title: Laxative treatment elevates plasma homocysteine: a study on a population-based Swedish sample of old people.
abstract: OBJECTIVE
  Elevated plasma homocysteine might indicate an increased risk of cancer, and cardiovascular and neurological diseases. The homocysteine level depends on the supply of folate and cobalamine, and constipation and/or laxative treatment might compromise this supply. The present study examined the impact of constipation and laxative treatment on the blood levels of homocysteine, folate and cobalamine in a population-based sample of aged people, including consideration of frailty and impaired renal function, both of which may also influence the homocysteine level.
  
  
  METHODS
  The study was based on biochemical tests in 341 females and 183 males aged 82 years or older. The concentrations of homocysteine (plasma), folate, cobalamine and urea (serum) were measured in subjects with and without ongoing treatment with laxative drugs. Values were adjusted for age, gender and frailty, as well as for clinical diagnoses and drug therapies known to affect homocysteine levels.
  
  
  RESULTS
  Homocysteine levels were increased and those of folate reduced in aged subjects on laxatives. Homocysteine remained elevated after adjusting for frailty and various neurological disorders. There was no significant effect on homocysteine and folate in constipated subjects without laxatives.
authors.affiliation: Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
authors.forename: Sven E
authors.initials: SE
authors.lastname: Nilsson
authors.forename: Sanna
authors.initials: S
authors.lastname: Takkinen
authors.forename: Boo
authors.initials: B
authors.lastname: Johansson
authors.forename: Gerhard
authors.initials: G
authors.lastname: Dotevall
authors.forename: Arne
authors.initials: A
authors.lastname: Melander
authors.forename: Stig
authors.initials: S
authors.lastname: Berg
authors.forename: Gerald
authors.initials: G
authors.lastname: McClearn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D003248:Constipation / Q000188:drug therapy / Q000503:physiopathology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005492:Folic Acid / Q000096:biosynthesis / Q000187:drug effects; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006710:Homocysteine / Q000096:biosynthesis* / Q000097:blood*; D006801:Humans; D007792:Lactulose / Q000627:therapeutic use; D008297:Male; D013548:Sweden; D014805:Vitamin B 12 / Q000096:biosynthesis / Q000097:blood
chemical_list: D002400:Cathartics; D006710:Homocysteine; D007792:Lactulose; D005492:Folic Acid; D014805:Vitamin B 12