Homocysteine Lowering by Folate-Rich Diet or Pharmacological Supplementations in Subjects with Moderate Hyperhomocysteinemia

Abstract

Background/Objectives: To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocols in subjects with “moderate” hyperhomocysteinemia, also taking into account C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene. Subjects/Methods: We performed a 13 week open, randomized, double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia, with daily 200 μg from a natural folate-rich diet, 200 μg [6S]5-methyltetrahydrofolate (5-MTHF), 200 μg folic acid or placebo. Participants were stratified according to their MTHFR genotype. Results: Homocysteine (Hcy) levels were reduced after folate enriched diet, 5-MTHF or folic acid supplementation respectively by 20.1% (p < 0.002), 19.4% (p < 0.001) and 21.9% (p < 0.001), as compared to baseline levels and significantly as compared to placebo (p < 0.001, p < 0.002 and p < 0.001, respectively for enriched diet, 5-MTHF and folic acid). After this enriched diet and the folic acid supplementation, Hcy in both genotype groups decreased approximately to the same level, with higher percentage decreases observed for the TT group because of their higher pre-treatment value. Similar results were not seen by genotype for 5-MTHF. A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations, as compared to placebo. Conclusions: Supplementation with natural folate-rich foods, folic acid and 5-MTHF reached a similar reduction in Hcy concentrations.

Serum Homocysteine, Vitamin B12, and Folate, and the Prevalence and Incidence of Posterior Subcapsular Cataract

“…We estimated that our longitudinal study sample would be able to 19 detect a smallest odds ratio of 3.7 comparing the highest versus the lowest 20 quintiles of homocysteine level. 21 Detailed examination procedures have been described previously 12 6 Detailed photographic and grading procedures have been described 7 previously 12 . Briefly, lens photographs taken during the examinations were 8 assessed for cataract in a masked manner by trained graders using the 9 Wisconsin Cataract Grading System 13 .…”

“…Of the remaining 3015 participants, 371 were excluded because of 20 missing or ungradable photographs or because cataract surgery had been 21 performed previously. Thus, 2644 (75.4%) participants had data available for 22 the cross-sectional association analysis.…”

“…17 Briefly, fasting blood was collected at the study site and tested at Westmead Serum homocysteine assays were conducted on an IMx Analyzer (Abbott 20 Laboratories, Abbott Park, Illinois, USA) using a fluorescence polarization 21 immunoassay method. Serum vitamin B12 and folate assays were conducted 22 on a Beckman-Access analyzer (Beckman Coulter Inc, Fullerton, California, 23 USA) using a competitive-binding assay method.…”

La nutrición en el periodo preconcepcional y los resultados del embarazo: revisión bibliográfica y propuesta de intervención del Dietista-Nutricionista

“…En primer lugar, destacaron los resultados de estudios que analizaron si el adecuado consumo de ácido fólico antes de la concepción podría reducir otros defectos congénitos por su implicación en la vía de la metilación. Dichos estudios asociaron la hiperhomocisteinemia con un consumo inadecuado de ácido fólico [20][21][22] , siendo dicha alteración la que estaría relacionada con la aparición de defectos congénitos.…”

“…En correlación con lo comentado anteriormente acerca de la hiperhomocisteinemia [20][21][22] , en un estudio de caso-control (n=434 mujeres) realizado en China, se observó que niveles elevados de homocisteína junto con una subóptima ingesta preconcepcional de vitamina B 12 y B 6 podía aumentar el riesgo de parto prematuro, de modo que dichos niveles elevados se asociaban con una probabilidad aumentada de casi 4 veces de riesgo de experimentar parto prematuro. El riesgo era 60% menor en las mujeres sin deficiencia de vitamina B 12 y un 50% menor en las mujeres con niveles óptimos de vitamina B 6 52 , por lo tanto, también resultaría de interés realizar estudios para aclarar si la influencia de la homocisteína sobre la aparición del riesgo de padecer algunos trastornos se debe a una acción sinérgica con deficiencias de micronutrientes, o si se ve potenciada por la misma.…”