Low vitamin B6 plasma levels, a risk factor for thrombosis, in inflammatory bowel disease: role of inflammation and correlation with acute phase reactants

Saibeni, Simone; Cattaneo, Marco; Vecchi, Maurizio; Zighetti, Maddalena L.; Lecchi, Anna; Lombardi, Rossana; Meucci, G.; Spina, Luisa; Franchis, Roberto de

doi:10.1111/j.1572-0241.2003.07160.x

Cited by 155 publications

(67 citation statements)

References 33 publications

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“…The clinical significance of this finding, however, is difficult to interpret, since data from prospective cohort trials on the presumed increased cardiovascular risk in these patients are still lacking. Recently, Saibeni et al reported decreased vitamin B 6 levels in IBD patients, especially in those with active disease, which appeared to be associated with hyperhomocysteinemia (37). The abnormal methionine loading tests in IBD patients with arterial thrombosis in our study could partly be explained by a disturbed transulfuration of homocysteine due to a relative deficiency of vitamin B 6 .…”

Section: Discussionmentioning

confidence: 70%

Risk Factors for Thromboembolic Complications in Inflammatory Bowel Disease: The Role of Hyperhomocysteinaemia

et al. 2005

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Inflammatory bowel disease (IBD) is associated with an increased risk for thromboembolic events. Aim of this study was to examine the relationship of hyperhomocysteinemia and thrombosis in IBD patients and to assess the role of this factor in addition to other known prothrombotic abnormalities. IBD patients with a history of thrombosis (n = 22) and sex-, age-, and diagnosis-matched IBD controls (n = 23) were studied. Homocysteine (tHcy) was assessed before and after methionine loading. Plasma levels of protein C, protein S, antithrombin III, and fibrinogen and the presence of anticardiolipin and antiphospholipid antibodies were determined and genetic testing for factor V Leiden and the prothrombin gene mutation was performed. Results showed that fasting homocysteine levels in IBD patients with a history of arterial or venous thrombosis tended to be higher than in IBD controls, although not significantly. The increase in homocysteine levels after methionine loading was significantly higher in IBD patients in the arterial thrombosis group than in IBD controls (40.9 +/- 17.7 vs. 27.2 +/- 9.9 microM; P < 0.05). Among the other prothrombotic factors, only factor V Leiden was significantly associated with a history of venous thrombosis (20 vs. 0%). At least one risk factor was found in 64% of the IBD patients with previous thromboembolic complications. We conclude that there is an association between hyperhomocysteinemia and a history of arterial thrombosis in IBD patients. We confirm the high prevalence of factor V Leiden in IBD patients with a history of venous thrombosis. In the majority of IBD patients with previous thromboembolic complications, at least one prothrombotic risk factor is detected.

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Section: Discussionmentioning

confidence: 70%

Risk Factors for Thromboembolic Complications in Inflammatory Bowel Disease: The Role of Hyperhomocysteinaemia

et al. 2005

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“…Hypercoagulable state may result from increased levels of fibrinogen, factor V, factor VII, factor VIII, lipoprotein a, prothrombin fragments 1 and 2, homocysteine, and decreased levels of antithrombin-3, protein S, protein C, and vitamin B 6 . Increased sponta- neous platelet aggregation and a high prevalence of anticardiolipin antibodies, anti-β 2 glycoprotein I antibody, and antiphospholipid antibodies, resistance to activated protein C, Factor V Leiden mutation, and the G20210A mutation have also been reported to be associated with thromboembolic events (7)(8)(9)(10)(11)(12)(13). Cigarette smoking is also an independent risk factor.…”

Section: Discussionmentioning

confidence: 94%

Crohn’s and Behçet’s Disease Association Presenting with Superior Vena Cava Thrombosis

et al. 2005

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A 21-year-old male patient with a 6-year history of Crohn's disease presented with shoulder pain and edema in the neck and bilateral supraclavicular fossa. Color Doppler ultrasonography and computed tomography scan revealed bilateral thrombosis of the external jugular veins, brachiocephalic veins, and superior vena cava. Other etiologies were appropriately ruled out and the thrombosis was initially attributed to Crohn's disease. In the follow-up, the patient developed recurrent, painful orogenital ulcers and acne vulgaris-like skin eruptions. HLA tissue typing was HLA B-51. The diagnosis of Crohn's disease associated with Behçet's disease was made. Although there are several case reports describing such an association, a Medline research revealed that this was the first presentation of such an association with thrombosis. Thrombosis in unusual sites may reflect the uncommon association of Crohn's disease with hypercoagulable conditions such as Behçet's disease.

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“…Interestingly, the study by Danese et al [5] also showed increased homocysteine production by cultured lamina propria mononuclear cells isolated from mucosal biopsies from IBD versus normal patients. Other studies in IBD patients have shown that increased plasma homocysteine is associated with decreased B-vitamin levels, particularly those involved in methionine metabolism (folate, B6, and B12) [83][84][85]. Multiple factors can lead to malnutrition of these vitamins in IBD patients, including drug interactions, reduced nutrient intake, and reduced ability of the small intestine to absorb nutrients [86].…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Intestinal Metabolism of Sulfur Amino Acids

Benight

Burrin

Stoll

2008

Glutathione and Sulfur Amino Acids in Human Health and Disease

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Low vitamin B6 plasma levels, a risk factor for thrombosis, in inflammatory bowel disease: role of inflammation and correlation with acute phase reactants

Abstract: Low vitamin B(6) plasma levels, an independent risk factor for thrombosis, are frequent in patients with IBD, especially those with active disease.

Cited by 155 publications

References 33 publications

Risk Factors for Thromboembolic Complications in Inflammatory Bowel Disease: The Role of Hyperhomocysteinaemia

Risk Factors for Thromboembolic Complications in Inflammatory Bowel Disease: The Role of Hyperhomocysteinaemia

Crohn’s and Behçet’s Disease Association Presenting with Superior Vena Cava Thrombosis

Intestinal Metabolism of Sulfur Amino Acids

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