Folic acid—an innocuous means to reduce plasma homocysteine

Brattström, Lars; Israelsson, Bo; Jeppsson, Jan‐Olof; Hultberg, Björn

doi:10.3109/00365518809167487

Cited by 326 publications

(137 citation statements)

References 14 publications

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“…However, studies on fasting homo cysteine levels in healthy twins and also in families of cardiovascular patients have been performed already previously, showing a strong correlation [18][19][20][21][22]. We prefer to perform both fasting and post-load homocysteine concentrations in vascu lar patients and family members to investigate their individual homocysteine status more com pletely [11,25,[34][35][36][37].…”

Section: Vascular Complications In Family Membersmentioning

confidence: 99%

“…This suggests that familial mild hyperhomocysteinemia i leading to symptomatic vascular disease has a low expression, may be age dependent and that homo cysteine in mild excess may require more trigger ing factors. mHH in vascular patients can be normalized by vitamin B6 and/or folic acid treatment [11,25,[34][35][36][37]. In case homocysteine-lowering intervention in hyperhomocysteinemic vascular patients and their hyperhomocysteinemic family members is clini cally beneficial in terms of preventing recurrent and first occurrence of arterial disease, respec tively, such treatment will be of significant impor tance in general health care.…”

Section: Vascular Complications In Family Membersmentioning

confidence: 99%

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Prevalence of familial mild hyperhomocysteinemia

et al. 1996

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Previous studies have shown that elevated basal homocysteine levels are correlated among family members of patients with coronary vascular disease and juvenile venous thrombosis. This suggests the possibility of the presence of inherited basal mild hyperhomocysteinemia (mHH). We studied homocysteine levels, fasting as well as after methionine load, among 96 family members of 21 post-load hyperhomocysteinemic vascular index patients, i.e. 6 parents, 27 offspring, 38 siblings, 19 uncles and aunts and 6 cousins. In 15 out of 21 screened families post-load ml-IH was esti in at least one family member. Fa:>ting and post-load mHH was observed in 19 out of 89 (21%) screened family members (fasting homocysteine levels not measured in seven family members), and 31 out of 96 screened family members (32%), respectively. In 40% of all family members, post-load mHH was not accompanied by fasting mHH.conclude that both fasting and post-load mHH seems to be inherited in the majority of ic vascular patients.

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Section: Vascular Complications In Family Membersmentioning

confidence: 99%

Section: Vascular Complications In Family Membersmentioning

confidence: 99%

Prevalence of familial mild hyperhomocysteinemia

et al. 1996

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“…There is now solid evidence that folic acid supplementation during the periconceptional period significantly reduces the risk of giving birth to a child with a neural tube defect (NTD) (MRC, 1991;Czeizel & Duda Âs, 1992). More recent ®ndings indicate that supplementation with folic acid decreases plasma homocysteine levels (Brattstro Èm et al, 1988;Ubbink et al, 1993aUbbink et al, , 1993bUbbink et al, , 1994. This a signi®cant ®nding, since elevated plasma homocysteine levels are found to be an independent risk factor for vascular diseases (Boushey et al, 1995).…”

Section: Introductionmentioning

confidence: 98%

Folate intake in Europe: recommended, actual and desired intake

Dusseldorp²,

et al. 1997

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Objectives: To evaluate possible inconsistencies between recommended, actual and desired folate intake in European adult populations. Design: Review of dietary recommendations, of food consumption surveys, and of intervention and observational studies relating folate intake to the risk of neural tube defects and plasma homocysteine levels. Results: In Europe, mean dietary folate intake in adults is 291 mgad (range 197±326) for men and 247 mgad (range 168±320) for women. The recommended intakes vary between 200±300 mgad (men) and 170±300 mgad (women). However, women with a previous pregnancy affected by a neural tube defect (NTD), are recommended to take 4000 mgad of supplemental folic acid when planning a subsequent pregnancy. For those without a history of NTD, the use of 400 mgad of supplemental folic acid is the best option to prevent the occurrence of NTDs. A daily dose of 650 mg supplemental folic acid normalises elevated plasma homocysteine levels, which is a risk factor for cardiovascular diseases. A dietary folate intake of at least 350 mgad is desired to prevent an increase in plasma homocysteine levels of the adult population in general. Conclusions: Mean dietary folate intake in Europe is in line with recommendations, but the desired dietary intake of b350 mgad is only reached by a small part of studied European populations. It is considered unethical to investigate whether supplements with a dose lower than 400 mgad of folic acid are also protective against NTDs. However, research to establish the lowest effective dose of dietary folateasupplemental folic acid to optimise homocysteine levels and research on the bioavailability of folate is required. This will enable the choice of a strategy to achieve desired folate intakes in the general population. In the meantime, consumption of plant foods like vegetables, fruits, and cereals should be stimulated to reach the desired level of 350 mg of dietary folate per day.

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“…In a situation with deficiency of cobalamin, methylmalonyl-CoA is converted to methylmalonic acid (MMA) rather than to succinyl-CoA [9]. In addition, cobalamin is needed to convert homocysteine (Hcy) to methionine, which means that serum MMA and serum total Hcy (tHcy) increase if there is a deficiency of cobalamin [8,10,11]. Methyltetrahydrofolate is required for homocysteine remethylation to methionine, which means that if there is a deficiency of folate, homocysteine is accumulated in spite of availability of cobalamin [10±12].…”

Section: Introductionmentioning

confidence: 99%

Elevated serum levels of methylmalonic acid and homocysteine in elderly people. A population‐based intervention study

Björkegren

Svärdsudd²

1999

Journal of Internal Medicine

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Abstract. Bjo Èrkegren K, Sva Èrdsudd K (University Hospital Uppsala; Skutska Èr Primary Health Care Center, Skurska Èr, Sweden). Elevated serum levels of methylmalonic acid and homocysteine in elderly people. A population-based intervention study. J Intern Med; 246: 317±324.Objectives. There is uncertainty amongst clinicians about the definitions of cobalamin and folate deficiency and therefore about the indications for treatment. In this report we present the results of systematic cobalamin and folic acid treatment based upon serum cobalamin, total homocysteine (tHcy) and methylmalonic acid (MMA) analyses in a population-based sample. Subjects. A 20% random sample of persons 70 years or older in a defined geographical area were invited to a survey (n = 266). Sixty-nine persons who had serum cobalamin , 300 pmol L 21 and serum MMA $0.37 mmol L 21 or serum tHcy $15 mmol L 21 and who had no cobalamin or folic acid substitution were selected for treatment.Interventions. Initially all 69 patients were given cobalamin orally or intramuscularly. Those who remained high in tHcy were in addition given folic acid treatment. Main outcome measures. Serum cobalamin, serum MMA and serum tHcy. Results. After 6 months of cobalamin treatment, serum MMA became normal in 13 out of 15 persons. Mean serum tHcy decreased but was normalized in only 15 out of 56 persons. After 3 months of folic acid treatment added to those who still had an abnormal serum tHcy, serum tHcy had normalized in all but one person. Conclusions. Cobalamin treatment normalizes increased MMA values and combined cobalamin and folic acid treatment normalizes tHcy, suggesting a pretreatment deficiency of tissue cobalamin and folate in spite of normal serum cobalamin and folate values in the majority of cases.

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Folic acid—an innocuous means to reduce plasma homocysteine

Cited by 326 publications

References 14 publications

Prevalence of familial mild hyperhomocysteinemia

Prevalence of familial mild hyperhomocysteinemia

Folate intake in Europe: recommended, actual and desired intake

Elevated serum levels of methylmalonic acid and homocysteine in elderly people. A population‐based intervention study

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