Treatment of hyperhomocysteinemia with folic acid: effects on homocysteine levels, coagulation status, and oxidative stress markers.
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.
Mayer
Otto
O
Department of Clinical Pharmacology, University Hospital, Plzen, Czech Republic.
Filipovský
Jan
J
Hromádka
Milan
M
Svobodová
Vlasta
V
Racek
Jaroslav
J
Mayer
Otto
O
Stehlík
Pavel
P
Trefil
Ladislav
L
Zárybnická
Marta
M
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
D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid