Plasmatic homocysteine response to vitamin supplementation in elderly people

Abstract

Homocysteine (Hcy) increase is now widely accepted as a risk factor for vascular disease. The effects of folic acid (FA) and vitamins B 12 and B 6 in lowering Hcy have been extensively studied, but there is still little data on the response to FA dietary administration. Our purpose was to evaluate the impact of the diet and the degree of response to different doses of pharmacological FA supplementation. In a prospective, randomized, and simple blind study, 50 elderly subjects were given a 400-μg/day FA diet and were randomly assigned to one of the following treatments: Group I=placebo tablet; Group II=tablet containing 1-mg folic acid, 1-mg B 12, and 25-mg B 6; and Group III=tablet containing 2.5-mg folic acid and same B 6 and B 12 doses as Group II. Forty-four subjects completed the study, and their plasmas were evaluated. Hcy concentration significantly decreased even in patients with normal basal values, and there were no differences in the response between individuals receiving diet plus placebo and those receiving diet plus pharmacological supplementation. After the treatment, the mean decrease of plasmatic Hcy levels was 10.8 (9.4, 12.5) μmol/l, geometric mean [95% confidence interval (95% CI)], and particularly, the values for Group I were 10.6 (7.4, 14.8) μmol/l. In 31% of the subjects, the post-treatment Hcy levels were ≤5 μmol/l. These results show that a special diet, with or without pharmacological FA and B 12 and B 6 supplementation, significantly decreases the Hcy levels in elderly people. Therefore, a diet with high contents of FA might have an enormous impact on the morbidity and mortality of atherothrombosis.