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Lowering homocysteine and modifying nutritional status with folic acid and vitamin B(12) in Indian patients of vascular disease.

Bhargava S, Ali A, Bhargava EK, Manocha A, Kankra M, Das S, Mohan Srivastava L - J Clin Biochem Nutr (2012)

Bottom Line: Homocysteine exhibited a significant negative correlation with B(12) only in cerebrovascular disease and peripheral vascular diseasepatients, and with folate in coronary artery disease and cerebrovascular disease patients as well as controls.Single daily dose of folate was as effective as a combination of folate and cobalamin in reducing plasma homocysteine concentrations.Hence, large-scale corrective measures like food fortification or dietary supplementation with folate might benefit the Indian population and reduce the incidence and morbidity of vascular disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, India.

ABSTRACT
Hyperhomocysteinemia is more commonly associated with vascular disease in Indians than in the western populations. It is caused by genetic polymorphisms or dietary deficiencies of the B vitamins. We attempted to identify the association of hyperhomocysteinemia with vitamin B(12) and folate in Indian patients of vascular disease. Homocysteine, vitamin B(12) and folate levels were estimated in 100 controls and 100 patients of vascular disease. Homocysteine estimation was repeated in 73 patients on different vitamin supplements for 6 months. Homocysteine exhibited a significant negative correlation with B(12) only in cerebrovascular disease and peripheral vascular diseasepatients, and with folate in coronary artery disease and cerebrovascular disease patients as well as controls. Single daily dose of folate was as effective as a combination of folate and cobalamin in reducing plasma homocysteine concentrations. Low levels of B(12) contribute to the higher incidence of cerebrovascular disease and peripheral vascular disease, and low folate levels account for higher prevalence of hyperhomocysteinemia in coronary artery disease and cerebrovascular disease. Moreover, irrespective of the cause of hyperhomocysteinemia, folate is known to ameliorate it. Hence, large-scale corrective measures like food fortification or dietary supplementation with folate might benefit the Indian population and reduce the incidence and morbidity of vascular disease.

No MeSH data available.


Related in: MedlinePlus

Homocysteine metabolism and its relation with folate cycle
© Copyright Policy - open-access
Related In: Results  -  Collection


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Figure 1: Homocysteine metabolism and its relation with folate cycle

Mentions: The association of homocysteine with vascular disease is demonstrated to be inter-related with its role in the methionine metabolism. In the remethylation cycle, homocysteine metabolism is integrally related to the folate cycle (Fig. 1), where circulating folate is converted to tetrahydrofolate (THF). This, on methylation, yields 5,10 methylene THF, which is then reduced to 5-methyl THF by the action of the enzyme methylene tetrahydrofolate reductase (MTHFR). The remethylation cycle is so named as homocysteine gets remethylated to methionine by acquiring a methyl group from 5-methyl THF from the folate cycle through a reaction catalysed by the enzyme methionine synthase that requires vitamin B12 as a cofactor. Hence, folate and vitamin B12 are both necessary for the remethylation of homocysteine.


Lowering homocysteine and modifying nutritional status with folic acid and vitamin B(12) in Indian patients of vascular disease.

Bhargava S, Ali A, Bhargava EK, Manocha A, Kankra M, Das S, Mohan Srivastava L - J Clin Biochem Nutr (2012)

Homocysteine metabolism and its relation with folate cycle
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3334376&req=5

Figure 1: Homocysteine metabolism and its relation with folate cycle
Mentions: The association of homocysteine with vascular disease is demonstrated to be inter-related with its role in the methionine metabolism. In the remethylation cycle, homocysteine metabolism is integrally related to the folate cycle (Fig. 1), where circulating folate is converted to tetrahydrofolate (THF). This, on methylation, yields 5,10 methylene THF, which is then reduced to 5-methyl THF by the action of the enzyme methylene tetrahydrofolate reductase (MTHFR). The remethylation cycle is so named as homocysteine gets remethylated to methionine by acquiring a methyl group from 5-methyl THF from the folate cycle through a reaction catalysed by the enzyme methionine synthase that requires vitamin B12 as a cofactor. Hence, folate and vitamin B12 are both necessary for the remethylation of homocysteine.

Bottom Line: Homocysteine exhibited a significant negative correlation with B(12) only in cerebrovascular disease and peripheral vascular diseasepatients, and with folate in coronary artery disease and cerebrovascular disease patients as well as controls.Single daily dose of folate was as effective as a combination of folate and cobalamin in reducing plasma homocysteine concentrations.Hence, large-scale corrective measures like food fortification or dietary supplementation with folate might benefit the Indian population and reduce the incidence and morbidity of vascular disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, India.

ABSTRACT
Hyperhomocysteinemia is more commonly associated with vascular disease in Indians than in the western populations. It is caused by genetic polymorphisms or dietary deficiencies of the B vitamins. We attempted to identify the association of hyperhomocysteinemia with vitamin B(12) and folate in Indian patients of vascular disease. Homocysteine, vitamin B(12) and folate levels were estimated in 100 controls and 100 patients of vascular disease. Homocysteine estimation was repeated in 73 patients on different vitamin supplements for 6 months. Homocysteine exhibited a significant negative correlation with B(12) only in cerebrovascular disease and peripheral vascular diseasepatients, and with folate in coronary artery disease and cerebrovascular disease patients as well as controls. Single daily dose of folate was as effective as a combination of folate and cobalamin in reducing plasma homocysteine concentrations. Low levels of B(12) contribute to the higher incidence of cerebrovascular disease and peripheral vascular disease, and low folate levels account for higher prevalence of hyperhomocysteinemia in coronary artery disease and cerebrovascular disease. Moreover, irrespective of the cause of hyperhomocysteinemia, folate is known to ameliorate it. Hence, large-scale corrective measures like food fortification or dietary supplementation with folate might benefit the Indian population and reduce the incidence and morbidity of vascular disease.

No MeSH data available.


Related in: MedlinePlus