Laxative treatment elevates plasma homocysteine: a study on a population-based Swedish sample of old people.
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.
Nilsson
Sven E
SE
Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden.
Takkinen
Sanna
S
Johansson
Boo
B
Dotevall
Gerhard
G
Melander
Arne
A
Berg
Stig
S
McClearn
Gerald
G
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
D002400:Cathartics; D006710:Homocysteine; D007792:Lactulose; D005492:Folic Acid; D014805:Vitamin B 12