Effect of homocysteine reduction by B-vitamin supplementation on markers of clotting activation.
Homocysteine may have an effect on risk of cardiovascular disease by stimulating procoagulant factors and/or impair anti-coagulant mechanisms or fibrinolysis. However, data in humans of such effects are sparse. In this intervention study, we examined the effect of homocysteine lowering by B-vitamin supplementation on prothrombin fragments 1 and 2 (F1 + 2), thrombin-antithrombin complex (TAT), and fibrin degradation products (D-dimer). The study comprised 118 healthy volunteers, 50 with homocysteine > 16 mumol/L and 68 with homocysteine < or = 16 mumol/L, who were randomized to placebo or high-dose B-vitamin supplements (5 mg folic acid, 0.4 mg hydroxycobalamin, and 50 mg pyridoxine) daily for 8 weeks. Although homocysteine concentrations were 27.7% (p < 0.0001) reduced in the B-vitamin group compared to the placebo group, no effect on F1 + 2 and TAT concentrations was observed. A 10.4% reduction was observed for D-dimer (p = 0.08). In conclusion, it appears that in healthy subjects homocysteine reduction by B-vitamin supplementation has a modest beneficial effect on clotting activation.
Division of Human Nutrition and Epidemiology, Wageningen University, Wageningen Centre for Food Sciences, Wageningen.
Mariska
M
Klerk
Petra
P
Verhoef
Bert
B
Verbruggen
Evert G
EG
Schouten
Henk J
HJ
Blom
Gerard M J
GM
Bos
Martin
M
den Heijer
D000328:Adult; D000368:Aged; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects*; D019587:Dietary Supplements; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005492:Folic Acid / Q000008:administration & dosage / Q000494:pharmacology; D006710:Homocysteine / Q000097:blood* / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006879:Hydroxocobalamin / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D010447:Peptide Hydrolases / Q000097:blood; D011516:Prothrombin; D011736:Pyridoxine / Q000008:administration & dosage / Q000494:pharmacology; D014803:Vitamin B Complex / Q000008:administration & dosage* / Q000494:pharmacology
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D006710:Homocysteine; D014803:Vitamin B Complex; D000990:Antithrombin III; D011516:Prothrombin; D005492:Folic Acid; D010447:Peptide Hydrolases; D011736:Pyridoxine; D006879:Hydroxocobalamin