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Effect of Homocysteine ,Vitamin B12 , Folic acid during pregnancy
Arpita Patel,Chandan Chakrabarty,Arjun Singh,Jatin Patel
NHL Journal of Medical Sciences , 2012,
Abstract: Vitamin B12, folic acid and homocysteine are metabolically closely related. At the same time homocysteine is found to be offending factor for vascular pathology causing preeclampsia. On the other hand periconceptional nutritional status influences the vitamin B12 & folic acid level. Which further affect the homocysteine level thus may affect pregnancy outcome. Various contributory factors lead these vitamin deficiencies, maternal nutrition is one of them. Ahmedabad being a predominantly vegetarian city, its population is at higher risk of vitamin B12 deficiency. But no systematic study has been done in Ahmedabad to know whether B12, folic acid and homocysteine levels influence pregnancy. To know this answer this study was planned to know total homocysteine level and its correlation in preeclampsia and normotensive pregnant women.Vitamin B12, folic acid and homocysteine were measured in all the subjects using fluorescence polarized immunoassay in AxSym Immunochemistry analyzer on 60 non vitamin supplemented vegetarian women. Vitamin levels were within lower normal limit. Homocysteine level was higher among preeclampsia patient. From the findings of the present study it can be concluded that measurement of these biochemical parameter in ante natal care are useful for further management and prevention of complication of pregnancy like preeclampsia
Homocysteine, folic acid and vitamin B12 levels in serum of epileptic children
ON Eldeen, SH Abd Eldayem, RH Shatla, NA Omara, SS Elgammal
Egyptian Journal of Medical Human Genetics , 2012,
Abstract: The relationship between increased homocysteine (Hcy) level and epileptic seizure remains controversial in human, despite a growing evidence of the pro-convulsive effect of the hyperhomocysteinemia (HHcy) observed in the animal studies. The mechanism of this association with epileptogenesis has not been clearly understood, although there is emerging evidence to support the unfavorable effects of some anti-epileptic drugs (AEDs) on the plasma homocysteine (Hcy) concentrations. The aim of this study was to uncover the relationship between the levels of homocysteine (Hcy), the cofactors involved in its metabolism as folic acid and vitamin B12 and anti-epileptic drugs (AEDs) in epileptic patients. Serum level of homocysteine (Hcy), folic acid and vitamin B12 was measured in 60 patients with idiopathic epilepsy; and its level was compared to 30 healthy children serving as control group. No significant difference was found regarding the plasma homocysteine (Hcy) levels between patients (both receiving anti-epileptics and non anti-epileptic drug users) and controls. Epileptic patients on polytherapy showed higher mean serum levels of homocysteine (Hcy) and lower mean serum levels of folic acid compared to those on monotherapy. However, the mean serum levels of homocysteine (Hcy), vitamin B12 and folic acid showed non significant differences between patients using valproic acid (VPA) or carbamazepine (CBZ). Duration of AED therapy showed a significant positive correlation with mean serum levels of homocysteine (Hcy) and a significant negative correlation with mean serum levels of folic acid. To conclude; AEDs upset the homeostatic balance of homocysteine (Hcy) and its cofactors and cause abnormalities in their serum levels.
Homocysteine, folic acid and vitamin B12 serum levels in hemodialysis patients referring to hemodialysis unit of Jahrom hospital
abdoreza Sotoodeh Jahromi,Mohammad Reza Farjam,Mohammad Shojaei
Journal of Jahrom University of Medical Sciences , 2011,
Abstract: Homocysteine, folic acid and vitamin B12 serum levels in hemodialysis patients referring to hemodialysis unit of Jahrom hospitalSotoodeh Jahromi A1,2, Farjam MR*3, Shojaei M4Received: 09/25/2010Revised: 01/27/2011Accepted: 01/29/20111. Dept. of Immunology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran2. Research Center for Zoonotic Diseases, Jahrom University of Medical Sciences, Jahrom, Iran 3. Dept. of Biochemistry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran4. Dept. of Internal Medicine, School of Medicine, Jahrom University of Medical Sciences, Jahrom, IranJournal of Jahrom University of Medical Sciences, Vol. 9, No. 1, Spring 2011 AbstractIntroduction:Homocysteine is an amino acid yielded from methionin to cysteine metabolism. Increased level of homocysteine can increase the risk of cardiovascular diseases. Several factors such as uremia, genetic factors, dialysis related factors and vitamin B group deficiency lead to increased plasma level of homocysteine in dialysis patients. This study aimed to evaluate plasma levels of homocysteine, vitamin B12 and folic acid in Jahrom hemodialysis patients.Materials and Methods:This cross-sectional study was carried out on a total of 43 hemodialysis patients and 43 age and sex matched healthy individuals without any underlying renal disease as control group during December 2008 and September 2009. The serum level of homocysteine was measured using ELISA method and the serum levels of vitamin B12 and folic acid were measured by radioimmunoassay method.Results:Comparing the patients with the control group, there were significant differences between the two groups in mean serum levels of homocysteine (22.709±5.765 μmol/L vs. 16.518±5.425 μmol/L), folic acid (513.814±15.378 ng/ml vs. 22.976±7.462 ng/ml) and vitamin B12 (5366.814±1734.752 pg/ml vs. 868.907±251.484 pg/ml) (P<0.001). A significant positive correlation was found between mean serum level of homocysteine and duration of hemodialysis therapy (r=0.893, P<0.001).Conclusion:Although in the present study the homocysteine level in the patients was more than that of the healthy subjects, it was lower than that of hemodialysis patients in other countries.
The effect of atorvastatin on plasma homocysteine, vitamin B12 and folic acid levels
Karabudak, E.,K?z?ltan, G.,Aksoy, H.,Tayfun, E.
Erciyes Medical Journal , 2006,
Abstract: Purpose: The aim of present study is to investigate the effect of atorvastatin (statin group drugs, 20mg/day) intake on plasma homocysteine (tHcy), vitamin B12 and folic acid concentrations. Material and methods: The sample of this study consists of 20 voluntary patients, who applied to Cardiology Outpatient clinic of Ba kent University Hospital, Ankara, from November 2003 to February 2004. Ten patients used atorvastatin 20 mg/day for a mean (±SD) duration of 24.14±6.5 months (range, 3.6 to 156 months) and the remaining 10 patients did not use any atorvastatin and were used as a control subjects in this study. Anthropometric measurements, a three-day 24-h dietary record and biochemical parameters such as plasma tHcy, folate and vitamin B12 level were measured. Results: Age, BMI, body fat, waist/hip ratio of each patient were similar (p>0.05). When the energy and nutrient intake of the groups were compared, no significant differences were found (p>0.05). Serum folate levels of atorvastatin group were higher than the control group but there were no significant differences in vitamin B12, plasma tHcy, total cholesterol and its fractions between two groups. Plasma triglyceride levels of the control group were higher than the atorvastatin group. There was a negative but not significant correlation between plasma tHcy concentration, and serum folate and vitamin B12 for atorvastatin group and between plasma tHcy concentration and vitamin B12 for control group. Conclusion: No significant differences in plasma tHcy concentration between 2 groups could be attributed to usage of low dose of atorvastatin and inadequate intake of folate and vitamin B12 of patients.
Effects of Oxcarbazepine on Plasma Homocysteine, Vitamin B12, Folic Acid Levels  [PDF]
Demet ?lhan ALGIN,O?uz Osman ERD?N?,?zkan ALATA?,Aysun TOKER
N?ropsikiyatri Ar?ivi , 2009,
Abstract: Objective: It is known that plasma homocysteine (Hcy), folic acid (FA) and vitamin B12 (vit B12) levels are affected by antiepileptic drugs (AED). The aim of this study was to assess the effects of oxcarbazepine (OXC) on plasma Hcy, FA and vit B12 levels. Method: A total of 42 epileptic outpatients receiving AED therapy were selected. Patients were divided into four different groups according to their medications. The patients of group 1 received OXC for less than 1 year (n=12), group 2 received OXC for more than 1 year (n=11), group 3 received OXC with valproate (VPA) for more than 1 year (n=9), group 4 received VPA monotherapy (n=10 ). A control group of 30 healthy subjects without any AED medication were also included. The plasma Hcy, FA and vit B12 levels of the groups were statistically compared with each other using one way ANOVA method. Results: The levels of plasma Hcy for the groups 1, 2, 3, 4 and the controls were 10.7±4.1 mmol/l, 15.5±10.7 mmol/l, 12.7±4.10 mmol/l, 10.2±2.9 mmol/l, 10.6±4.7 mmol/l respectively. No differences have been found between HS, FA and vit B12 levels statistically (p>0.05).Conclusion: According to the findings of our study, it seems that OXC does not have any influence on plasma Hcy, FA and vit B12 levels when folate nutriture is adequate. (Archives of Neuropsychiatry 2009; 46: 49-51)
Serum Levels of Homocysteine, Vitamin B12, and Folic Acid in Patients with Alzheimer’s Disease
Fariba Karimi,Afshin Borhani Haghighi,Payman Petramfar
Iranian Journal of Medical Sciences , 2009,
Abstract: Background: Alzheimer's disease is the most common formof dementia in the elderly. Serum levels of homocysteine havebeen related to increased cortical and hippocampal atrophy.We aimed to determine the serum levels of homocysteine,folate, and vitamin B12 in patients with Alzheimer's disease.Methods: Blood levels of homocysteine and its biologicaldeterminants, folate, and vitamin B12 were measured in 51patients who were diagnosed as having Alzheimer's diseaseaccording to DSM-IV criteria and compared with the serumlevels obtained from 49 control individuals.Results: The mean serum homocysteine concentration wassignificantly higher in patients with Alzheimer's disease thanthe controls (20.4 ± 16.5 μmol/L v 14.5 ± 5 μmol/L; P= 0.02).There were no statistically significant differences between themean serum levels of vitamin B12 (P=0.6) and folate (P= 0.3)in the patients and the controls. There was no correlation betweenage and serum homocysteine concentration in bothgroups (P= 0.8).Conclusion: Serum homocysteine concentration was significantlyhigher in the patients with Alzheimer's disease. Thisbiomarker might be considered as a predictor of cognitive performance.
Levels of serum B12, folic acid and homocysteine in thromboembolic diseases on admission to the Emergency Department
A Bay?r, K U?ar Karabulut, A Ak
Critical Care , 2011, DOI: 10.1186/cc9434
Abstract: This study included 100 subjects with acute myocardial infarctus (AMI), acute pulmonary embolism, deep vein thrombosis, ischemic cerebrovascular disease (ICD), acute mesentery embolism, and peripheric artery embolism (PAE), and 110 healthy voluntary subjects were included in the control group. Vitamin B12, folic acid and homocysteine levels were examined in the blood samples obtained at admission, The data were loaded onto SPSS 16 for Windows program. P ≤ 0.05 was considered significant.Mean serum homocysteine and plasma vitamin B12 levels were significantly higher in the patient group than the control group (P = 0.002 and 0.000 respectively). There was no significant difference in the levels of folic acid between the patient and control groups. Mean serum B12 values of the AMI and ICD groups in the patient group were significantly lower than those of the control group (P < 0.05). Serum folic acid values of the PAE and AMI groups were considerably lower than the control group (P < 0.05). Plasma homocysteine levels were significantly higher in all patient groups according to their diagnosis than the control group (P < 0.05).Mean serum homocysteine and plasma vitamin B12 levels were significantly higher in the patient group than the control group (P = 0.002 and 0.000 respectively). There was no significant difference in the levels of folic acid between the patient and control groups. Mean serum B12 values of the AMI and ICD groups in the patient group were significantly lower than those of the control group (P < 0.05). Serum folic acid values of the PAE and AMI groups were considerably lower than the control group (P < 0.05). Plasma homocysteine levels were significantly higher in all patient groups according to their diagnosis than the control group (P < 0.05).
The effect of folate and vitamin B12 supplementation on homocysteine concentrations: a study in hemodialysis patients
Azadibakhsh N.,Shaker Hosseini R.,Atabak SH.,Nateghiyan N.
Tehran University Medical Journal , 2007,
Abstract: Background: Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. The frequency of hyperhomocysteinemia is higher in hemodialysis (HD) patients than the general population. The objective of this study is to assess the efficacy of high-dose folic acid supplementation with and without vitamin B12 on lowering plasma total homocysteine (tHcy) concentrations in HD patients. Methods: Thirty-six HD patients at Imam Hossein Hospital, Tehran, Iran, who had been given folic acid supplements (5 mg/d) for at least 3 months before, were enrolled in this clinical trial. Subjects were also checked for other inclusion and exclusion criteria. The subjects were divided randomly into four groups and underwent two months of supplementation as follows: 5 mg/d oral folic acid + placebo in group one, 5 mg/d oral folic acid + vitamin B12 (1 mg/d orally) in group two, 15 mg/d oral folic acid + placebo in group three and 15 mg/d oral folic acid + vitamin B12 (1 mg/d orally) in group four. Concentrations of plasma tHcy and serum folic acid and vitamin B12 were measured at baseline and after the supplementation period. Dietary intake of patients was also determined during the supplementation period.Results: Of the folic acid supplemented patients, 27.8% had normal levels of tHcy at baseline and 72.2% had hyperhomocysteinemia. After the supplementation period, plasma tHcy increased by 1.35% in group one and decreased by 6.99%, 14.54% and 30.09% in groups two, three and four respectively. Changes in plasma tHcy and serum vitamin B12 were only significant in group four; however, no significant changes were seen for serum folic acid. The percentage of subjects reaching normal levels of plasma tHcy was 5.6 fold higher in group four than in the reference group. Conclusions: Supplementation with 15 mg/d folic acid together with 1 mg/d oral vitamin B12 is more effective in reducing tHcy levels in HD patients.
Vitamin B12, Folate, Homocysteine, and Bone Health in Adults and Elderly People: A Systematic Review with Meta-Analyses  [PDF]
J. P. van Wijngaarden,E. L. Doets,A. Szczecińska,O. W. Souverein,M. E. Duffy,C. Dullemeijer,A. E. J. M. Cavelaars,B. Pietruszka,P. van't Veer,A. Brzozowska,R. A. M. Dhonukshe-Rutten,C. P. G. M. de Groot
Journal of Nutrition and Metabolism , 2013, DOI: 10.1155/2013/486186
Abstract: Elevated homocysteine levels and low vitamin B12 and folate levels have been associated with deteriorated bone health. This systematic literature review with dose-response meta-analyses summarizes the available scientific evidence on associations of vitamin B12, folate, and homocysteine status with fractures and bone mineral density (BMD). Twenty-seven eligible cross-sectional ( ) and prospective ( ) observational studies and one RCT were identified. Meta-analysis on four prospective studies including 7475 people showed a modest decrease in fracture risk of 4% per 50?pmol/L increase in vitamin B12 levels, which was borderline significant (RR = 0.96, 95% CI = 0.92 to 1.00). Meta-analysis of eight studies including 11511 people showed an increased fracture risk of 4% per μmol/L increase in homocysteine concentration (RR = 1.04, 95% CI = 1.02 to 1.07). We could not draw a conclusion regarding folate levels and fracture risk, as too few studies investigated this association. Meta-analyses regarding vitamin B12, folate and homocysteine levels, and BMD were possible in female populations only and showed no associations. Results from studies regarding BMD that could not be included in the meta-analyses were not univocal. 1. Introduction Osteoporosis is a chronic, multifactorial disorder which is characterized by low bone mass and microarchitectural deterioration of bone tissue [1]. Its major consequence is fractures. Especially hip fractures are frequently associated with institutionalization and increased mortality, and thus with an increased social and economic burden. This burden is expected to increase substantially in Europe in the coming decades due to a rise in life expectancy [2]. Elevated homocysteine concentrations and low vitamin B12 and folate status have been associated in several studies with lower bone mineral density (BMD) and higher fracture risk in elderly [3–11]. An elevated plasma homocysteine level (>15?μmol/L) is prevalent in 30–50% of people older than 60 years [12–14]. The cause is multifactorial; a combination of environmental and genetic factors, nutrition, lifestyle, and hormonal factors [15]. Vitamin B12 and folate are major determinants of homocysteine metabolism [16, 17] and supplementation with vitamin B12 and folic acid has been shown to be effective in normalizing homocysteine levels [18, 19]. Reversing elevated homocysteine levels through folic acid and vitamin B12 supplementation could theoretically prevent the problem of impaired bone health and osteoporosis. However, at present, no consensus is reached on the magnitude of
Homocysteine, vitamin B12 and folate levels in premature coronary artery disease
Saeed Sadeghian, Faramarz Fallahi, Mojtaba Salarifar, Gholamreza Davoodi, Mehran Mahmoodian, Nader Fallah, Soodabeh Darvish, Abbasali Karimi, Tehran Heart Center
BMC Cardiovascular Disorders , 2006, DOI: 10.1186/1471-2261-6-38
Abstract: We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran.After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 ± 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia.We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (bellow 45 years old) – especially in men -and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia.Homocysteine is a sulfhydryl containing amino acid produced by demethylation of an essential amino acid (methionine) [1]. Methylation of homocysteine, catalyzed by methionine synthetase produces methionine. This enzyme needs vitamin B12 as a co-factor. Homocysteine can also change to cystathionine through the action of the Cystathionine-B-Synthetase (CBS) enzyme [2,4].In humans, vitamin B12 acts as a coenzyme while folic a
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