The effect of folic acid supplementation on carotid intima-media thickness in patients with cardiovascular risk: A randomized, placebo-controlled trial

Ntaios, George; Savopoulos, Christos; Karamitsos, Dimitrios T.; Economou, I.; Destanis, Evangelos; Chryssogonidis, Ioannis; Pidonia, Ifigenia; Zebekakis, Pantelis; Polatides, C.; Sion, Michel; Grekas, Dimitrios; Hatzitolios, Apostolos

doi:10.1016/j.ijcard.2009.01.023

Cited by 41 publications

(30 citation statements)

References 22 publications

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“…Group A (intervention; 17 females and 13 males; n = 30) received 5 mg/day folate supplements as tablet and group B (placebo; 17 females and 13 males; n = 30) received daily placebo tablets for 12 weeks. Due to lack of evidence about the appropriate dosage of folate for patients with T2DM, overweight and CHD, we used the above-mentioned dose of folate based on a previous study in patients with cardiovascular risk [20]. Folate supplements and its placebos (cellulose) were produced by Iran Daru Pharmaceutical Company (Tehran, Iran) and Barij Essence Pharmaceutical Company (Kashan, Iran), respectively.…”

Section: Methodsmentioning

confidence: 99%

The Effects of Folate Supplementation on Carotid Intima-Media Thickness and Metabolic Status in Patients with Metabolic Syndrome

Talari¹,

Rafiee²,

Farrokhian³

et al. 2016

Ann Nutr Metab

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Background: This study was carried out to evaluate the effects of folate supplementation on carotid intima-media thickness (CIMT) and metabolic status among patients with metabolic syndrome (MetS). Methods: This randomized, double-blind, placebo-controlled trial was conducted among 60 patients with type 2 diabetes mellitus and coronary heart disease. They were all overweight in the age range 40-85 years. Participants were randomly divided into 2 groups: group A (n = 30) received 5 mg folate supplements and group B (n = 30) received placebo for 12 weeks. Results: Folate supplementation resulted in a significant reduction in maximum levels of left CIMT (-0.05 ± 0.13 vs. +0.02 ± 0.11 mm, p = 0.01) compared with the placebo. Changes in fasting plasma glucose (-2.2 ± 37.5 vs. +30.2 ± 65.8 mg/dl, p = 0.02), serum insulin concentration (-2.0 ± 10.7 vs. +3.0 ± 7.6 µIU/ml, p = 0.04) and homeostasis of assessment-estimated insulin resistance (-0.6 ± 2.3 vs. +0.9 ± 2.3, p = 0.01) in supplemented patients were significantly different from those of patients in the placebo group. Changes in serum triglycerides (p = 0.04), high-density lipoprotein-cholesterol (p = 0.001), high sensitivity C-reactive protein (p = 0.01) and plasma nitric oxide concentrations (p < 0.001) were significantly different between the supplemented patients and placebo group. Conclusions: Overall, 5 mg/day folate supplementation for 12 weeks among patients with MetS had beneficial effects on CIMT and the metabolic status.

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Section: Methodsmentioning

confidence: 99%

The Effects of Folate Supplementation on Carotid Intima-Media Thickness and Metabolic Status in Patients with Metabolic Syndrome

Talari¹,

Rafiee²,

Farrokhian³

et al. 2016

Ann Nutr Metab

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“…On the other hand, other investigators failed to find an association between the C677T MTHFR variant and IS (Ntaios et al, 2008) (Mueller et al, 2005) (Marie et al, 2007) (Endre et al, 2001) (Pasquale et al, 2002) (Harland et al, 2002) (Ehab Shaker et al, 2008. These conflicting results of different studies can be explained by the differences in study size and design, the ethnic or environmental differences of the subjects and the intake of folic acid, vit B 6 or vit B 12 which could ameliorate the effect of MTHFR on HCY levels and can also be explained by interaction with other genetic risk factors (Ganji et al, 2003) (Szolnoki and Melegh, 2006).…”

Section: Discussionmentioning

confidence: 99%

Methylene Tetrahydrofolate Reductase Gene Polymorphism and the Risk of Ischemic Stroke in Type 2 Diabetic Egyptian Patients

Mackawy¹,

Badawy²

2011

GJHS

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Background: A common C677T mutation of methylenetetrahydrofolate reductase (MTHFR) gene is reported to be associated with hyperhomocysteinemia a risk for atherosclerotic vascular diseases and ischemic stroke (IS). Aim: To clarify the possible role of the MTHFR 677C>T polymorphism in predisposition to IS and to assess the relationship of allelic variants of MTHFR gene with homocysteine (Hcy) plasma levels and other risk factors of atherosclerosis and IS in type 2 diabetic Egyptians. Subjects: Group I: 40 healthy non diabetic volunteers. Group II: 40 patients with type 2 diabetes mellitus (DM) without IS. Group III: 40 patients with type 2 DM and IS. Methods: Fasting blood samples were collected for research investigations. HPLC technique was used to estimate plasma Hcy levels. Polymerase chain reaction (PCR) assay with restriction fragment length polymorphism (RFLP) were used to examine the MTHFR polymorphism. Results: The frequencies of T allele and TT genotype were significantly higher in group III patients when compared to group I and group II (P<0.001) .Total plasma Hcy and uric acid levels were significantly higher in group III patients who carry the TT genotype. Conclusion: The MTHFR 677C>T polymorphism is associated with elevated Hcy and uric acid plasma levels which increases the atherogenic risk and the prevalence of IS in type 2 diabetic Egyptian patients.

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“…Concerning this, a randomized study conducted in 103 patients at increased risk of stroke, investigated the effect of folic acid supplementation on carotid intima-media thickness (IMT). After 18 months of folic acid (vitamin B 9 ) supplementation, a significant regression of carotid IMT in the treated group compared to IMT progression recorded in the placebo group was found [34] . Similar results were reported in a study examining the influence of folic acid on carotid artery atherosclerosis.…”

Section: Stroke --+ +mentioning

confidence: 93%

High Homocysteine Serum Levels as A Cause of Early and Massive Atherosclerosis: Vitamins B-6-9-12 Supplementation: More Shadows Than Lights

Cacciapuoti

2016

Journal of Cardiology and Therapy

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addition, some experiences performed in this field demonstrated that these nutrients could favor some negative effects, as the growth of an unknown neoplastic mass, especially the cells of prostate cancer. Therefore, the supplementation with folates and other vitamins of B group can be performed cautiously in patients with increased Hcy serum concentration. INTRODUCTIONApart from traditional risk factors for cardiovascular disease, a powerful cause for raised cardiovascular morbility and mortality can be the inherited or acquired hyper-homocysteinemia (H-Hcy). In this field, several reports referred that H-Hcy can be responsible for early and massive atherosclerosis, inducing some vascular diseases life threatening, such as myocardial infarction (MI), ischemic acute stroke (IS), and peripheral vascular disease (PVD) [1][2][3][4][5] . Concerning this, several studies and trials demonstrated that elevated plasma total Hcy may promote atherothrombosis with several mechanisms [6][7][8] . Among these, increased Hcy and S-adenosyl-homocysteine (SAH) serum values, inhibiting the methyltransferases, result in abnormal smooth muscle cell proliferation and reduction of endothelial cells' growth. A critical role in the atherosclerotic process is played by DNA hypomethylation [9,10] . But, H-Hcy also causes down regulation of cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE), resulting in depletion of H2S, an angiogenic agent with antioxidant and vasorelaxing properties. Therefore, its depletion results in ABSTRACTFolic acid and/or Vitamins B6-12 deficiency induces high-homocysteine (H-Hcy) serum levels for reduced activity of methylene-tetra hydro folate reductase (MTHFR). This metabolic derangement can be responsible for early and massive atherosclerosis, that could favour ischemic acute events. It can be assumed that vitamins' supplementation, reducing the elevated Hcy serum concentration, could reduce atherosclerotic risk. In this review,we evaluated if, the reduction of the high Hcy values by the B-vitamins' supplementation, is able to reduce the incidence of atherosclerotic events.Retrospective trials performed in patients already suffered of acute ischemic episodes, demonstrated that vitamins B6-9-12 supplementation was unable to reduce the incidence of new ischemic events, even if it lowers the high Hcy levels. On the contrary, perspective studies carried out in patients not previously suffered of cardiovascular acute events, evidenced that the vitamins' supplementation significantly reduced both Hcy serum concentration and atherosclerotic risk. These conflicting results demonstrate that folic acid and vitamins B6/12 supplementation is effective in to reduce high Hcy serum concentration in patients with signs of previous atherosclerosis, but is unable to reduce the atherosclerotic risk. On the contrary, the supplementation is useful in to lower both high Hcy serum levels and atherosclerotic risk in patients without atherosclerotic marks. In

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The effect of folic acid supplementation on carotid intima-media thickness in patients with cardiovascular risk: A randomized, placebo-controlled trial

Cited by 41 publications

References 22 publications

The Effects of Folate Supplementation on Carotid Intima-Media Thickness and Metabolic Status in Patients with Metabolic Syndrome

The Effects of Folate Supplementation on Carotid Intima-Media Thickness and Metabolic Status in Patients with Metabolic Syndrome

Methylene Tetrahydrofolate Reductase Gene Polymorphism and the Risk of Ischemic Stroke in Type 2 Diabetic Egyptian Patients

High Homocysteine Serum Levels as A Cause of Early and Massive Atherosclerosis: Vitamins B-6-9-12 Supplementation: More Shadows Than Lights

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