title: Treatment of hyperhomocysteinemia with folic acid: effects on homocysteine levels, coagulation status, and oxidative stress markers.
abstract: The aim of the study was to determine whether folic acid treatment in subjects with homocysteinemia would change their coagulation and oxidative status. Thirty-three patients with peripheral vascular disease and 26 elderly subjects with no symptoms of atherosclerosis, all of whom had total homocysteine >20 microM, were treated with folic acid (5 or 10 mg) for 3 months. In the 33 patients with peripheral vascular disease, homocysteine levels decreased from a median of 26.7 microM at baseline to 20.0 microM (p < 0.0001), whereas in the 26 asymptomatic elderly subjects, homocysteine level decreased from 24.4 microM to 18.6 microM (p < 0.0001). Plasma fibrinogen decreased whereas plasminogen and anti-thrombin increased; the differences between pre- and posttreatment values were significant in both patients and healthy subjects. Oxidative status markers showed a shift toward lower oxidative stress. This effect was observed in both study groups. An association of the therapeutic effect with the genetic polymorphism of 5,10-methylenetetrahydrofolate reductase was not detected. Folic acid supplementation to hyperhomocysteinemic subjects resulted in a decrease in total blood homocysteine concentrations; moreover, there was a tendency to reverse the coagulation status and oxidative stress.
authors.affiliation: Department of Clinical Pharmacology, University Hospital, Plzen, Czech Republic.
authors.forename: Otto
authors.initials: O
authors.lastname: Mayer
authors.forename: Jan
authors.initials: J
authors.lastname: Filipovský
authors.forename: Milan
authors.initials: M
authors.lastname: Hromádka
authors.forename: Vlasta
authors.initials: V
authors.lastname: Svobodová
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Racek
authors.forename: Otto
authors.initials: O
authors.lastname: Mayer
authors.forename: Pavel
authors.initials: P
authors.lastname: Stehlík
authors.forename: Ladislav
authors.initials: L
authors.lastname: Trefil
authors.forename: Marta
authors.initials: M
authors.lastname: Zárybnická
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005492:Folic Acid / Q000494:pharmacology* / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects* / Q000502:physiology
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid