 305 mug in males and females, respectively. About 10% of both male and female students showed low serum folate (<6.8 nmol/l). Folate intake was positively correlated with serum and erythrocyte folate concentrations in female students (r=0.27 and 0.29, respectively, P<0.05), and negatively correlated with serum homocysteine in male students (r=-0.41, P<0.05). CONCLUSIONS Mean dietary folate intake was higher than those of previous studies since the database was updated using values obtained with trienzyme extraction. Folate intake for the general population should be re-evaluated using reliable food folate values obtained with trienzyme extraction.
Collapse
Affiliation(s)
- Y H Han
- Department of Food and Nutrition, Chungbuk National University, Gaeshin-dong, Cheongju, Korea
| | | | | |
Collapse
|
46
|
Bates CJ, Lean MEJ, Mansoor MA, Prentice A. Nutrient intakes; biochemical and risk indices associated with Type 2 diabetes and glycosylated haemoglobin, in the British National Diet and Nutrition Survey of people aged 65 years and over. Diabet Med 2004; 21:677-84. [PMID: 15209758 DOI: 10.1111/j.1464-5491.2004.01228.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To characterize nutritional differences between survey participants diagnosed with Type 2 diabetes; those without diabetes, and those with "undiagnosed diabetes" based on glycosylated haemoglobin (HbA(1c)). SUBJECTS AND METHODS The 1994/5 British National Diet and Nutrition Survey, of people aged 65 years and over (mean age 78 years), included 73 respondents with diagnosed Type 2 diabetes [mean (sd) HbA(1c) = 7.06 (2.05)%], and 30 with "undiagnosed diabetes" (defined as HbA(1c) > 6.3%; mean (sd) HbA(1c) = 7.40 (1.66)%], among a representative sample of 1038 with anthropometry; 4-day weighed diet; blood and urine status measurements. RESULTS The prevalence of Type 2 diabetes (diagnosed + undiagnosed) was 10%. In subjects without diagnosis of diabetes, those with HbA(1c) > 6.3% had on average a significantly higher body weight (73.6 vs. 67.9 kg), higher waist circumference (99.8 vs. 91.8 cm), higher body mass index (28.6 vs. 25.9 kg/m(2)) and higher white cell counts (7.64 vs. 7.09 x 10(9)/l), than those with mean HbA(1c) < or = 6.3%. Diagnosed diabetic subjects had significantly higher energy-adjusted intakes of protein, fibre, vitamins and minerals than those not in this category (P < 0.01). In contrast, those with undiagnosed diabetes (HbA(1c) > 6.3%) were nutritionally "at risk", having low plasma concentrations of lycopene (0.13 vs. 0.24 micromol/l) and high density lipoprotein cholesterol (0.99 vs. 1.27 micromol/l) and a trend towards low vitamin C (24 vs. 36 micromol/l) which was significant (P < 0.01) for men. HbA(1c) was positively correlated with white cell count, plasma fasting triglycerides, plasma alkaline phosphatase and homocysteine (all P < 0.01 overall), being particularly striking amongst men. CONCLUSIONS Among older British citizens, those with diagnosed diabetes had healthier nutritional profiles than those undiagnosed with high HbA(1c). Important health-promoting benefits are therefore predicted following early diagnosis and nutritional advice for people with Type 2 diabetes.
Collapse
Affiliation(s)
- C J Bates
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK.
| | | | | | | |
Collapse
|
47
|
de Bree A, Mennen LI, Hercberg S, Galan P. Evidence for a protective (synergistic?) effect of B-vitamins and omega-3 fatty acids on cardiovascular diseases. Eur J Clin Nutr 2004; 58:732-44. [PMID: 15116076 DOI: 10.1038/sj.ejcn.1601871] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The results of dietary intervention trials favor the hypothesis that higher intakes of B-vitamins (folate, vitamin B(6) and B(12)), and subsequently lower total homocysteine (tHcy) concentrations, are causally associated with a decreased risk of vascular disease in patients with cardiovascular diseases (CVD). The same is true for a higher intake of omega-3 fish fatty acids. Yet, the lack of hard end points and/or appropriate study designs precludes a definitive conclusion about causality. In the future, intervention trials with hard end points and randomized double-blind placebo-controlled designs should be able to elucidate the causality problem. There are several pathways by which B-vitamins and omega-3 fatty acids may exert their protective effect on CVD, a common pathway is a beneficial effect on the endothelial function and hemostasis. With respect to synergy between B-vitamins and omega-3 fatty acids, there is no evidence that fish oils have a tHcy-lowering effect beyond the effect of the B-vitamins. Nevertheless, animal studies clearly illustrate that vitamin B(6)- as well as folate-metabolism are linked with those of long-chain omega-3 fatty acids. Furthermore, a human study indicated synergistic effects of folic acid (synthetic form of folate) and vitamin B(6) together with omega-3 fatty acids on the atherogenic index and the fibrinogen concentration. Although these results are promising, they were produced in very small selective study populations. Thus, confirmation in large well-designed intervention trials is warranted.
Collapse
Affiliation(s)
- A de Bree
- Scientific and Technical Institute of Nutrition and Food (ISTNA-CNAM), INSERM U557, INRA U1125, Paris, France.
| | | | | | | |
Collapse
|
48
|
Abstract
The increased focus on risk factors for CHD in women has greatly improved our understanding of this disease in women. The evidence against cigarette smoking, elevated serum cholesterol, and high blood pressure is strong, and sustained campaigns are underway to prevent and appropriately manage these conditions. The importance of adequate physical activity and weight control is well established, and research continues on other emerging risk factors. The focus of future research will be on clarifying the role of these factors, particularly for women and ethnic minorities.
Collapse
Affiliation(s)
- Katherine M Newton
- Center for Health Studies Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA.
| |
Collapse
|
49
|
Wilmink ABM, Welch AA, Quick CRG, Burns PJ, Hubbard CS, Bradbury AW, Day NE. Dietary folate and vitamin b6 are independent predictors of peripheral arterial occlusive disease. J Vasc Surg 2004; 39:513-6. [PMID: 14981440 DOI: 10.1016/j.jvs.2003.09.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It has been suggested that hyperhomocysteinemia (HHcy) is an independent risk factor for peripheral arterial occlusive disease (PAOD). However, the relationship between dietary folate and vitamin B6, cofactors in the metabolism of homocysteine (Hcy), and PAOD is unclear. AIMS To study the relationship between dietary folate and B6 and PAOD. METHODS Case-control population based study of 392 men older than 50 years living in Huntingdon, United Kingdom. PAOD, defined as an ankle-brachial pressure index (ABPI) < 0.9, was present in 86 (22%) of subjects. Folate, vitamin B6, and vitamin B12 intakes were calculated by means of the EPIC (European Prospective Investigation into Cancer) food frequency questionnaire. RESULTS Daily folate intake was significantly lower in case subjects (mean, 288; 95% confidence interval [CI], 266-309 microg) than in control subjects (324; 95% CI, 313-335 microg). Daily vitamin B6 intake was also lower in case subjects (2.05; 95% CI, 1.92-2.19 mg versus 2.26; 95% CI, 2.19-2.33 mg). Daily folate and vitamin B6 intakes were independent predictors of PAOD after adjusting for age, blood pressure, cholesterol levels, diabetes, and smoking status in a logistic regression model. This model suggests that increasing daily folate intake by 1 standard deviation decreased the risk of PAOD by 46%. A similar increase in daily vitamin B6 intake decreased the risk of PAOD by 29%. CONCLUSION In men older than 50 years, dietary folate and B6 intakes are independent predictors of PAOD. Longitudinal studies are required to determine whether dietary modification can reduce the incidence of PAOD in the population.
Collapse
Affiliation(s)
- Antonius B M Wilmink
- University Department of Vascular Surgery, Birmingham Heartlands Hospital, University of Birmingham, Birmingham, UK.
| | | | | | | | | | | | | |
Collapse
|
50
|
Refsum H, Smith AD, Ueland PM, Nexo E, Clarke R, McPartlin J, Johnston C, Engbaek F, Schneede J, McPartlin C, Scott JM. Facts and Recommendations about Total Homocysteine Determinations: An Expert Opinion. Clin Chem 2004; 50:3-32. [PMID: 14709635 DOI: 10.1373/clinchem.2003.021634] [Citation(s) in RCA: 685] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground: Measurement of plasma total homocysteine has become common as new methods have been introduced. A wide range of disorders are associated with increased concentrations of total homocysteine. The purpose of this review is to provide an international expert opinion on the practical aspects of total homocysteine determinations in clinical practice and in the research setting and on the relevance of total homocysteine measurements as diagnostic or screening tests in several target populations.Methods: Published data available on Medline were used as the basis for the recommendations. Drafts of the recommendations were critically discussed at meetings over a period of 3 years.Outcome: This review is divided into two sections: (a) determination of homocysteine (methods and their performance, sample collection and handling, biological determinants, reference intervals, within-person variability, and methionine loading test); and (b) risk assessment and disease diagnosis (homocystinuria, folate and cobalamin deficiencies, cardiovascular disease, renal failure, psychiatric disorders and cognitive impairment, pregnancy complications and birth defects, and screening of elderly and newborns). Each of these subsections concludes with a separate series of recommendations to assist the clinician and the research scientist in making informed decisions. The review concludes with a list of unresolved questions.
Collapse
Affiliation(s)
- Helga Refsum
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|