Efecto del ácido fólico, el ácido levofolínico y el ácido fólico más vitamina B 12 en los valores de homocisteína plasmática total en mujeres sanas en edad reproductiva

Abstract

Objective A high plasma total homocysteine (tHcy) concentration is a risk factor for neural tube defects, recurrent spontaneous abortion, and abruptio placentae. Elevated plasma tHcy can be lowered by administration of pharmacological doses of folic and levofolinic acid. The present study was performed to compare the homocysteine-lowering potential of folic acid with and without vitamin B 12 and levofolinic acid supplementation in healthy young women. Subjects and methods In a randomized, controlled trial, 60 healthy non-pregnant women, aged 18-40years old, were randomly assigned to receive one of the following three treatments for 30 days: supplementation with 5 mg/day of folic acid (oral) (n = 20) or 5 mg/day of levofolinic acid (oral) (n = 20) or 400 mg folic acid plus 2 μg vitamin B 12 (oral) (n =20). All the women followed their normal diets. Venous blood samples were collected after the subjects had fasted overnight, beginning at the start of the 30-day intervention period (day 0) and on days 2, 5, 10, 30, 60 and 90 of intervention. Plasma tHcy levels were determined by fluorescence polarization immunoassay (coefficient of variation: 3.1%). Data are expressed as total value (mmol/l). The data were analyzed for statistical differences using the Kolmogorov, Student, Bonferroni and ANOVA tests. Results There were no significant differences among the three groups with respect to baseline concentrations of plasma tHcy. Plasma tHcy levels decreased during the 30-day intervention and persisted below basal values on days 60 and 90. The differences in decreases among groups were statistically significant. Levofolinic acid had a faster and stronger effect in reducing tHcy levels than the same doses of folic acid and folic acid plus vitamin B 12. Conclusions These results suggest that supplementation with 5 mg/day levofolinic acid has a faster and stronger effect in reducing tHcy levels than the same doses of folic acid and folic acid plus vitamin B 12. This difference was significant from the fifth day of supplementation.