title: Low plasma vitamin B-6 concentrations and modulation of coronary artery disease risk.
abstract: BACKGROUND
  Low concentrations of pyridoxal-5'-phosphate (PLP), the active metabolite of vitamin B-6, are associated with high C-reactive protein (CRP) concentrations. Both low PLP and elevated inflammatory markers, such as high-sensitivity CRP (hs-CRP) and fibrinogen, are related to higher risk of coronary artery disease (CAD).
  
  
  OBJECTIVE
  The objectives were to evaluate the relation between PLP and acute-phase reactants in affecting CAD risk and to estimate the risk of CAD related to low plasma PLP, either alone or in combination with high concentrations of acute-phase reactants and other classic risk factors for CAD.
  
  
  METHODS
  A case-control study was conducted with 742 participants: 475 with severe multivessel CAD and 267 free from coronary atherosclerosis (CAD-free). We measured plasma PLP, fibrinogen, hs-CRP, and serum lipid concentrations and all major biochemical CAD risk factors, including total homocysteine.
  
  
  RESULTS
  A significant, inverse, graded relation was observed between PLP and both hs-CRP and fibrinogen (P < 0.001). The prevalence of PLP concentrations in the lower half of the population (<50th percentile: 36.3 nmol/L) was significantly higher among CAD patients than among CAD-free subjects (P < 0.001). The odds ratio for CAD risk related to low PLP concentrations after adjustments for the major classic CAD risk factors, including hs-CRP and fibrinogen, was 1.89 (95% CI: 1.18, 3.03; P = 0.008). The CAD risk as a result of low PLP was additive when considered in combination with elevated hs-CRP concentrations or with an increased ratio of LDL to HDL.
  
  
  CONCLUSIONS
  Low plasma PLP concentrations are inversely related to major markers of inflammation and independently associated with increased CAD risk.
authors.affiliation: Department of Clinical and Experimental Medicine,University of Verona School of Medicine, Verona, Italy. simonetta.friso@univr.it
authors.forename: Simonetta
authors.initials: S
authors.lastname: Friso
authors.forename: Domenico
authors.initials: D
authors.lastname: Girelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Martinelli
authors.forename: Oliviero
authors.initials: O
authors.lastname: Olivieri
authors.forename: Valentina
authors.initials: V
authors.lastname: Lotto
authors.forename: Claudia
authors.initials: C
authors.lastname: Bozzini
authors.forename: Francesca
authors.initials: F
authors.lastname: Pizzolo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Faccini
authors.forename: Federico
authors.initials: F
authors.lastname: Beltrame
authors.forename: Roberto
authors.initials: R
authors.lastname: Corrocher
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011732:Pyridoxal Phosphate / Q000097:blood*; D012307:Risk Factors; D026681:Vitamin B 6 Deficiency / Q000097:blood*
chemical_list: D000209:Acute-Phase Proteins; D011732:Pyridoxal Phosphate; D002097:C-Reactive Protein; D002784:Cholesterol