Changes of homocysteine levels and arterial endothelial function in patients with high risk of coronary artery disease after 6-month folic acid supplementation.
OBJECTIVE
This study aimed to assess whether folic acid supplementation could produce longer-term (6-month) improvements in homocysteine levels and arterial endothelial function in patients with a high risk (3 or more traditional risk factors) of coronary artery disease (CAD) and hyperhomocysteinaemia.


METHODS
Thirty-one adults with 3 or more traditional risk factors of CAD and hyperhomocysteinaemia were selected, without CAD (the criterion of CAD is that more than one main vessel has an obstruction > or = 50%) by coronary angiography. All subjects were given folic acid (5 mg/day) for 6 months. Fasting plasma homocysteine levels were measured by high-performance liquid chromatography. Plasma folic acid and vitamin B12 levels were measured with immunoassay. Arterial endothelial function was measured as flow-mediated dilation of the brachial artery using high-resolution B-mode ultrasound.


RESULTS
Folic acid supplementation for 6 months was associated with a significant increase in mean (+/- SD) plasma levels of folic acid (4.6 +/- 1.4 microg/l to 9.1 +/- 2.5 microg/l; P < 0.01) and a significant decline in homocysteine levels (18.3 +/- 3.9 micromol/l to 11.5 +/- 2.8 micromol/l; P < 0.01). Flow-mediated dilation also improved significantly, from 6.8% +/- 2.1% to 8.9% +/- 1.7% (P < 0.01).


CONCLUSIONS
These results demonstrate that long-term (6-month) folic acid administration significantly declines homocysteine levels and improves arterial endothelial function and has potential implications for the prevention of atherosclerosis in adults with 3 or more traditional risk factors of CAD and hyperhomocysteinaemia.
Guo
Hangyuan
H
Department of Cardiology, Huayu Hospital, China Medical University, Shaoxing 312030, China. ghangyuan@hotmail.com
Lee
Jong-Dae
JD
Xing
Yangbo
Y
Cheng
Jianfeng
J
Ueda
Takanori
T
Toyoda
Kiyohiro
K
Geshi
Tooru
T
D000368:Aged; D001158:Arteries / Q000187:drug effects*; D002851:Chromatography, High Pressure Liquid; D003324:Coronary Artery Disease / Q000517:prevention & control*; D019587:Dietary Supplements; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D006710:Homocysteine / Q000187:drug effects*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013995:Time; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000097:blood
D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12