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Liu J, Wei X, Wang T, Zhang M, Gao Y, Cheng Y, Chi L. Intestinal mucosal barrier: a potential target for traditional Chinese medicine in the treatment of cardiovascular diseases. Front Pharmacol 2024; 15:1372766. [PMID: 38469405 PMCID: PMC10925767 DOI: 10.3389/fphar.2024.1372766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
Cardiovascular disease (CVD) is a serious public health problem, and among non-communicable diseases, CVD is now the leading cause of mortality and morbidity worldwide. CVD involves multiple organs throughout the body, especially the intestinal tract is the first to be involved. The impairment of the intestinal mucosal barrier is considered a significant pathological alteration in CVD and also contributes to the accelerated progression of the disease, thereby offering novel insights for CVD prevention and treatment. The treatment of Chinese medicine is characterized by multi-metabolites, multi-pathways, and multi-targets. In recent years, the studies of Traditional Chinese Medicine (TCM) in treating CVD by repairing the intestinal mucosal barrier have gradually increased, showing great therapeutic potential. This review summarizes the studies related to the treatment of CVD by TCM (metabolites of Chinese botanical drugs, TCM formulas, and Chinese patent medicine) targeting the repair of the intestinal mucosal barrier, as well as the potential mechanisms. We have observed that TCM exerts regulatory effects on the structure and metabolites of gut microbiota, enhances intestinal tight junctions, improves intestinal dyskinesia, repairs intestinal tissue morphology, and preserves the integrity of the intestinal vascular barrier through its anti-inflammatory, antioxidant, and anti-apoptotic properties. These multifaceted attributes position TCM as a pivotal modulator of inhibiting myocardial fibrosis, and hypertrophy, and promoting vascular repairment. Moreover, there exists a close association between cardiovascular risk factors such as hyperlipidemia, obesity, and diabetes mellitus with CVD. We also explore the mechanisms through which Chinese botanical drugs impact the intestinal mucosal barrier and regulate glucose and lipid metabolism. Consequently, these findings present novel insights and methodologies for treating CVD.
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Affiliation(s)
- Jiahui Liu
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiunan Wei
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tong Wang
- College of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Miaomiao Zhang
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ying Gao
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yan Cheng
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lili Chi
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Guo J, Liu X, Wang Z, Lu R, Liu Y, Zhang Y, Tian W, Fang S, Wang S, Yu B. Methylmalonic acid, vitamin B12, and mortality risk in patients with preexisting coronary heart disease: a prospective cohort study. Nutr J 2023; 22:63. [PMID: 38017447 PMCID: PMC10685606 DOI: 10.1186/s12937-023-00900-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The inconsistent relationship between Vitamin B12 (B12), methylmalonic acid (MMA, marker of B12 deficiency) and mortality was poorly understood, especially in patients with coronary heart disease (CHD). This study aims to investigate the association of serum MMA, and B12-related biomarkers (serum level, dietary intake, supplement use, and sensibility to B12) with all-cause and cardiovascular mortality in adults with CHD. METHODS The data of this study were from a subcohort within the US National Health and Nutrition Examination Survey (NHANES). We included adults with preexisting CHD with serum MMA and B12, and dietary B12 intake measurements at recruitment. All participants were followed up until 31 December 2019. Weighted Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% CI of mortality risk. RESULTS Overall, 1755 individuals (weighted mean [SE] age, 65.2 [0.5] years; 1047 men [weighted 58.5%]) with CHD were included, with geometric mean levels of serum MMA 182.4 nmol/L, serum B12 494.5 pg/ml, and dietary B12 intake 4.42 mg/day, and percentage of B12 supplements use 39.1%. During a median follow-up of 7.92 years, 980 patients died. Serum B12 concentration, dietary B12 intake and supplements use were not significantly associated with mortality risk (each p ≥ 0.388). In contrast, individuals in the top tertile of MMA had multivariable-adjusted HRs (95% CIs) of 1.70 (1.31-2.20) for all-cause mortality, and 2.00 (1.39-2.89) for cardiovascular mortality (both p trend < 0.001) compared to those in the bottom tertile of MMA. MMA-related mortality risk was particularly higher among participants with sufficient serum B12 (p < 0.001). CHD patients with increased levels of both MMA and B12 had a doubled mortality risk compared to those with lower MMA and B12 (p < 0.001). CONCLUSION MMA accumulation but not serum or dietary vitamin B12 was associated with increased cardiovascular mortality risk among patients with CHD. This paradox may be related to decreased response to vitamin B12.
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Affiliation(s)
- Junchen Guo
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - XiaoXuan Liu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Zeng Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Rongzhe Lu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Yige Liu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Yiying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, 154000, China
| | - Wei Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin, 150000, China
| | - Shaohong Fang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China.
| | - Bo Yu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China.
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Elgormus Y, Okuyan O, Dumur S, Sayili U, Uzun H. The Epidemiology of Deficiency of Vitamin B12 in Preschool Children in Turkey. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1809. [PMID: 37893527 PMCID: PMC10608353 DOI: 10.3390/medicina59101809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
Background: Vitamin B12 is a water-soluble vitamin with important cellular functions; it is an essential vitamin. The aim of this study is to determine the B12 levels of children in the period from the 6th month when they start taking additional foods to the age of seven (preschool children) and the risk factors affecting them. Methods: One hundred pediatric patients aged 6-72 months who were diagnosed with vitamin B12 deficiency and their parents who agreed to attend Istanbul Atlas University, Medical Faculty, "Medicine Hospital" Pediatric Clinic between September 2022 and June 2023 were prospectively included in this study. Results: B12 deficiency was significantly higher in the 6-11 (25%)-month group than in the 12-23 (5.8%)- and 24-47 (2.8%)-month groups. Homocysteine levels were highest in those with insufficient B12 levels compared to the other groups. There was no statistically significant difference in weekly dairy and meat consumption levels between age groups. B12 levels were lower in the 6-11-month group than in the other groups. Homocysteine levels were highest in those with insufficient B12 levels (<200 pg/mL (148 pmol/L)). Folic acid levels were lower in the 24-47-month and 48-72-month groups than in the 6-11-month and 12-23-month groups. Conclusions: The results obtained in this study showed that low vitamin B12 and increased homocysteine levels seem to be important risk factors in preschool children, especially from the 6th month when they start consuming additional foods. The diagnosis of B12 deficiency can be confirmed by elevated serum total homocysteine levels, which are evidence of functional cobalamin deficiency.
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Affiliation(s)
- Yusuf Elgormus
- Department of Pediatrics, Medicine Hospital, Faculty of Medicine, Istanbul Atlas University, 34403 Istanbul, Turkey; (Y.E.); (O.O.)
| | - Omer Okuyan
- Department of Pediatrics, Medicine Hospital, Faculty of Medicine, Istanbul Atlas University, 34403 Istanbul, Turkey; (Y.E.); (O.O.)
| | - Seyma Dumur
- Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34403 Istanbul, Turkey;
| | - Ugurcan Sayili
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey;
| | - Hafize Uzun
- Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34403 Istanbul, Turkey;
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Lim JY, Kim E. The Role of Organokines in Obesity and Type 2 Diabetes and Their Functions as Molecular Transducers of Nutrition and Exercise. Metabolites 2023; 13:979. [PMID: 37755259 PMCID: PMC10537761 DOI: 10.3390/metabo13090979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Maintaining systemic homeostasis requires the coordination of different organs and tissues in the body. Our bodies rely on complex inter-organ communications to adapt to perturbations or changes in metabolic homeostasis. Consequently, the liver, muscle, and adipose tissues produce and secrete specific organokines such as hepatokines, myokines, and adipokines in response to nutritional and environmental stimuli. Emerging evidence suggests that dysregulation of the interplay of organokines between organs is associated with the pathophysiology of obesity and type 2 diabetes (T2D). Strategies aimed at remodeling organokines may be effective therapeutic interventions. Diet modification and exercise have been established as the first-line therapeutic intervention to prevent or treat metabolic diseases. This review summarizes the current knowledge on organokines secreted by the liver, muscle, and adipose tissues in obesity and T2D. Additionally, we highlighted the effects of diet/nutrition and exercise on the remodeling of organokines in obesity and T2D. Specifically, we investigated the ameliorative effects of caloric restriction, selective nutrients including ω3 PUFAs, selenium, vitamins, and metabolites of vitamins, and acute/chronic exercise on the dysregulation of organokines in obesity and T2D. Finally, this study dissected the underlying molecular mechanisms by which nutrition and exercise regulate the expression and secretion of organokines in specific tissues.
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Affiliation(s)
- Ji Ye Lim
- Department of Biochemistry and Molecular Biology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), 6431 Fannin St., Houston, TX 77030, USA
| | - Eunju Kim
- Department of Biochemistry and Molecular Biology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), 6431 Fannin St., Houston, TX 77030, USA
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5
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Fiedler MK, Drechsel J, Schmidt R, Luppa PB, Bach NC, Sieber SA. Rapid Diagnostic Platform for Personalized Vitamin B6 Detection in Erythrocytes via PLP Cofactor Mimics. ACS Chem Biol 2023. [PMID: 37406307 DOI: 10.1021/acschembio.3c00279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Personalized assessment of vitamin levels in point-of-care (POC) devices is urgently needed to advance the recognition of diseases associated with malnutrition and unbalanced diets. We here introduce a diagnostic platform, which showcases an easy and rapid readout of vitamin B6 (pyridoxal phosphate, PLP) levels in erythrocytes as a first step toward a home-use POC. The technology is based on fluorescent probes, which bind to PLP-dependent enzymes (PLP-DEs) and thereby indirectly report their occupancy with endogenous B6. For example, low vitamin levels result in high probe binding, yielding a strong signal and vice versa. Antibodies against signature human PLP-DEs were immobilized on microarrays to capture probe labeled enzymes for fluorescent detection. Calibrating the system with defined B6 levels revealed a concentration-depended readout as well as sufficient sensitivity for its detection in erythrocytes. To account for individual differences in protein expression, a second antibody was used to normalize protein abundance. This sandwiched assay correctly reported relative B6 levels in human erythrocyte samples, as confirmed by classical laboratory diagnostics. In principle, the platform layout can be easily expanded to other crucial vitamins beyond B6 via an analogous probe strategy.
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Affiliation(s)
- Michaela K Fiedler
- TUM School of Natural Sciences, Department Biosciences, Chair of Organic Chemistry II, Center for Functional Protein Assemblies (CPA), Technical University Munich (TUM), Ernst-Otto-Fischer Str. 8, Garching 85748, Germany
| | - Jonas Drechsel
- TUM School of Natural Sciences, Department Biosciences, Chair of Organic Chemistry II, Center for Functional Protein Assemblies (CPA), Technical University Munich (TUM), Ernst-Otto-Fischer Str. 8, Garching 85748, Germany
- Evotec München, Anna-Sigmund-Str. 5, Neuried 82061, Germany
| | - Ronny Schmidt
- Sciomics GmbH, Karl-Landsteiner-Straße 6, Neckargemünd bei Heidelberg 69151, Germany
| | - Peter B Luppa
- Klinikum rechts der Isar (MRI), Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich (TUM), Ismaninger Str. 22, Munich 81675, Germany
| | - Nina C Bach
- TUM School of Natural Sciences, Department Biosciences, Chair of Organic Chemistry II, Center for Functional Protein Assemblies (CPA), Technical University Munich (TUM), Ernst-Otto-Fischer Str. 8, Garching 85748, Germany
| | - Stephan A Sieber
- TUM School of Natural Sciences, Department Biosciences, Chair of Organic Chemistry II, Center for Functional Protein Assemblies (CPA), Technical University Munich (TUM), Ernst-Otto-Fischer Str. 8, Garching 85748, Germany
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Santos AJM, Khemiri S, Simões S, Prista C, Sousa I, Raymundo A. The importance, prevalence and determination of vitamins B6 and B12 in food matrices: A review. Food Chem 2023; 426:136606. [PMID: 37356238 DOI: 10.1016/j.foodchem.2023.136606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/21/2023] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
Vitamins are a vast group of fundamental organic compounds, which are not produced by the human body but are essential for the living organisms' good health. Vitamins B6 and B12 belong to the same group of hydrophilic vitamins. Structurally unrelated, they share the same purpose as essential components for normal cellular operation, growth and development. Vitamin B6 is an enzymatic co-factor that is vital for countless biochemical reactions, and is also important in sugar and fatty acid metabolization. It encompasses three natural and inter-convertible pyridine-derivatives: pyridoxine, pyridoxal and pyridoxamine. Vitamin B12 is a cobalt organometallic complex also indispensable in numerous human physiological functions. It has four bioactive forms: cyanocobalamin, methylcobalamin, hydroxocobalamin and 5'-deoxyadenosylcobalamin, and only a few prokaryotes have the ability to biosynthesize cobalamin. This work reviews the significant aspects of vitamins B6 and B12: their vital roles, consequences of deficit; food sources; and methods of determination and respective matrices, with heavy emphasis on chromatographic techniques developed within the last two decades.
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Affiliation(s)
- A J M Santos
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Centre, Higher Institute of Agronomy of the University of Lisbon, Tapada da Ajuda, 1349-017 Lisbon, Portugal.
| | - S Khemiri
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Centre, Higher Institute of Agronomy of the University of Lisbon, Tapada da Ajuda, 1349-017 Lisbon, Portugal
| | - S Simões
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Centre, Higher Institute of Agronomy of the University of Lisbon, Tapada da Ajuda, 1349-017 Lisbon, Portugal
| | - C Prista
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Centre, Higher Institute of Agronomy of the University of Lisbon, Tapada da Ajuda, 1349-017 Lisbon, Portugal
| | - I Sousa
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Centre, Higher Institute of Agronomy of the University of Lisbon, Tapada da Ajuda, 1349-017 Lisbon, Portugal
| | - A Raymundo
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Centre, Higher Institute of Agronomy of the University of Lisbon, Tapada da Ajuda, 1349-017 Lisbon, Portugal
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Manapurath R, Strand TA, Chowdhury R, Kvestad I, Yajnik CS, Bhandari N, Taneja S. Daily Folic Acid and/or Vitamin B12 Supplementation Between 6 and 30 Months of Age and Cardiometabolic Risk Markers After 6-7 Years: A Follow-Up of a Randomized Controlled Trial. J Nutr 2023; 153:1493-1501. [PMID: 36889645 PMCID: PMC10196576 DOI: 10.1016/j.tjnut.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Deficiencies of vitamin B12 and folate are associated with elevated concentrations of metabolic markers related to CVDs. OBJECTIVES We investigated the effect of supplementation of vitamin B12 with or without folic acid for 6 mo in early childhood on cardiometabolic risk markers after 6-7 y. METHODS This is a follow-up study of a 2 × 2 factorial, double-blind, randomized controlled trial of vitamin B12 and/or folic acid supplementation in 6-30-mo-old children. The supplement contained 1.8 μg of vitamin B12, 150 μg of folic acid, or both, constituting >1 AI or recommended daily allowances for a period of 6 mo. Enrolled children were contacted again after 6 y (September 2016-November 2017), and plasma concentrations of tHcy, leptin, high molecular weight adiponectin, and total adiponectin were measured (N = 791). RESULTS At baseline, 32% of children had a deficiency of either vitamin B12 (<200 pmol/L) or folate (<7.5 nmol/L). Combined supplementation of vitamin B12 and folic acid resulted in 1.19 μmol/L (95% CI: 0.09; 2.30 μmol/L) lower tHcy concentration 6 y later compared to placebo. We also found that vitamin B12 supplementation was associated with a lower leptin-adiponectin ratio in subgroups based on their nutritional status. CONCLUSIONS Supplementation with vitamin B12 and folic acid in early childhood was associated with a decrease in plasma tHcy concentrations after 6 y. The results of our study provide some evidence of persistent beneficial metabolic effects of vitamin B12 and folic acid supplementation in impoverished populations. The original trial was registered at www. CLINICALTRIALS gov as NCT00717730, and the follow-up study at www.ctri.nic.in as CTRI/2016/11/007494.
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Affiliation(s)
- Rukman Manapurath
- Centre for Health Research and Development, Society for Applied Studies, Delhi, India; Centre for International Health, University of Bergen, Norway
| | - Tor A Strand
- Centre for International Health, University of Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway.
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, Delhi, India
| | - Ingrid Kvestad
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, West, Norwegian Research Centre, Bergen, Norway
| | | | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, Delhi, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, Delhi, India
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Dhar I, Lysne V, Ulvik A, Svingen GFT, Pedersen ER, Bjørnestad EØ, Olsen T, Borsholm R, Laupsa-Borge J, Ueland PM, Tell GS, Berge RK, Mellgren G, Bønaa KH, Nygård OK. Plasma methylmalonic acid predicts risk of acute myocardial infarction and mortality in patients with coronary heart disease: A prospective 2-cohort study. J Intern Med 2023; 293:508-519. [PMID: 36682040 DOI: 10.1111/joim.13610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Elevated plasma methylmalonic acid (MMA) is reported in patients with established coronary heart disease (CHD) and is considered a marker of vitamin B12 deficiency. Moreover, MMA-dependent reactions have been linked to alterations in mitochondrial energy metabolism and oxidative stress, key features in the pathophysiology of cardiovascular diseases (CVDs). OBJECTIVES We examined whether plasma MMA prospectively predicted the long-term risk of acute myocardial infarction (AMI) and mortality. METHODS AND RESULTS Using Cox modeling, we estimated hazard ratios (HRs) for endpoints according to per 1-SD increment of log-transformed plasma MMA in two independent populations: the Western Norway Coronary Angiography Cohort (WECAC) (patients evaluated for CHD; n = 4137) and the Norwegian Vitamin Trial (NORVIT) (patients hospitalized with AMI; n = 3525). In WECAC and NORVIT, 12.8% and 18.0% experienced an AMI, whereas 21.8% and 19.9% died, of whom 45.5% and 60.3% from CVD-related causes during follow-up (range 3-11 years), respectively. In WECAC, age- and gender-adjusted HRs (95% confidence interval) were 1.18 (1.09-1.28), 1.25 (1.18-1.33), and 1.28 (1.17-1.40) for future AMI, total mortality, and CVD mortality, respectively. Corresponding risk estimates were 1.19 (1.10-1.28), 1.22 (1.14-1.31), and 1.30 (1.19-1.42) in NORVIT. These estimates were only slightly attenuated after multivariable adjustments. Across both cohorts, the MMA-risk association was stronger in older adults, women, and non-smokers. CONCLUSIONS Elevated MMA was associated with an increased risk of AMI and mortality in patients with suspected or verified CHD.
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Affiliation(s)
- Indu Dhar
- Centre for Nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway.,Mohn Nutrition Research Laboratory, University of Bergen, Bergen, Norway
| | - Vegard Lysne
- Centre for Nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway.,Mohn Nutrition Research Laboratory, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - Gard F T Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva R Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Espen Ø Bjørnestad
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Robert Borsholm
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Johnny Laupsa-Borge
- Centre for Nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rolf K Berge
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Gunnar Mellgren
- Mohn Nutrition Research Laboratory, University of Bergen, Bergen, Norway.,Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Kaare H Bønaa
- Department of Circulation and medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic for Heart Diseases, St. Olav's University Hospital, Trondheim, Norway
| | - Ottar K Nygård
- Centre for Nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway.,Mohn Nutrition Research Laboratory, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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9
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Xu J, Zhang Y, Lei C, Sun P, Chen R, Yuan T. Using machine learning to identify factors related to nitrous oxide (laughing gas) relapse among adolescents. Gen Psychiatr 2023; 36:e101003. [PMID: 37144158 PMCID: PMC10151853 DOI: 10.1136/gpsych-2022-101003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/06/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
- Jie Xu
- Beijing Gaoxin Hospital, Beijing, China
- Department of Psychology, Tsinghua University, Beijing, China
- Department of Psychiatry and Psychology, Tianjin Medical University, Tianjin, China
| | - Yi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Lei
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Pei Sun
- Department of Psychology, Tsinghua University, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China
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10
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Dong C, Wang G, Xian R, Li C, Wang S, Cui L. Association between Small Intestinal Bacterial Overgrowth and Subclinical Atheromatous Plaques. J Clin Med 2022; 12:jcm12010314. [PMID: 36615114 PMCID: PMC9821204 DOI: 10.3390/jcm12010314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Background: Several recent studies have reported the relationship between atherosclerosis and gut microbial imbalance. Small intestinal bacterial overgrowth (SIBO) is one of the most common forms of gut microbiota imbalance, and studies have shown that SIBO plays an important role in human health. However, the relationship between SIBO and subclinical atheromatous plaques remains unclear. The aim of this study was to investigate the frequency of subclinical atheromatous plaques in patients with SIBO and to explore the association between these two conditions. Methods: A total of 411 eligible subjects were included in this study. The lactulose hydrogen-methane breath test was used to diagnose SIBO, and ultrasound examinations of the carotid, abdominal aorta and lower extremity arteries were performed in all subjects to assess the presence of plaques. Results: Plaques were more common in the SIBO-positive group than in the SIBO-negative group (abdominal aorta, 74.2% vs. 38.8%, p < 0.01; carotid arteries, 71.7% vs. 52.3, p < 0.01; lower extremity arteries, 73.4% vs. 57.6%, p < 0.01). After adjusting for traditional confounders, compared to the SIBO-negative population, the SIBO-positive population had, respectively, OR = 4.18 (95% CI = 2.56−6.80, p < 0.001), OR = 1.93 (95% CI = 1.23−3.02, p = 0.004), OR = 1.81 (95% CI = 1.14−2.88, p = 0.011) and OR = 5.42 (95% CI = 2.78−10.58, p < 0.001) for abdominal, carotid, lower extremity and any-territory plaque presence. Conclusion: SIBO was found to be associated with subclinical atheromatous plaques, and the mechanism of this association warrants further exploration.
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Affiliation(s)
- Changhao Dong
- Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou 510006, China
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Guangxiang Wang
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Rui Xian
- Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou 510006, China
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Chao Li
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Shaoxin Wang
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
| | - Lihong Cui
- Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou 510006, China
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China
- Correspondence:
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11
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Wang J, Tang Y, Liu Y, Cai W, Xu J. Correlations between circulating methylmalonic acid levels and all-cause and cause-specific mortality among patients with diabetes. Front Nutr 2022; 9:974938. [DOI: 10.3389/fnut.2022.974938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
AimsEvidence regarding serum methylmalonic acid (MMA) levels and mortality in individuals with diabetes is limited. This study aimed to evaluate the correlation between MMA and all-cause and cause-specific deaths in patients with diabetes.Materials and methodsThis is a population-based cohort study based on data from both the National Health and Nutrition Examination Survey (NHANES) and National Death Index from 1999 to 2014. We assessed the association of serum MMA concentrations with mortality using Cox proportional hazard models after adjusting for lifestyle, demographic factors, and comorbidities.ResultsAmong the 3,097 participants, 843 mortalities occurred during a median follow-up of 4.42 years. There were 242 deaths due to cardiovascular disease (CVD) and 131 cancer-associated deaths. After multivariate adjustment, elevated serum MMA levels were markedly correlated with a high risk of all-cause, CVD-, and cancer-related deaths. Each one-unit increase in the natural log-transformed MMA level correlated with increased risk of all-cause mortality (2.652 times), CVD mortality risk (3.153 times), and cancer-related mortality risk (4.514). Hazard ratios (95% confidence intervals [CIs]) after comparing participants with MMA < 120 and ≥250 nmol/L were 2.177 (1.421–3.336) for all-cause mortality, 3.560 (1.809–7.004) for CVD mortality, and 4.244 (1.537–11.721) for cancer mortality.ConclusionHigher serum MMA levels were significantly associated with higher all-cause, CVD, and cancer mortality. These findings suggest that maintaining lower MMA status may lower mortality risk in individuals with diabetes.
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12
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Homocysteine is associated with higher risks of ischemic stroke: A systematic review and meta-analysis. PLoS One 2022; 17:e0276087. [PMID: 36227950 PMCID: PMC9560514 DOI: 10.1371/journal.pone.0276087] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High levels of homocysteine (Hct) have been associated with great risks of ischemic stroke. However, some controversy still exists. We performed a systematic review and meta-analysis to compare the levels of Hct between patients with ischemic stroke and controls. METHODS We performed a systematic literature search for articles reporting Hct levels of patients with occurrence of ischemic stroke. We employed a random-effects inverse-variance weighted meta-analytical approach in order to pool standardized mean differences, with estimation of τ2 through the DerSimonian-Laird method. RESULTS The initial search yielded 1361 studies. After careful analysis of abstracts and full texts, the meta-analysis included data from 38 studies, which involved almost 16 000 stroke events. However, only 13 studies reported means and standard deviations for cases and controls, and therefore were used in the meta-analysis. Those studies presented data from 5002 patients with stroke and 4945 controls. Standardized mean difference was 1.67 (95% CI 1.00-2.25, P < 0.01), indicating that Hct levels were significantly larger in patients with ischemic stroke compared to controls. Between-study heterogeneity was very large (I2 = 99%), particularly because three studies showed significantly large mean differences. CONCLUSION This meta-analysis shows that patients with ischemic stroke have higher levels of Hct compared to controls. Whether this is a modifiable risk factor remains to be assessed through larger prospective cohorts.
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Wang X, Li W, Xiang M. Increased serum methylmalonic acid levels were associated with the presence of cardiovascular diseases. Front Cardiovasc Med 2022; 9:966543. [PMID: 36299874 PMCID: PMC9588910 DOI: 10.3389/fcvm.2022.966543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Functional vitamin B12 deficiency is common in cardiovascular diseases (CVDs), such as heart failure and myocardial infarction. Methylmalonic acid (MMA) is a specific and sensitive marker of vitamin B12 deficiency. However, there are scarce data in regard to the relationship between MMA and CVDs. Materials and methods In this cross-sectional study, we analyzed data of 5,313 adult participants of the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Associations between MMA and other variables were assessed with linear regression models. Univariable and multivariable logistic regression models were employed to explore the association between MMA and CVDs. Results The weighted prevalence of CVDs was 8.8% in the general population of the USA. Higher MMA levels were found in participants with CVDs (p < 0.001). Linear regression models revealed positive associations between serum MMA level and age (p < 0.001), glycohemoglobin (p = 0.023), fasting glucose (p = 0.044), mean cell volume (p = 0.038), and hypertension (p = 0.003). In the multivariable logistic model adjusting for age, gender, ethnicity, smoking, hypertension, glycohemoglobin, body mass index (BMI), low-density lipoprotein-cholesterol (LDL-C), renal dysfunction and vitamin B12, serum MMA (adjusted odds ratio, 3.08; 95% confidence interval: 1.63-5.81, p = 0.002, per ln nmol/L increment) was associated with CVDs. Conclusion Our study demonstrated that elevated serum MMA levels were independently associated with the presence of CVDs and may be used to predict the occurrence of CVDs.
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Association between Intake of Total Dairy and Individual Dairy Foods and Markers of Folate, Vitamin B 6 and Vitamin B 12 Status in the U.S. Population. Nutrients 2022; 14:nu14122441. [PMID: 35745171 PMCID: PMC9229507 DOI: 10.3390/nu14122441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 02/05/2023] Open
Abstract
Vitamin B6, B12 and folate are required for energy metabolism and have been identified as nutrients of concern for certain population groups. This study examined the cross-sectional association between the consumption of dairy (total dairy, milk, yogurt and cheese) and biomarkers and adequacy for these nutrients in a nationally representative sample. Twenty-four-hour dietary recall data and concentrations of RBC folate (ng/mL), serum folate (ng/mL), and serum vitamins B6 (nmol/L) and B12 (pg/mL) were obtained from the National Health and Nutrition Examination Survey 2001−2018 (n = 72,831) and were analyzed by linear and logistic regression after adjusting for demographic variables. Significance was set at p < 0.01. Mean intakes of total dairy were 2.21, 2.17, 1.83 and 1.51 cups eq among consumers aged 2−8, 9−18, 19−50 and 51+ years, respectively. Higher intakes of total dairy as well as individual dairy foods (especially milk and yogurt) were positively associated with serum and RBC folate, serum vitamin B6 and serum B12, and generally, with 9−57% lower risk of inadequate or deficient levels of these vitamins. These findings suggest that encouraging dairy consumption may be an effective strategy for improving micronutrient status and provide continued evidence to support the current dietary recommendations for dairy and dairy products.
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Abstract
Chronic Kidney Disease (CKD) is an emerging public health issue with a fast-growing global prevalence. Impairment in vitamin B12 metabolism is considered a nontraditional risk factor of poor outcomes associated with CKD, and there is greater interest from the scientific community than ever before to explore the role and influence of vitamin B12 in CKD. Homocysteine metabolism forms an important component of the vitamin B12 metabolic pathway. Hyperhomocysteinemia is frequently observed in CKD and End-Stage Kidney Disease (ESKD), but its representation as a prognostic marker for CKD outcomes is still not fully clear. This chapter reviews the vitamin B12 and homocysteine metabolic pathways and their dysfunction in CKD states. Biochemical factors and the MTHFR genetic polymorphisms which disrupt vitamin B12 and homocysteine metabolism are explored. The mechanisms of homocysteine-mediated and vitamin B12-mediated tissue damage in CKD are discussed. This chapter reviews current perspective on definition and measurement of plasma vitamin B12 levels in the CKD population. Updated evidence investigating the prognostic role of vitamin B12 for CKD outcomes is presented. Findings from major clinical trials conducted relating to outcomes from multivitamin (including folic acid and vitamin B12) supplementation in nondialysis and dialysis-dependent CKD are highlighted. The prognostic value of vitamin B12 and effects of vitamin B12 supplementation in the context of kidney transplantation and acute kidney injury is also reviewed. Future research considerations are summarized based on evidence gaps in our knowledge base of this topic. Greater abundance of high-level evidence to guide an approach toward vitamin B12 measurement, monitoring and supplementation in CKD may contribute to improved clinical outcomes.
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Affiliation(s)
- Henry H L Wu
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom; Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom.
| | - Angela Yee-Moon Wang
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong, China
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Ashok T, Puttam H, Tarnate VCA, Jhaveri S, Avanthika C, Trejo Treviño AG, Sl S, Ahmed NT. Role of Vitamin B12 and Folate in Metabolic Syndrome. Cureus 2021; 13:e18521. [PMID: 34754676 PMCID: PMC8569690 DOI: 10.7759/cureus.18521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 12/11/2022] Open
Abstract
Metabolic syndrome (MS) is a collection of pathological metabolic conditions that includes insulin resistance, central or abdominal obesity, dyslipidemia, and hypertension. It affects large populations worldwide, and its prevalence is rising exponentially. There is no specific mechanism that leads to the development of MS. Proposed hypotheses range from visceral adiposity being a key factor to an increase in very-low-density lipoprotein and fatty acid synthesis as the primary cause of MS. Numerous pharmaceutical therapies are widely available in the market for the treatment of the individual components of MS. The relationship between MS and vitamin B complex supplementation, specifically folic acid and vitamin B12, has been a subject of investigation worldwide, with several trials reporting a positive impact with vitamin supplementation on MS. In this study, an all-language literature search was conducted on Medline, Cochrane, Embase, and Google Scholar till September 2021. The following search strings and Medical Subject Headings (MeSH) terms were used: “Vitamin B12,” “Folate,” “Metabolic Syndrome,” and “Insulin Resistance.” We explored the literature on MS for its epidemiology, pathophysiology, newer treatment options, with a special focus on the effectiveness of supplementation with vitamins B9 and B12. According to the literature, vitamin B12 and folate supplementation, along with a host of novel therapies, has a considerable positive impact on MS. These findings must be kept in mind while designing newer treatment protocols in the future.
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Affiliation(s)
- Tejaswini Ashok
- Internal Medicine, Jagadguru Sri Shivarathreeshwara Medical College, Mysore, IND
| | - Harivarsha Puttam
- Internal Medicine, Employees' State Insurance Corporation Medical College and Hospital, Hyderabad, IND
| | | | - Sharan Jhaveri
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Chaithanya Avanthika
- Medicine and Surgery, Karnataka Institute of Medical Sciences, Hubli, IND.,Pediatrics, Karnataka Institute of Medical Sciences, Hubli, IND
| | | | - Sandeep Sl
- Internal Medicine, SRM Medical College Hospital & Research Centre, Kattankulathur, IND
| | - Nazia T Ahmed
- Medicine, Shahabuddin Medical College and Hospital, Dhaka, BGD
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Wang S, Liu Y, Liu J, Tian W, Zhang X, Cai H, Fang S, Yu B. Mitochondria-derived methylmalonic acid, a surrogate biomarker of mitochondrial dysfunction and oxidative stress, predicts all-cause and cardiovascular mortality in the general population. Redox Biol 2020; 37:101741. [PMID: 33035815 PMCID: PMC7554255 DOI: 10.1016/j.redox.2020.101741] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/20/2020] [Accepted: 09/24/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Inherited methylmalonic acidemia is characterized by mitochondrial dysfunction, oxidative stress, and damage of mitochondria-rich organs in children. It is unclear whether methylmalonic acid (MMA) is related to poor prognosis in adults. The study aims to investigate the associations of MMA with all-cause and cause-specific mortality in the general population. METHODS Overall, 23,437 adults from the US National Health and Nutrition Examination Survey (NHANES) were enrolled. NHANES 1999-2004 and 2011-2014 were separately used as primary and validation subsets (median follow-up 13.5 and 2.8 years, respectively). Circulating MMA was measured with gas chromatography/mass spectrophotometry. Hazard ratios (HR) were estimated using weighted Cox regression models. RESULTS During 163,632 person-years of follow-up in NHANES 1999-2004, 3019 deaths occurred. Compared with participants with MMA <120 nmol/L, those with MMA≥250 nmol/L had increased all-cause and cardiovascular mortality in the multivariable-adjusted model [HR(95%CI), 1.62 (1.43-1.84) and 1.66 (1.22-2.27), respectively]. The association was especially significant among participants with normal cobalamin. MMA remained an independent predictor of all-cause mortality occurring whether within 5-year, 5-10 years, or beyond 10-year of follow-up (each p for trend≤0.007). That association was repeatable in NHANES 2011-2014. Moreover, baseline MMA improved reclassification for 10-year mortality in patients with cardiovascular disease (net reclassification index 0.239, integrated discrimination improvement 0.022), overmatched established cardiovascular biomarkers C-reactive protein or homocysteine. CONCLUSIONS Circulating level of mitochondrial-derived MMA is strongly associated with elevated all-cause and cardiovascular mortality. Our results support MMA as a surrogate biomarker of mitochondrial dysfunction to predict poor prognosis in adults. The biological mechanisms under cardiovascular disease warrant further investigation.
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Affiliation(s)
- Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Yige Liu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Jinxin Liu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Wei Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Xiaoyuan Zhang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Hengxuan Cai
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Shaohong Fang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
| | - Bo Yu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
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Swanepoel AC, Bester J, Emmerson O, Soma P, Beukes D, van Reenen M, Loots DT, du Preez I. Serum Metabolome Changes in Relation to Prothrombotic State Induced by Combined Oral Contraceptives with Drospirenone and Ethinylestradiol. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2020; 24:404-414. [PMID: 32471328 DOI: 10.1089/omi.2020.0009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The association between hypercoagulability and use of drospirenone (DRSP) and ethinylestradiol (EE) containing combined oral contraceptives (COCs) is an important clinical concern. We have previously reported that the two formulations of DRSP combined with EE (namely, DRSP/20EE and DRSP/30EE) bring about a prothrombotic state in hemostatic traits of female users. We report here the serum metabolomic changes in the same study cohort in relation to the attendant prothrombotic state induced by COC use, thus offering new insights on the underlying biochemical mechanisms contributing to the altered coagulatory profile with COC use. A total of 78 healthy women participated in this study and were grouped as follows: control group not using oral contraceptives (n = 25), DRSP/20EE group (n = 27), and DRSP/30EE group (n = 26). Untargeted metabolomics revealed changes in amino acid concentrations, particularly a decrease in glycine and an increase in both cysteine and lanthionine in the serum, accompanied by variations in oxidative stress markers in the COC users compared with the controls. Of importance, this study is the first to link specific amino acid variations, serum metabolites, and the oxidative metabolic profile with DRSP/EE use. These molecular changes could be linked to specific biophysical coagulatory alterations observed in the same individuals. These new findings lend evidence on the metabolomic substrates of the prothrombotic state associated with COC use in women and informs future personalized/precision medicine research. Moreover, we underscore the importance of an interdisciplinary approach to evaluate venous thrombotic risk associated with COC use.
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Affiliation(s)
- Albe Carina Swanepoel
- Department of Physiology and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Janette Bester
- Department of Physiology and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Odette Emmerson
- Department of Physiology and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Prashilla Soma
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Derylize Beukes
- Human Metabolomics, North-West University, Potchefstroom, South Africa
| | - Mari van Reenen
- Human Metabolomics, North-West University, Potchefstroom, South Africa
| | - Du Toit Loots
- Human Metabolomics, North-West University, Potchefstroom, South Africa
| | - Ilse du Preez
- Human Metabolomics, North-West University, Potchefstroom, South Africa
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Calderón-Larrañaga A, Saadeh M, Hooshmand B, Refsum H, Smith AD, Marengoni A, Vetrano DL. Association of Homocysteine, Methionine, and MTHFR 677C>T Polymorphism With Rate of Cardiovascular Multimorbidity Development in Older Adults in Sweden. JAMA Netw Open 2020; 3:e205316. [PMID: 32432712 PMCID: PMC7240355 DOI: 10.1001/jamanetworkopen.2020.5316] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Strong evidence links high total serum homocysteine (tHcy) and low methionine (Met) levels with higher risk of ischemic disease, but other cardiovascular (CV) diseases may also be associated with their pleiotropic effects. OBJECTIVES To investigate the association of serum concentrations of tHcy and Met with the rate of CV multimorbidity development in older adults and to explore the role of methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism in this association. DESIGN, SETTING, AND PARTICIPANTS The Swedish National Study on Aging and Care in Kungsholmen is a cohort study of randomly selected individuals aged 60 years or older. The present study included data on 1969 individuals with complete information and without CV diseases at baseline, collected from the baseline examination (2001-2004) to the fourth follow-up (2013-2016). Data analysis was conducted from January to May 2019. EXPOSURES Concentrations of tHcy and Met were measured from nonfasting venous blood samples. The Met:tHcy ratio was considered a possible indicator of methylation activity. MTHFR status was dichotomized as any T carriers vs noncarriers. MAIN OUTCOME AND MEASURES The number of CV diseases at each wave was ascertained based on medical interviews and records, laboratory test results, and drug data. Linear mixed models were used to study the association of baseline tHcy and Met levels and the rate of CV multimorbidity development, adjusting for sociodemographic characteristics, CV risk factors, chronic disease burden, and drug use. RESULTS Of 1969 participants, most were women (1261 [64.0%]), with a mean (SD) age of 70.9 (9.8) years; 1703 participants (86.6%) had at least a high school level of education. Baseline measurements of serum tHcy, Met, and the Met:tHcy ratio were associated with the rate of CV disease accumulation (tHcy: β = 0.023 per year; 95% CI, 0.015 to 0.030; P < .001; Met: β = -0.007 per year; 95% CI, -0.013 to -0.001; P = .02; Met:tHcy ratio: β = -0.017 per year; 95% CI, -0.023 to -0.011; P < .001). The association between low Met concentrations and the rate of CV multimorbidity development was restricted to the group with CT/TT alleles of MTHFR (β = 0.023 per year; 95% CI, 0.006 to 0.041; P = .009). Results remained largely significant when individual CV diseases were removed from the total count 1 at a time (eg, ischemic heart disease, tHcy: β = 0.023 per year; 95% CI, 0.013 to 0.027; P < .001; Met: β = -0.006 per year; 95% CI, -0.011 to -0.0003; P = .04; Met:tHcy ratio: β = -0.015 per year; 95% CI, -0.020 to -0.009; P < .001). CONCLUSIONS AND RELEVANCE In this study, high tHcy and low Met levels were associated with faster CV multimorbidity development in older age. The interactive association of Met concentrations and MTHFR polymorphism, together with the association found for the Met:tHcy ratio, point toward the relevance of impaired methylation in the pathogenesis of CV aging.
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Affiliation(s)
- Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Marguerita Saadeh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Babak Hooshmand
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Department of Neurology, Ulm University Hospital, Ulm, Germany
| | - Helga Refsum
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - A. David Smith
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Alessandra Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Davide L. Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Department of Geriatrics, Fondazione Policlinico “A. Gemelli” IRCCS and Catholic University of Rome, Rome, Italy
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20
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Du X, Xiao L, Sun R, Li K, Liang L, Song L, Liu Z. A prospective cohort study of MTHFR C677T gene polymorphism and its influence on the therapeutic effect of homocysteine in stroke patients with hyperhomocysteinemia. BMC Neurol 2020; 20:128. [PMID: 32278343 PMCID: PMC7149884 DOI: 10.1186/s12883-020-01701-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 03/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hyperhomocysteinemia (HHCY) is a risk factor for cardiovascular and cerebrovascular diseases. The C677T 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism increases homocysteine (HCY) levels. This study analyzed the relationship between C677T MTHFR polymorphism and the therapeutic effect of lowering HCY in stroke patients with HHCY. METHODS Baseline data were collected from stroke patients with HHCY for this prospective cohort study. The C677T MTHFR genotype was detected by polymerase chain reaction-restriction fragment length polymorphism and the therapeutic effect to reduce HCY was compared. RESULTS Of 200 stroke patients 162 (81.0%) completed follow-up and were evaluated. Most of them responded well to treatment (103 cases, 63.5%), but 59 (36.4%) patients were in the poor efficacy group. There was a significant difference in terms of age (P < 0.001), hypertension (P = 0.041), hyperuricemia (P = 0.042), HCY after treatment (P < 0.001), and MTHFR genotype (P < 0.001) between the poor efficacy and effective groups, with increased frequency of the TT genotype in the poor efficacy group. Logistic regression showed that the T allele was associated with poor efficacy (OR = 0.733, 95%CI: 0.693, 0.862, P < 0.001). In the codominant model the TT genotype was associated with poor outcome (OR = 0.862, 95%CI: 0.767, 0.970, P = 0.017) and this was also the case in the recessive model (OR = 0.585, 95%CI: 0.462, 0.741, P < 0.001) but there was no association between CT and TT in the dominant model. CONCLUSIONS The T allele and TT genotype of the MTHFR C677T polymorphism was associated with poor HCY reduction treatment efficacy in stroke patients with HHCY. TRIAL REGISTRATION The registration number of the clinical trial is ChiCTR1800020048. Registration date: December 12, 2018.
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Affiliation(s)
- Xiaoxia Du
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China.
| | - Lin Xiao
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Rong Sun
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Kunpeng Li
- Case Statistics Office, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Lin Liang
- Department of Clinical Laboratory, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Luping Song
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Zhizhong Liu
- Department of Clinical Laboratory, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China.
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Hooshmand B, Refsum H, Smith AD, Kalpouzos G, Mangialasche F, von Arnim CAF, Kåreholt I, Kivipelto M, Fratiglioni L. Association of Methionine to Homocysteine Status With Brain Magnetic Resonance Imaging Measures and Risk of Dementia. JAMA Psychiatry 2019; 76:1198-1205. [PMID: 31339527 PMCID: PMC6659152 DOI: 10.1001/jamapsychiatry.2019.1694] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Impairment of methylation status (ie, methionine to homocysteine ratio) may be a modifiable risk factor for structural brain changes and incident dementia. OBJECTIVE To investigate the association of serum markers of methylation status and sulfur amino acids with risk of incident dementia, Alzheimer disease (AD), and the rate of total brain tissue volume loss during 6 years. DESIGN, SETTING, AND PARTICIPANTS This population-based longitudinal study was performed from March 21, 2001, to October 10, 2010, in a sample of 2570 individuals aged 60 to 102 years from the Swedish Study on Aging and Care in Kungsholmen who were dementia free at baseline and underwent comprehensive examinations and structural brain magnetic resonance imaging (MRI) on 2 to 3 occasions during 6 years. Data analysis was performed from March 1, 2018, to October 1, 2018. MAIN OUTCOMES AND MEASURES Incident dementia, AD, and the rate of total brain volume loss. RESULTS This study included 2570 individuals (mean [SD] age, 73.1 [10.4] years; 1331 [56.5%] female). The methionine to homocysteine ratio was higher in individuals who consumed vitamin supplements (median, 1.9; interquartile range [IQR], 1.5-2.6) compared with those who did not (median, 1.8; IQR, 1.3-2.3; P < .001) and increased per each quartile increase of vitamin B12 or folate. In the multiadjusted model, an elevated baseline serum total homocysteine level was associated with an increased risk of dementia and AD during 6 years: for the highest homocysteine quartile compared with the lowest, the hazard ratios (HRs) were 1.60 (95% CI, 1.01-2.55) for dementia and 2.33 (95% CI, 1.26-4.30) for AD. In contrast, elevated concentrations of methionine were associated with a decreased risk of dementia (HR, 0.54; 95% CI, 0.36-0.81) for the highest quartile compared with the lowest. Higher values of the methionine to homocysteine ratio were significantly associated with lower risk of dementia and AD: for the fourth methionine-homocysteine quartile compared with the first quartile, the HR was 0.44 (95% CI, 0.27-0.71) for incident dementia and 0.43 (95% CI, 0.23-0.80) for AD. In the multiadjusted linear mixed models, a higher methionine to homocysteine ratio was associated with a decreased rate of total brain tissue volume loss during the study period (β [SE] per 1-SD increase, 0.038 [0.014]; P = .007). CONCLUSIONS AND RELEVANCE The methionine to homocysteine status was associated with dementia development and structural brain changes during the 6-year study period, suggesting that a higher methionine to homocysteine ratio may be important in reducing the rate of brain atrophy and decreasing the risk of dementia in older adults.
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Affiliation(s)
- Babak Hooshmand
- Aging Research Center, Karolinska Institute, Stockholm, Sweden,Department of Neurology, Ulm University Hospital, Ulm, Germany
| | - Helga Refsum
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,Institute of Nutrition, University of Oslo, Oslo, Norway
| | - A. David Smith
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden,Theme Aging, Karolinska University Hospital, Stockholm, Sweden,Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom,Department of Neurology, University of Eastern Finland, Kuopio, Finland
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Park HS, Kim JO, An HJ, Ryu CS, Ko EJ, Kim YR, Ahn EH, Lee WS, Kim JH, Kim NK. Genetic polymorphisms of the cobalamin transport system are associated with idiopathic recurrent implantation failure. J Assist Reprod Genet 2019; 36:1513-1522. [PMID: 31123954 DOI: 10.1007/s10815-019-01455-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Vitamin B12 (cobalamin, Cbl) plays a role in the recycling of folate, which is important in pregnancy. Transcobalamin II (TCN2) and transcobalamin receptor (TCblR) proteins are involved in the cellular uptake of Cbl. TCN2 binds Cbl in the plasma, and TCblR binds TCN2-Cbl at the cell surface. Therefore, we investigated the potential association between polymorphisms in Cbl transport proteins, TCN2 and TCblR, and recurrent implantation failure (RIF) susceptibility. METHODS The genotypes of TCN2 67A>G, TCN2 776C>G, and TCblR 1104C>T were determined for RIF patients and healthy controls using a polymerase chain reaction restriction fragment length polymorphism assay. Additionally, statistical analysis was performed to compare the genotype frequencies between RIF patients and controls. RESULTS The TCN2 67 polymorphism AG type was associated with RIF risk. Some allele combinations that contained the TCN2 67 polymorphism G allele were associated with increased RIF risk, whereas other allele combinations that contained the TCblR 1104 polymorphism T alleles were associated with decreased RIF risk. In genotype combination analysis, two combinations containing the TCN2 67 polymorphism AG type were associated with RIF risk. CONCLUSION Our study showed that the polymorphisms of TCN2 and TCblR are associated with RIF and are potential genetic predisposing factors for RIF among Korean women. Additionally, our findings support a potential role for TCN2 and TCblR in RIF among Korean women. However, further studies are required to investigate the role of the polymorphisms in those proteins and RIF because the roles of the TCN2 and TCblR polymorphisms in RIF are not clear.
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Affiliation(s)
- Han Sung Park
- Department of Biomedical Science, College of Life Science, CHA University, 355, Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Jung Oh Kim
- Department of Biomedical Science, College of Life Science, CHA University, 355, Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Hui Jeong An
- Department of Biomedical Science, College of Life Science, CHA University, 355, Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Chang Soo Ryu
- Department of Biomedical Science, College of Life Science, CHA University, 355, Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Eun Ju Ko
- Department of Biomedical Science, College of Life Science, CHA University, 355, Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Young Ran Kim
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, 11, Yatap-ro 65beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea
| | - Eun Hee Ahn
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, 11, Yatap-ro 65beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea
| | - Woo Sik Lee
- Fertility Center of CHA Gangnam Medical Center, CHA University, 566, Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Republic of Korea
| | - Ji Hyang Kim
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, 11, Yatap-ro 65beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea.
| | - Nam Keun Kim
- Department of Biomedical Science, College of Life Science, CHA University, 355, Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea.
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23
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Carral-Santander IE, Santos-Palacios A, Martínez-Baez BE, Cernichiaro-Espinosa L, Elizondo-Camacho JM, Valdés-Lara CA, Morales-Cantón V, Velez-Montoya R. Secondary hyperhomocysteinemia-related occlusive retinal vasculopathy: A case report. Am J Ophthalmol Case Rep 2019; 13:41-45. [PMID: 30511034 PMCID: PMC6258140 DOI: 10.1016/j.ajoc.2018.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 07/15/2018] [Accepted: 11/07/2018] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To report a case of occlusive retinal vasculopathy, secondary to hyperhomocysteinemia. OBSERVATIONS A 43-year-old male was examined at the retina outpatient clinic due to complaints of bilateral decrease in visual acuity. The patient underwent a comprehensive ophthalmological examination, wide-field fundus photographs and fluorescein angiography, as well as spectral domain optical coherence tomography with enhanced-deep imaging. The patient had a significant medical history of chronic kidney disease and progressive bilateral vision loss over the last two years, which worsened in the left eye during the past 3 months. Fundus examination revealed a vitreous hemorrhage in the left eye and bilateral proliferative retinopathy. Blood glucose and systemic blood pressure were unremarkable. Plasma homocysteine was reported at >500 μmol/L, which is higher than the corrected reference range by age. CONCLUSION AND IMPORTANCE Hyperhomocysteinemia is a rare but well-known disease, capable of accelerating atherosclerotic disease and generating a prothrombotic state that can lead to multiple systemic complications. Despite its low incidence, the disease should be part of the differential diagnosis in patients with bilateral proliferative retinopathy, in the absence of diabetes mellitus and systemic hypertension.
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Affiliation(s)
| | | | | | - Linda Cernichiaro-Espinosa
- Retina Department, Asociación para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes” IAP, Mexico City, Mexico
| | - Juan Manuel Elizondo-Camacho
- Retina Department, Asociación para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes” IAP, Mexico City, Mexico
| | - Carlos Andrés Valdés-Lara
- Retina Department, Asociación para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes” IAP, Mexico City, Mexico
| | - Virgilio Morales-Cantón
- Retina Department, Asociación para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes” IAP, Mexico City, Mexico
| | - Raul Velez-Montoya
- Retina Department, Asociación para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes” IAP, Mexico City, Mexico
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Dhar I, Svingen GFT, Pedersen ER, DeRatt B, Ulvik A, Strand E, Ueland PM, Bønaa KH, Gregory JF, Nygård OK. Plasma cystathionine and risk of acute myocardial infarction among patients with coronary heart disease: Results from two independent cohorts. Int J Cardiol 2018; 266:24-30. [PMID: 29728335 DOI: 10.1016/j.ijcard.2018.04.083] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/06/2018] [Accepted: 04/18/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cystathionine is a thio-ether and a metabolite formed from homocysteine during transsulfuration. Elevated plasma cystathionine levels are reported in patients with cardiovascular disease; however prospective relationships with acute myocardial infarction (AMI) are unknown. We investigated associations between plasma cystathionine and AMI among patients with suspected and/or verified coronary heart disease (CHD). METHODS Subjects from two independent cohort studies, the Western Norway Coronary Angiography Cohort (WECAC) (3033 patients with stable angina pectoris; 263 events within 4.8 years of median follow-up) and the Norwegian Vitamin Trial (NORVIT) (3670 patients with AMI; 683 events within 3.2 years of median follow-up) were included. RESULTS In both cohorts, plasma cystathionine was associated with several traditional CHD risk factors (P < 0.001). Comparing the cystathionine quartile 4 to 1, age and gender adjusted hazard ratios (95% confidence intervals) for AMI were 2.08 (1.43-3.03) and 1.41 (1.12-1.76) in WECAC and NORVIT, respectively. Additional adjustment for traditional risk factors slightly attenuated the risk estimates, which were generally stronger in both cohorts among non-smokers, patients with higher age, and lower BMI or PLP status (P-interaction ≤ 0.04). Risk associations also tended to be stronger in patients not treated with B-vitamins. Additionally, in a subset of 80 WECAC patients, plasma cystathionine associated strongly negatively with glutathione, an important antioxidant and positively with lanthionine, a marker of H2S production (P < 0.001). CONCLUSIONS Plasma cystathionine is associated with increased risk of AMI among patients with either suspected or verified coronary heart disease, and is possibly related to altered redox homeostasis.
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Affiliation(s)
- Indu Dhar
- Department of Clinical Science, University of Bergen, Bergen, Norway; KG Jebsen Centre for Diabetes Research, University of Bergen, Bergen, Norway.
| | - Gard F T Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva R Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Barbara DeRatt
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL
| | | | - Elin Strand
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Per M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway; Bevital AS, Bergen, Norway
| | - Kaare H Bønaa
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jesse F Gregory
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL
| | - Ottar K Nygård
- Department of Clinical Science, University of Bergen, Bergen, Norway; KG Jebsen Centre for Diabetes Research, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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25
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Plasma methionine and risk of acute myocardial infarction: Effect modification by established risk factors. Atherosclerosis 2018; 272:175-181. [PMID: 29621698 DOI: 10.1016/j.atherosclerosis.2018.03.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/14/2018] [Accepted: 03/22/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Methionine (Met) is an essential amino acid involved in methylation reactions and lipid metabolism. A Met-deficient diet may cause hepatic lipid accumulation, which is considered an independent risk factor for atherosclerosis. However, the prospective relationship between circulating Met and incident acute myocardial infarction (AMI) is unknown. METHODS We studied the associations of plasma Met and incident AMI in 4156 patients (77% men; median age 62 years) with stable angina pectoris, among whom the majority received lipid lowering therapy with statins. Risk associations were estimated using Cox-regression analyses. RESULTS Plasma Met was negatively related to age, serum levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and apolipoprotein (apo) B at baseline (all p≤0.05). During a median follow-up of 7.5 years, 534 (12.8%) patients experienced an AMI. There was no overall association between plasma Met and incident AMI; however, plasma Met was inversely associated with risk among patients with high as compared to low levels of serum LDL-C or apo B 100 (multivariate adjusted HRs per SD [95% CI] 0.84 [0.73-0.96] and 0.83[0.73-0.95], respectively; p-interaction ≤0.02). Trends towards an inverse risk relationship were also observed among those younger than 62 years and patients without diabetes or hypertension. CONCLUSIONS Low plasma Met was associated with increased risk of AMI in patients with high circulating levels of atherogenic lipids, but also in subgroups with presumably lower cardiovascular risk. The determinants of Met status and their relation with residual cardiovascular risk in patients with coronary heart disease should be further investigated.
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26
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Chen CYJ, Yang TC, Chang C, Lu SC, Chang PY. Homocysteine is a bystander for ST-segment elevation myocardial infarction: a case-control study. BMC Cardiovasc Disord 2018; 18:33. [PMID: 29433446 PMCID: PMC5809814 DOI: 10.1186/s12872-018-0774-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 02/07/2018] [Indexed: 11/25/2022] Open
Abstract
Background Homocysteine has been long considered a risk factor for atherosclerosis. However, cardiovascular events cannot be reduced through homocysteine lowering by B vitamin supplements. Although several association studies have reported an elevation of serum homocysteine levels in cardiovascular diseases, the relationship of homocysteine with ST-segment elevation myocardial infarction (STEMI) is not well established. Methods We prospectively enrolled STEMI patients who were consecutively admitted to an intensive care unit following coronary intervention in a single medical center in Taiwan. Control subjects were individuals who presented to the outpatient or emergency department with acute chest pain but subsequently revealed patent coronary arteries by coronary arteriography. The association between serum homocysteine levels and STEMI was investigated. A culture system using human coronary artery endothelial cells was also established to examine the toxic effects of homocysteine at the cellular level. Results Patients with chest pain were divided into two groups. The STEMI group included 56 patients who underwent a primary percutaneous coronary intervention. The control group included 17 subjects with patent coronary arteries. There was no difference in serum homocysteine levels (8.4 ± 2.2 vs. 7.6 ± 1.9 μmol/L, p = 0.142). When stratifying STEMI patients by the Killip classification into higher (Killip III-IV) and lower (Killip I-II) grades, CRP (3.3 ± 4.1 vs. 1.4 ± 2.3 mg/L, p = 0.032), peak creatine kinase (3796 ± 2163 vs. 2305 ± 1822 IU/L, p = 0.023), and SYNTAX scores (20.4 ± 11.1 vs. 14.8 ± 7.6, p = 0.033) were significantly higher in the higher grades, while serum homocysteine levels were similar. Homocysteine was not correlated with WBCs, CRP, or the SYNTAX score in STEMI patients. In a culture system, homocysteine at even a supraphysiological level of 100 μmol/L did not reduce the cell viability of human coronary artery endothelial cells. Conclusions Homocysteine was not elevated in STEMI patients regardless of Killip severity, suggesting that homocysteine is a bystander instead of a causative factor of STEMI. Our study therefore supports the current notion that homocysteine-lowering strategies are not essential in preventing cardiovascular disease.
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Affiliation(s)
- Ching-Yu Julius Chen
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, 100, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine, No.1, Ren-Ai Road Section 1, 100, Taipei, Taiwan
| | - Tzu-Ching Yang
- Department of Biochemistry and Molecular Biology, National Taiwan University College of Medicine, No.1, Ren-Ai Road Section 1, 100, Taipei, Taiwan
| | - Christopher Chang
- Taipei American School, 800 Chung Shan North Road Section 6, Taipei, 11152, Taiwan
| | - Shao-Chun Lu
- Department of Biochemistry and Molecular Biology, National Taiwan University College of Medicine, No.1, Ren-Ai Road Section 1, 100, Taipei, Taiwan
| | - Po-Yuan Chang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, 100, Taipei, Taiwan. .,Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine, No.1, Ren-Ai Road Section 1, 100, Taipei, Taiwan.
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Niro A, Sborgia G, Sborgia A, Alessio G. Hyperhomocysteinemia in bilateral anterior ischemic optic neuropathy after conventional coronary artery bypass graft: a case report. J Med Case Rep 2018; 12:11. [PMID: 29338755 PMCID: PMC5771151 DOI: 10.1186/s13256-017-1539-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 12/07/2017] [Indexed: 11/30/2022] Open
Abstract
Background The incidence of anterior ischemic optic neuropathy after coronary artery bypass graft procedures ranges from 1.3 to 0.25%. The mechanisms of anterior ischemic optic neuropathy after cardiovascular procedures remain undefined but many systemic and related-to-surgery risk factors could underlie anterior ischemic optic neuropathy. In this case, we report a rare presentation of a bilateral anterior ischemic optic neuropathy after coronary artery bypass graft and speculate on the preoperative hyperhomocysteinemia as an independent risk factor for anterior ischemic optic neuropathy. Case presentation A 56-year-old white man, a tobacco smoker with type 2 diabetes and coronary artery disease, underwent a conventional coronary artery bypass graft with extracorporeal circulation. In spite of ongoing anti-aggregation, antithrombotic, and vasodilator therapy, 10 days after the surgery he complained of severe bilateral visual loss. Funduscopy and fluorescein angiography revealed a bilateral anterior ischemic optic neuropathy. Analysis of preoperative laboratory tests revealed hyperhomocysteinemia. Conclusion Hyperhomocysteinemia could increase the risk of ocular vascular damage and bilateral ocular involvement in patients who have undergone conventional coronary artery bypass graft.
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Affiliation(s)
- A Niro
- Department of Medical Sciences, Neuroscience and Sense Organs,, University of Bari "A. Moro", Eye Clinic, Piazza G. Cesare, 11, 70124, Bari, Italy. .,Clinica Oculistica Azienda Ospedaliero-Universitaria Policlinico Bari, Piazza G. Cesare,11, 70124, Bari, Italy.
| | - G Sborgia
- Department of Medical Sciences, Neuroscience and Sense Organs,, University of Bari "A. Moro", Eye Clinic, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - A Sborgia
- Department of Medical Sciences, Neuroscience and Sense Organs,, University of Bari "A. Moro", Eye Clinic, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - G Alessio
- Department of Medical Sciences, Neuroscience and Sense Organs,, University of Bari "A. Moro", Eye Clinic, Piazza G. Cesare, 11, 70124, Bari, Italy
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Ala OA, Akintunde AA, Ikem RT, Kolawole BA, Ala OO, Adedeji TA. Association between insulin resistance and total plasma homocysteine levels in type 2 diabetes mellitus patients in south west Nigeria. Diabetes Metab Syndr 2017; 11 Suppl 2:S803-S809. [PMID: 28610915 DOI: 10.1016/j.dsx.2017.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/05/2017] [Indexed: 11/19/2022]
Abstract
AIM To determine the levels of serum homocysteine and its association with insulin resistance among T2DM patients at Obafemi Awolowo University Teaching Hospital, Ile Ife Nigeria. METHODS It was a cross sectional study. It involved consecutive recruitment of 100 T2DM subjects with 100 age and sex matched controls. The fasting plasma glucose, serum creatinine, fasting lipid profile, glycosylated haemoglobin levels, fasting serum insulin and plasma homocysteine concentration were done. Insulin resistance was also determined. SPSS version 17.0 was used for data analysis. RESULTS The mean age of subjects was not significantly different from controls. (58.9±8.3 vs. 59.0±8.3years, p=0.926 respectively). Mean Homocysteine level (tHcy) was significantly higher among T2DM subjects compared to controls (27.4±12.1 and 8.3±3.2μmol/L respectively, p=0.0001). Hyperhomocystinaemia was commoner among diabetic subjects compared with controls (81% vs. 5%, p<0.0001). T2DM with hyperhomocystinaemia were more likely to have poorer glucose control profile using glycated haemoglobin (7.4±1.9 vs 6.4±1.4%, p=0.04) and fasting blood glucose 8.6±2.2 vs 7.5±2.4mmol/L p=0.047 and insulin resistance (4.4±4.3 vs. 2.0±0.6, p=0.02) compared with T2DM with normohomocystenaemia. There were significant associations between hyperhomocystinaemic T2DM patients and IR, HbA1c, TC, TG and LDL cholesterol. CONCLUSION The study showed higher homocysteine levels in T2DM than controls. Homocysteine level is worsened by increasing insulin resistance, dyslipidaemia and poor glucose control. Homocysteine level is a potential cardiovascular risk marker in type 2 diabetic mellitus subjects.
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Affiliation(s)
- Oluwabukola A Ala
- Department of Medicine, Bowen University/Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria; Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria.
| | - Adeseye A Akintunde
- Department of Medicine, Bowen University/Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria; Department of Medicine, Ladoke Akintola University of Technology (LAUTECH)/LAUTECH Teaching Hospital, Ogbomoso, Nigeria
| | - Rosemary T Ikem
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Babatope A Kolawole
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Olufemi O Ala
- Department of Obstetrics & Gynaecology, Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo, Osun State, Nigeria
| | - T A Adedeji
- Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State, Nigeria
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DeRatt BN, Ralat MA, Lysne V, Tayyari F, Dhar I, Edison AS, Garrett TJ, Midttun Ø, Ueland PM, Nygård OK, Gregory JF. Metabolomic Evaluation of the Consequences of Plasma Cystathionine Elevation in Adults with Stable Angina Pectoris. J Nutr 2017; 147:1658-1668. [PMID: 28794210 PMCID: PMC5572496 DOI: 10.3945/jn.117.254029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/30/2017] [Accepted: 06/29/2017] [Indexed: 02/02/2023] Open
Abstract
Background: An elevated circulating cystathionine concentration, which arises in part from insufficiencies of vitamin B-6, B-12, or folate, has been shown to be associated with cardiovascular disease (CVD) risk. Hydrogen sulfide (H2S) is a gasotransmitter involved in vasodilation, neuromodulation, and inflammation. Most endogenously produced H2S is formed by pyridoxal phosphate (PLP)-dependent enzymes by noncanonical reactions of the transsulfuration pathway that yield H2S concurrently form lanthionine and homolanthionine. Thus, plasma lanthionine and homolanthionine concentrations can provide relative information about H2S production in vivo.Objective: To determine the metabolic consequences of an elevated plasma cystathionine concentration in adults with stable angina pectoris (SAP), we conducted both targeted and untargeted metabolomic analyses.Methods: We conducted NMR and LC-mass spectrometry (MS) metabolomic analyses on a subset of 80 plasma samples from the Western Norway Coronary Angiography Cohort and selected, based on plasma cystathionine concentrations, a group with high cystathionine concentrations [1.32 ± 0.60 μmol/L (mean ± SD); n = 40] and a group with low cystathionine concentrations [0.137 ± 0.011 μmol/L (mean ± SD); n = 40]. Targeted and untargeted metabolomic analyses were performed and assessed with the use of Student's t tests corrected for multiple testing. Overall differences between the cystathionine groups were assessed by untargeted NMR and LC-MS metabolomic methods and evaluated by partial least squares discriminant analysis (PLS-DA) with significant discriminating metabolites identified with 99% confidence.Results: Subjects with high cystathionine concentrations had 75% higher plasma lanthionine concentrations (0.12 ± 0.044 μmol/L) than subjects with low cystathionine concentrations [0.032 ± 0.013 μmol/L (P < 0.001)]. Although plasma homolanthionine concentrations were notably higher than lanthionine concentrations, they were not different between the groups (P = 0.47). PLS-DA results showed that a high plasma cystathionine concentration in SAP was associated with higher glucose, branched-chain amino acids, and phenylalanine concentrations, lower kidney function, and lower glutathione and plasma PLP concentrations due to greater catabolism. The high-cystathionine group had a greater proportion of subjects in the postprandial state.Conclusion: These data suggest that metabolic perturbations consistent with higher CVD risk exist in SAP patients with elevated plasma cystathionine concentrations.
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Affiliation(s)
| | | | - Vegard Lysne
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Fariba Tayyari
- Departments of Biochemistry and,Genetics, Institute of Bioinformatics, and Complex Carbohydrate Research Center, University of Georgia, Athens, GA
| | - Indu Dhar
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Arthur S Edison
- Departments of Biochemistry and,Genetics, Institute of Bioinformatics, and Complex Carbohydrate Research Center, University of Georgia, Athens, GA
| | - Timothy J Garrett
- Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL
| | | | - Per Magne Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway;,Laboratory of Clinical Biochemistry and
| | - Ottar Kjell Nygård
- Department of Clinical Science, University of Bergen, Bergen, Norway;,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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Wang H, Xu BP, Xu RB, Walker SO, Wang G. Joint effect of maternal plasma homocysteine and prepregnancy obesity on child blood pressure: a prospective birth cohort study. Int J Obes (Lond) 2017; 41:1447-1453. [PMID: 28465603 PMCID: PMC5585041 DOI: 10.1038/ijo.2017.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/06/2017] [Accepted: 04/19/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Elevated homocysteine (Hcy) is a known cardiovascular risk factor. However, its role in intergenerational cardiometabolic risk is unknown. We hypothesized that maternal elevated Hcy can act alone or in combination with maternal prepregnancy obesity to increase child systolic blood pressure (SBP). METHODS This study included 1279 mother-child pairs who were enrolled at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Child SBP percentile was calculated according to US reference data and elevated SBP was defined as SBP⩾75th percentile. RESULTS A U-shaped relationship between maternal Hcy and her child SBP was observed. The risk for child elevated SBP was higher among those in the lowest quartile (Q1, odds ratio (OR): 1.27; 95% confidence interval (CI): 0.94-1.72), and highest quartile (Q4, OR: 1.34; 95% CI: 1.00-1.81) as compared with those in quartiles 2 and 3. The highest risk of child elevated SBP was found among children born to obese mothers with Hcy in Q4 (OR: 2.22; 95%CI: 1.35-3.64), compared with children of non-obese mothers with Hcy in Q2-Q3. This association was independent from maternal folate and vitamin B12 status, and was not mediated by gestational age or size at birth. CONCLUSIONS In this prospective birth cohort, we observed a U-shaped association between maternal Hcy levels and child elevated SBP. Maternal high Hcy (Q4) and prepregnancy obesity jointly increased the risk of child elevated SBP by more than two-fold.
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Affiliation(s)
- Hongjian Wang
- Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Benjamin P. Xu
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Richard B. Xu
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sheila O. Walker
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- School of Education, Johns Hopkins University, Baltimore, MD, USA
- University of California, Irvine, Irvine, USA
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Abstract
BACKGROUND In western populations, a higher level of dietary B vitamins intake has been associated with a lower risk of hypertension. However, data in Chinese is limited, whose B vitamins consumption is low and rates of hypertension are high. AIM OF THE STUDY To investigate whether the three B vitamins are associated with hypertension in rural Chinese. METHODS Cross-sectional survey among 2241 rural Chinese aged 18-80 years was conducted in northwestern China in 2010. Blood pressure was measured by trained medical staff and dietary nutrients were assessed with a semiquantitative food frequency questionnaire. RESULTS 592 cases of hypertension were newly diagnosed. The deficiency proportions were 20.5% for vitamin B-6, 43.9% for folate and 98.5% for B-12. For females, participants in the highest quartile of B-6 intake had a significantly lower risk of hypertension (OR = 0.69; 95% CI: 0.50-0.93; p for trend <0.05). For males, the multivariable OR for the same comparison was 0.75 (95% CI: 0.56-0.99, p for trend >0.05). No significant associations were observed between B-12, folate intake and hypertension. For females, the highest quartile of both folate and B-6 intake was associated with a reduced risk of hypertension (OR = 0.53; 95% CI: 0.29-0.89), compared with in the middle quartile of both vitamins. CONCLUSIONS Higher intake of vitamin B-6 is independently associated with lower risk of hypertension in Chinese rural adults. Among females with high folate intake, the association between B-6 and hypertension was strongest. Additional studies are warrant to establish the causal inference.
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Wang H, Mueller NT, Li J, Sun N, Huo Y, Ren F, Wang X. Association of Maternal Plasma Folate and Cardiometabolic Risk Factors in Pregnancy with Elevated Blood Pressure of Offspring in Childhood. Am J Hypertens 2017; 30:532-540. [PMID: 28338750 PMCID: PMC5861539 DOI: 10.1093/ajh/hpx003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/05/2016] [Accepted: 01/17/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of childhood elevated blood pressure (BP) has increased in the United States, particularly among African Americans. The influence of maternal plasma folate levels, alone or in combination with maternal cardiometabolic risk factors (hypertensive disorders, diabetes, and prepregnancy obesity), on child systolic BP (SBP) has not been examined in a prospective birth cohort. We hypothesize that adequate maternal folate levels can reduce the risk of elevated SBP in children born to mothers with cardiometabolic risk factors. METHODS This study included 1,290 mother-child dyads (875 African Americans (67.8%)) recruited at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Child SBP percentile was calculated according to US reference data and elevated SBP was defined as SBP ≥75th percentile. RESULTS Maternal folate levels, overall, were not associated with child SBP. However, we found a significant multiplicative interaction between maternal cardiometabolic risk factors and maternal folate levels (Pinteraction = 0.015) on childhood elevated SBP. Among children born to mothers with any cardiometabolic risk factors, those whose mothers had folate levels above (vs. below) the median had 40% lower odds of elevated childhood SBP (odds ratio = 0.60, 95% confidence interval: 0.40-0.90). The associations did not differ appreciably in analyses restricted to African Americans, and they were not explained by gestational age, size at birth, prenatal folate intake, or breastfeeding. CONCLUSIONS Findings from our urban minority birth cohort suggest that higher levels of maternal folate may help counteract the adverse associations of maternal cardiometabolic risk factors on child SBP.
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Affiliation(s)
- Hongjian Wang
- Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ninglin Sun
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fazheng Ren
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Laboratory for Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science & Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Stanhewicz AE, Kenney WL. Role of folic acid in nitric oxide bioavailability and vascular endothelial function. Nutr Rev 2017; 75:61-70. [PMID: 27974600 PMCID: PMC5155615 DOI: 10.1093/nutrit/nuw053] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Folic acid is a member of the B-vitamin family and is essential for amino acid metabolism. Adequate intake of folic acid is vital for metabolism, cellular homeostasis, and DNA synthesis. Since the initial discovery of folic acid in the 1940s, folate deficiency has been implicated in numerous disease states, primarily those associated with neural tube defects in utero and neurological degeneration later in life. However, in the past decade, epidemiological studies have identified an inverse relation between both folic acid intake and blood folate concentration and cardiovascular health. This association inspired a number of clinical studies that suggested that folic acid supplementation could reverse endothelial dysfunction in patients with cardiovascular disease (CVD). Recently, in vitro and in vivo studies have begun to elucidate the mechanism(s) through which folic acid improves vascular endothelial function. These studies, which are the focus of this review, suggest that folic acid and its active metabolite 5-methyl tetrahydrofolate improve nitric oxide (NO) bioavailability by increasing endothelial NO synthase coupling and NO production as well as by directly scavenging superoxide radicals. By improving NO bioavailability, folic acid may protect or improve endothelial function, thereby preventing or reversing the progression of CVD in those with overt disease or elevated CVD risk.
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Affiliation(s)
- Anna E Stanhewicz
- A.E. Stanhewicz and W.L. Kenney are with the Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, USA.
| | - W Larry Kenney
- A.E. Stanhewicz and W.L. Kenney are with the Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, USA
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Thelle DS, Strandhagen E. Coffee and disease: an overview with main emphasis on blood lipids and homocysteine. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/11026480510037138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Dag S. Thelle
- Cardiovascular Institute, Department of Medicine, Sahlgrenska University Hospital/ö stra, Göteborg, Sweden
| | - Elisabeth Strandhagen
- Institute of Clinical Epidemiology and Molecular Biology, Akershus Unversity Hospital, Oslo, Norway
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Ueland PM, McCann A, Midttun Ø, Ulvik A. Inflammation, vitamin B6 and related pathways. Mol Aspects Med 2016; 53:10-27. [PMID: 27593095 DOI: 10.1016/j.mam.2016.08.001] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/27/2016] [Indexed: 12/11/2022]
Abstract
The active form of vitamin B6, pyridoxal 5'-phosphate (PLP), serves as a co-factor in more than 150 enzymatic reactions. Plasma PLP has consistently been shown to be low in inflammatory conditions; there is a parallel reduction in liver PLP, but minor changes in erythrocyte and muscle PLP and in functional vitamin B6 biomarkers. Plasma PLP also predicts the risk of chronic diseases like cardiovascular disease and some cancers, and is inversely associated with numerous inflammatory markers in clinical and population-based studies. Vitamin B6 intake and supplementation improve some immune functions in vitamin B6-deficient humans and experimental animals. A possible mechanism involved is mobilization of vitamin B6 to the sites of inflammation where it may serve as a co-factor in pathways producing metabolites with immunomodulating effects. Relevant vitamin B6-dependent inflammatory pathways include vitamin B6 catabolism, the kynurenine pathway, sphingosine 1-phosphate metabolism, the transsulfuration pathway, and serine and glycine metabolism.
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Affiliation(s)
- Per Magne Ueland
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Laboratory of Clinical Biochemistry, Haukeland University Hospital, 5021 Bergen, Norway.
| | | | | | - Arve Ulvik
- Bevital A/S, Laboratoriebygget, 5021 Bergen, Norway
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Functionalized nanoparticles based solid-phase membrane micro-tip extraction and high-performance liquid chromatography analyses of vitamin B complex in human plasma. J Sep Sci 2016; 39:2678-88. [DOI: 10.1002/jssc.201600194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/29/2016] [Accepted: 05/04/2016] [Indexed: 12/23/2022]
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Shen M, Tan H, Zhou S, Retnakaran R, Smith GN, Davidge ST, Trasler J, Walker MC, Wen SW. Serum Folate Shows an Inverse Association with Blood Pressure in a Cohort of Chinese Women of Childbearing Age: A Cross-Sectional Study. PLoS One 2016; 11:e0155801. [PMID: 27182603 PMCID: PMC4868331 DOI: 10.1371/journal.pone.0155801] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 05/04/2016] [Indexed: 12/20/2022] Open
Abstract
Background It has been reported that higher folate intake from food and supplementation is associated with decreased blood pressure (BP). The association between serum folate concentration and BP has been examined in few studies. We aim to examine the association between serum folate and BP levels in a cohort of young Chinese women. Methods We used the baseline data from a pre-conception cohort of women of childbearing age in Liuyang, China, for this study. Demographic data were collected by structured interview. Serum folate concentration was measured by immunoassay, and homocysteine, blood glucose, triglyceride and total cholesterol were measured through standardized clinical procedures. Multiple linear regression and principal component regression model were applied in the analysis. Results A total of 1,532 healthy normotensive non-pregnant women were included in the final analysis. The mean concentration of serum folate was 7.5 ± 5.4 nmol/L and 55% of the women presented with folate deficiency (< 6.8 nmol/L). Multiple linear regression and principal component regression showed that serum folate levels were inversely associated with systolic and diastolic BP, after adjusting for demographic, anthropometric, and biochemical factors. Conclusions Serum folate is inversely associated with BP in non-pregnant women of childbearing age with high prevalence of folate deficiency.
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Affiliation(s)
- Minxue Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
- OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
| | - Shujin Zhou
- Liuyang Maternal and Child Hospital, Department of maternal and child health care, Liuyang, Hunan, People’s Republic of China
| | - Ravi Retnakaran
- Division of Endocrinology, Department of Medicine, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Graeme N. Smith
- Department of Obstetrics and Gynecology, Queen’s University, Kingston, Ontario, Canada
| | - Sandra T. Davidge
- Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada
| | - Jacquetta Trasler
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Human Genetics, Research Institute of the McGill University Health Centre at The Montreal Children’s Hospital, Montreal, Quebec, Canada
- Department of Pharmacology and Therapeutics, Research Institute of the McGill University Health Centre at The Montreal Children’s Hospital, Montreal, Quebec, Canada
| | - Mark C. Walker
- OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
- School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shi Wu Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
- OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
- School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
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Duschek N, Basic J, Falkensammer J, Taher F, Assadian A. B-Vitamin Serum Concentrations Predicting Long-Term Overall and Stroke-Free Survival after Carotid Endarterectomy. J Stroke Cerebrovasc Dis 2016; 25:1235-1243. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.01.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 01/29/2016] [Indexed: 10/22/2022] Open
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Gregory JF, DeRatt BN, Rios-Avila L, Ralat M, Stacpoole PW. Vitamin B6 nutritional status and cellular availability of pyridoxal 5'-phosphate govern the function of the transsulfuration pathway's canonical reactions and hydrogen sulfide production via side reactions. Biochimie 2016; 126:21-6. [PMID: 26765812 DOI: 10.1016/j.biochi.2015.12.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/30/2015] [Indexed: 02/08/2023]
Abstract
The transsulfuration pathway (TS) acts in sulfur amino acid metabolism by contributing to the regulation of cellular homocysteine, cysteine production, and the generation of H2S for signaling functions. Regulation of TS pathway kinetics involves stimulation of cystathionine β-synthase (CBS) by S-adenosylmethionine (SAM) and oxidants such as H2O2, and by Michaelis-Menten principles whereby substrate concentrations affect reaction rates. Although pyridoxal phosphate (PLP) serves as coenzyme for both CBS and cystathionine γ-lyase (CSE), CSE exhibits much greater loss of activity than CBS during PLP insufficiency. Thus, cellular and plasma cystathionine concentrations increase in vitamin B6 deficiency mainly due to the bottleneck caused by reduced CSE activity. Because of the increase in cystathionine, the canonical production of cysteine (homocysteine → cystathionine → cysteine) is largely maintained even during vitamin B6 deficiency. Typical whole body transsulfuration flux in humans is 3-7 μmol/h per kg body weight. The in vivo kinetics of H2S production via side reactions of CBS and CSE in humans are unknown but they have been reported for cultured HepG2 cells. In these studies, cells exhibit a pronounced reduction in H2S production capacity and rates of lanthionine and homolanthionine synthesis in deficiency. In humans, plasma concentrations of lanthionine and homolanthionine exhibit little or no mean change due to 4-wk vitamin B6 restriction, nor do they respond to pyridoxine supplementation of subjects in chronically low-vitamin B6 status. Wide individual variation in responses of the H2S biomarkers to such perturbations of human vitamin B6 status suggests that the resulting modulation of H2S production may have physiological consequences in a subset of people. Supported by NIH grant DK072398. This paper refers to data from studies registered at clinicaltrials.gov as NCT01128244 and NCT00877812.
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Affiliation(s)
- Jesse F Gregory
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611-0370, USA.
| | - Barbara N DeRatt
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611-0370, USA
| | - Luisa Rios-Avila
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611-0370, USA
| | - Maria Ralat
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611-0370, USA
| | - Peter W Stacpoole
- Division of Endocrinology and Metabolism, Departments of Biochemistry and Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
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Zhang J, Liu TT, Zhang W, Li Y, Niu XY, Fang YL, Ma LS, Li CX. Hyperhomocysteinemia Is Associated with Vitamin B-12 Deficiency: A Cross-sectional Study in a Rural, Elderly Population of Shanxi China. J Nutr Health Aging 2016; 20:594-601. [PMID: 27273348 DOI: 10.1007/s12603-015-0650-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To report the association of lifestyle factors and plasma vitamin B-12 with hyperhomocysteinemia in a large sample of men and women living in a region of China where there is an increased risk of NTDs. DESIGN Community-based, cross-sectional study of Lvliang City, Shanxi Province, China. SETTING Hyperhomocysteinemia is an independent risk factor for cardiovascular disease (CVD) and a sensitive marker of vitamin B-12 and folate deficiency. PARTICIPANTS A total of 2355 (1044 men and 1311 women) participants born before 1 January 1958 (≥55 years of age) and living in Lvliang City for at least 2 months a year were included. MEASUREMENTS The participants were assessed regarding demographic characteristics, height, weight, as well as having a physical examination and blood sampling for serum cholesterol, total homocysteine (tHcy), folate, and vitamin B12 levels. RESULTS The median (25th-75th percentile) tHcy concentration was 21.5 (15.8-33.6) µmol/L in men and 18.0 (13.4-24.8) µmol/L in women. The overall prevalence of hyperhomocysteinemia (tHcy ≥15 µmol/L) was 72.6% (84.3% in men and 63.2% in women), inversely correlated with folate (r=-0.230, P=0.006) and vitamin B-12 (r=-0.540, P<0.001), and positively correlated with uric acid (r=0.054, P<0.001). Vitamin B-12 and folate deficiency, older age, and male gender were associated with elevated tHcy; with vitamin B-12 deficiency being the strongest. CONCLUSIONS Plasma tHcy concentration and hyperhomocysteinemia were significantly higher in this population than in previously studied populations. Vitamin B-12 and folate supplementation, concomitant lifestyle changes such as smoking cessation, and lipid-lowering treatments may help to decrease plasma tHcy concentrations and reduce the CVD risk in this population.
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Affiliation(s)
- J Zhang
- Professor Xiao-Yuan Niu, Department of Neurology, First Hospital of Shanxi Medical University. No. 85, Jiefang Nan Street, Yingze District, Taiyuan City, PRC. E-mail: , Telephone/Fax: +8603514639510
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Naz S, Calderón ÁA, García A, Gallafrio J, Mestre RT, González EG, de Cabo CM, Delgado MCM, Balanza JÁL, Simionato AVC, Vaeza NN, Barbas C, Rupérez FJ. Unveiling differences between patients with acute coronary syndrome with and without ST elevation through fingerprinting with CE-MS and HILIC-MS targeted analysis. Electrophoresis 2015; 36:2303-2313. [PMID: 26177736 DOI: 10.1002/elps.201500169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/25/2015] [Accepted: 06/26/2015] [Indexed: 12/25/2022]
Abstract
Differences in the degree and severity of Acute Coronary Syndrome, associated to differences in the electrocardiogram, together with blood tests of biomarkers classify patients for diagnosis and treatment. Cases where the electrocardiogram and/or biomarkers are not conclusive still appear, and there is a need for complementary biomarkers for routine determinations. Metabolomics approaches with blind fingerprinting could reveal differences in metabolites, which must be confirmed by means of targeted determinations. CE-MS and HILIC-MS are well suited for the determination of highly polar compounds, like those from to the intermediate metabolism, altered due to acute stress induced by myocardial infarction. Serum from patients with ST-elevated and non-ST elevated myocardial infarction was collected at intensive care and emergency units, and fingerprinted with CE-MS. Data pretreatment and analysis showed up carnitine-related compounds and amino acids differentially present in both groups. Acylcarnitines and amino acids were then quantitatively measured with HILIC-MS-QqQ. The significance of the differences and the sensitivity/specificity of each compound were individually evaluated. The ratio of free carnitine to acylcarnitines, together with the ratios of acetylcarnitine to betaine, to threonine, and to citrulline, showed high significance and area under the curve in the respective receiver operating characteristic curves. This study opens new possibilities for defining new sets of biomarkers for refining the diagnosis of the patients with difficult classification.
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Affiliation(s)
- Shama Naz
- CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
| | | | - Antonia García
- CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
| | - Jessica Gallafrio
- CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain.,Departamento de Química Analítica, Instituto de Química, State University of Campinas, São Paulo, Brazil
| | | | | | | | | | | | | | | | - Coral Barbas
- CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
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Firoz CK, Jabir NR, Kamal MA, Alama MN, Damanhouri GA, Khan W, Alzahrani AS, Almehdar HA, Tabrez S. Neopterin: An immune biomarker of coronary artery disease and its association with other CAD markers. IUBMB Life 2015; 67:453-9. [DOI: 10.1002/iub.1390] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 05/16/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Chelapram Kandy Firoz
- King Fahd Medical Research Center; King Abdulaziz University; Jeddah 21589 Saudi Arabia
| | - Nasimudeen R. Jabir
- King Fahd Medical Research Center; King Abdulaziz University; Jeddah 21589 Saudi Arabia
| | - Mohammad A. Kamal
- King Fahd Medical Research Center; King Abdulaziz University; Jeddah 21589 Saudi Arabia
| | - Mohammed Nabil Alama
- Department of Cardiology, Faculty of Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
| | - Ghazi A. Damanhouri
- King Fahd Medical Research Center; King Abdulaziz University; Jeddah 21589 Saudi Arabia
| | - Waseem Khan
- Department of Radiology, Faculty of Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
| | - Anas S. Alzahrani
- Department of Cardiology; King Saud Bin Abdulaziz University for Health Sciences; Jeddah Saudi Arabia
| | - Hussein A. Almehdar
- Department of Biology, Faculty of Science; King Abdulaziz University; Jeddah Saudi Arabia
| | - Shams Tabrez
- King Fahd Medical Research Center; King Abdulaziz University; Jeddah 21589 Saudi Arabia
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Skeie E, Strand E, Pedersen ER, Bjørndal B, Bohov P, Berge RK, Svingen GFT, Seifert R, Ueland PM, Midttun Ø, Ulvik A, Hustad S, Drevon CA, Gregory JF, Nygård O. Circulating B-vitamins and smoking habits are associated with serum polyunsaturated Fatty acids in patients with suspected coronary heart disease: a cross-sectional study. PLoS One 2015; 10:e0129049. [PMID: 26039046 PMCID: PMC4454679 DOI: 10.1371/journal.pone.0129049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/03/2015] [Indexed: 12/31/2022] Open
Abstract
The long-chain polyunsaturated fatty acids are considered to be of major health importance, and recent studies indicate that their endogenous metabolism is influenced by B-vitamin status and smoking habits. We investigated the associations of circulating B-vitamins and smoking habits with serum polyunsaturated fatty acids among 1,366 patients who underwent coronary angiography due to suspected coronary heart disease at Haukeland University Hospital, Norway. Of these, 52% provided information on dietary habits by a food frequency questionnaire. Associations were assessed using partial correlation (Spearman’s rho). In the total population, the concentrations of most circulating B-vitamins were positively associated with serum n-3 polyunsaturated fatty acids, but negatively with serum n-6 polyunsaturated fatty acids. However, the associations between B-vitamins and polyunsaturated fatty acids tended to be weaker in smokers. This could not be solely explained by differences in dietary intake. Furthermore, plasma cotinine, a marker of recent nicotine exposure, showed a negative relationship with serum n-3 polyunsaturated fatty acids, but a positive relationship with serum n-6 polyunsaturated fatty acids. In conclusion, circulating B-vitamins are, in contrast to plasma cotinine, generally positively associated with serum n-3 polyunsaturated fatty acids and negatively with serum n-6 polyunsaturated fatty acids in patients with suspected coronary heart disease. Further studies should investigate whether B-vitamin status and smoking habits may modify the clinical effects of polyunsaturated fatty acid intake.
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Affiliation(s)
- Eli Skeie
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Elin Strand
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Eva R. Pedersen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bodil Bjørndal
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Pavol Bohov
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rolf K. Berge
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - Reinhard Seifert
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Per M. Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Arve Ulvik
- Bevital AS, Laboratory building, Bergen, Norway
| | - Steinar Hustad
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Christian A. Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jesse F. Gregory
- Food Science and Human Nutrition Department, University of Florida, Gainesville, Florida, United States of America
| | - Ottar Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Jonnavithula N, Elmati P, Duddu K, Murthy PVLN, Ramachandran G. Anaesthetic concerns during adrenalectomy for Cushing′s syndrome with known hyperhomocysteinemia. Indian J Anaesth 2015; 59:182-5. [PMID: 25838591 PMCID: PMC4378080 DOI: 10.4103/0019-5049.153041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Maintenance of homeostasis during anaesthesia in the patient with two major metabolic disorders whose systemic effects either compliment or contradict each other is a challenge to the anaesthesiologist. A 25-year-old male patient with Cushing's syndrome and known hyperhomocysteinemia was scheduled for open adrenalectomy. Both these disorders compound the hypercoagulable state and differ in glucose metabolism. In addition, obesity, difficult airway, electrolyte and metabolic derangements that accompany Cushing's syndrome warrant special attention. He was on anticoagulant therapy and inferior vena cava filter following an episode of pulmonary thromboembolism with deep vein thrombosis. Perioperative hydrocortisone was administered. Thoracic epidural catheter was placed at T10–T11 interspace, standard general anaesthesia was administered without nitrous oxide. Patient was extubated following an uneventful procedure and discharged home on 10th post-operative day. Understanding the anaesthetic implications and the pathophysiological interactions of multiple metabolic disorders with a potential for multisystem involvement is key to the successful management of these patients.
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Orimadegun BE, Orimadegun AE, Ademola AD, Agbedana EO. Plasma homocysteine and B vitamins levels in Nigerian children with nephrotic syndrome. Pan Afr Med J 2014; 18:107. [PMID: 25404967 PMCID: PMC4232175 DOI: 10.11604/pamj.2014.18.107.3678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/26/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Available data on plasma homocysteine level in patients with nephrotic syndrome (NS) are controversial with increased, decreased and unchanged values reported. Therefore, plasma homocysteine and serum B vitamins in Nigerian children with NS were assessed in this study. METHODS Fasting blood samples were analysed for plasma homocysteine, serum folate and B vitamins in 42 children with NS and 42 age and sex-matched healthy controls in this case control study. Data were compared between NS and control using t test and Chi square. Relationships were tested with regression analysis with p set at 0.05. RESULTS Prevalence of hyperhomocysteinaemia, low folate and cyanocobalamin in NS was 57.1%, 14.3% and 9.5% respectively. The mean homocysteine level was significantly higher in NS than control (11.3±2.6 µmol/L versus 5.5±2.3 µmol/L). Also, NS had lower folate and cyanocobalamin than control: 9.1±3.9 ng/mL versus 11.2±3.1 ng/dL and 268.5±95.7 pg/mL versus 316±117.2 pg/mL respectively. Weak but significant correlation between homocysteine and serum albumin (r = 0.347), folate (r = -0.607) and vitamin B12 (r = -0.185) were found in the NS group. Significant relationship was also found between homocysteine and vitamin B12 (ß = -0.64, 95% CI = -1.20, -0.08) after controlling for folate and vitamin B6 levels. CONCLUSION Clinically important hyperhomocysteinaemia and low B vitamins occur in Nigerian children with nephrotic syndrome. This data suggest that potential usefulness of folate and vitamin B supplementation for reducing high homocysteine levels in nephrotic syndrome need to be further investigated.
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Kucukhuseyin O, Kurnaz O, Akadam-Teker AB, Isbir T, Bugra Z, Ozturk O, Yilmaz-Aydogan H. The association of MTHFR C677T gene variants and lipid profiles or body mass index in patients with diabetic and nondiabetic coronary heart disease. J Clin Lab Anal 2014; 27:427-34. [PMID: 24218123 DOI: 10.1002/jcla.21623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 04/09/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The aim of this study is to investigate whether methylenetetrahydrofolate reductase (MTHFR) C677T mutation is associated with the development of hyperlipoproteinemia and obesity in coronary heart disease (CHD). METHODS This study was carried out in 82 diabetic and 112 nondiabetic patients with CHD and in 138 CHD-free healthy controls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and agarose gel electrophoresis techniques were used to determine the MTHFR C677T. RESULTS Distributions of MTHFR genotypes (C677T dbSNP: rs1801133) were similar in our study groups (P > 0.05). There was no statistical association between biochemical parameters and genotype distribution in nondiabetic CHD patients, while diabetic CC genotype carriers have elevated levels of body mass index (BMI) independently from lipid profiles (P = 0.002). In diabetic CHD patients, while evaluating the clinical parameters according to gender, it was found that gender had an impact on BMI (P = 0.013). Due to this gender effect, a multivariate analysis was conducted on the diabetic CHD patient group. The multivariate logistic regression analysis confirmed that the MTHFR-CC genotype was associated with elevated BMI levels in diabetic CHD patients (odds ratio [OR] = 5.42, P = 0.003). CONCLUSION The results of the present study demonstrated that possessing T allele of MTHFR C677T mutation indicates a protective association on BMI independently from other risk factors.
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Affiliation(s)
- Ozlem Kucukhuseyin
- Department of Molecular Medicine, The Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
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Grigoletti SS, Guindani G, Moraes RS, Ribeiro JP, Sprinz E. Short-term folinic acid supplementation improves vascular reactivity in HIV-infected individuals: a randomized trial. Nutrition 2014; 29:886-91. [PMID: 23660169 DOI: 10.1016/j.nut.2013.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 01/12/2013] [Accepted: 01/16/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE HIV-infected individuals present a cluster of conditions that activate or injure the vascular endothelium. The administration of folates may exert beneficial effects on endothelial function in different populations at risk for cardiovascular disease. The aim of this study was to determine the effects of 4 wk of folinic acid supplementation on forearm vascular responses during reactive hyperemia in HIV-infected patients under highly active antiretroviral therapy. METHODS This was a prospective, randomized, double-blind, placebo-controlled trial to compare the effects of 4 wk of daily ingestion of 5 mg of folinic acid (n = 15) or placebo (n = 15). Participants had to have been on antiretroviral therapy (ART) for at least 6 mo before enrollment, with undetectable viral load, and CD4 cell count >200 cells/mm(3). Vascular function was evaluated with venous occlusion plethysmography at baseline and after 4 wk, for the determination of brachial artery reactive hyperemia, and after isosorbide dinitrate administration. RESULTS The groups were comparable. The mean age of patients was 45 y; there were eight women in each group. There was no difference regarding ART regimen. The supplementation of folinic acid produced a significant improvement in reactive hyperemia (from 14.9 to 21.2 mL•min•100 mL). The same was not observed in placebo group (from 15.3 to 14.6 mL•min•100 mL; group P, 0.017; time P < 0.001; interaction P < 0.001). Endothelium-independent responses remained unchanged. CONCLUSIONS Short-term folinic acid supplementation improved vascular reactivity in HIV-infected individuals enrolled in the studied. As folate supplementation is safe and relatively inexpensive, long-term clinical trials should be conducted.
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Affiliation(s)
- Shana S Grigoletti
- Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Zhang Y, Zhu T, Wang L, Pan YH, Zhang S. Homocysteine homeostasis and betaine-homocysteine S-methyltransferase expression in the brain of hibernating bats. PLoS One 2013; 8:e85632. [PMID: 24376891 PMCID: PMC3871600 DOI: 10.1371/journal.pone.0085632] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 12/05/2013] [Indexed: 12/31/2022] Open
Abstract
Elevated homocysteine is an important risk factor that increases cerebrovascular and neurodegenerative disease morbidity. In mammals, B vitamin supplementation can reduce homocysteine levels. Whether, and how, hibernating mammals, that essentially stop ingesting B vitamins, maintain homocysteine metabolism and avoid cerebrovascular impacts and neurodegeneration remain unclear. Here, we compare homocysteine levels in the brains of torpid bats, active bats and rats to identify the molecules involved in homocysteine homeostasis. We found that homocysteine does not elevate in torpid brains, despite declining vitamin B levels. At low levels of vitamin B6 and B12, we found no change in total expression level of the two main enzymes involved in homocysteine metabolism (methionine synthase and cystathionine β-synthase), but a 1.85-fold increase in the expression of the coenzyme-independent betaine-homocysteine S-methyltransferase (BHMT). BHMT expression was observed in the amygdala of basal ganglia and the cerebral cortex where BHMT levels were clearly elevated during torpor. This is the first report of BHMT protein expression in the brain and suggests that BHMT modulates homocysteine in the brains of hibernating bats. BHMT may have a neuroprotective role in the brains of hibernating mammals and further research on this system could expand our biomedical understanding of certain cerebrovascular and neurodegenerative disease processes.
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Affiliation(s)
- Yijian Zhang
- Laboratory of Molecular Ecology and Evolution, Institute for Advanced Studies in Multidisciplinary Science and Technology, East China Normal University, Shanghai, China
| | - Tengteng Zhu
- Laboratory of Molecular Ecology and Evolution, Institute for Advanced Studies in Multidisciplinary Science and Technology, East China Normal University, Shanghai, China
| | - Lina Wang
- Laboratory of Molecular Ecology and Evolution, Institute for Advanced Studies in Multidisciplinary Science and Technology, East China Normal University, Shanghai, China
| | - Yi-Hsuan Pan
- Laboratory of Molecular Ecology and Evolution, Institute for Advanced Studies in Multidisciplinary Science and Technology, East China Normal University, Shanghai, China
- * E-mail: (YP); (SZ)
| | - Shuyi Zhang
- Laboratory of Molecular Ecology and Evolution, Institute for Advanced Studies in Multidisciplinary Science and Technology, East China Normal University, Shanghai, China
- * E-mail: (YP); (SZ)
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Holstein JH, Schmalenbach J, Herrmann M, Ölkü I, Garcia P, Histing T, Herrmann W, Menger MD, Pohlemann T, Claes L. Excess dietary methionine does not affect fracture healing in mice. Med Sci Monit 2013. [PMID: 23197225 PMCID: PMC3560796 DOI: 10.12659/msm.883590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background An elevated serum concentration of homocysteine (hyperhomocysteinemia) has been shown to disturb fracture healing. As the essential amino acid, methionine, is a precursor of homocysteine, we aimed to investigate whether excess methionine intake affects bone repair. Material/Methods We analyzed bone repair in 2 groups of mice. One group was fed a methionine-rich diet (n=13), and the second group received an equicaloric control diet without methionine supplementation (n=12). Using a closed femoral fracture model, bone repair was analyzed by histomorphometry and biomechanical testing at 4 weeks after fracture. Blood was sampled to measure serum concentrations of homocysteine, the bone formation marker osteocalcin, and the bone resorption marker collagen I C-terminal crosslaps Results Serum concentrations of homocysteine were significantly higher in the methionine group than in the control group, while serum markers of bone turnover did not differ significantly between the 2 groups. Histomorphometry revealed no significant differences in size and tissue composition of the callus between animals fed the methionine-enriched diet and those receiving the control diet. Accordingly, animals of the 2 groups showed a comparable bending stiffness of the healing bones. Conclusions We conclude that excess methionine intake causes hyperhomocysteinemia, but does not affect fracture healing in mice.
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Affiliation(s)
- Joerg H Holstein
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany.
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Prevalence of MTHFR C677T single nucleotide polymorphism in genetically isolated populations in Jordan. Biochem Genet 2013; 51:780-8. [PMID: 23749065 DOI: 10.1007/s10528-013-9606-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 12/03/2012] [Indexed: 10/26/2022]
Abstract
Methylenetetrahydrofolate reductase (MTHFR) C677T single nucleotide polymorphism is a major inherited risk factor of venous thromboembolism. We sought to determine its prevalence in genetically isolated populations of Chechens and Circassians in Jordan. The MTHFR C677T mutation was analyzed from blood samples taken from 120 random unrelated Chechens and 72 Circassians. The prevalence of the MTHFR mutation in the Chechen population was 27.5% (allele frequency 15%); the prevalence among the Circassians was 50% (allele frequency 29.2%). The prevalence in the Chechen population is similar to that in Jordan and other world populations, but it is higher in the Circassian population. This study will contribute to understanding the interaction between genetic and environmental risk factors underlying thrombosis and will be useful in deciding which genetic variants should be tested in a clinical genetic testing service.
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