Decrease of carotid intima-media thickness in patients at risk to cerebral ischemia after supplementation with folic acid, Vitamins B6 and B12.
OBJECTIVE
Hyperhomocysteinemia is associated with atherosclerotic risk. Although vitamins can lower homocysteine (Hcy), information about effects on atherosclerosis is scarce.


METHODS
We used carotid intima-media thickness (IMT) as an accepted marker of atherosclerotic changes. Fifty patients (60 +/- 8 years) with IMT> or =1 mm were included. In a double blind, randomized trial they received daily 2.5 mg folic acid, 25 mg Vitamin B6, and 0.5mg Vitamin B12 or placebo for 1 year.


RESULTS
In the treatment group, Hcy decreased from 10.50 +/- 3.93 to 6.56 +/- 1.53 micromol/l (P < 0.0001), whereas it remained unchanged in the placebo group (10.76 +/- 2.36 versus 10.45+/-3.30 micromol/l). IMT decreased from 1.50 +/- 0.44 to 1.42 +/- 0.48 mm (P = 0.034) in the treatment group, whereas it increased from 1.47 +/- 0.57 to 1.54 +/- 0.71 mm in the placebo group. The mean individual changes of IMT between both groups differed significantly (-0.08 +/- 0.17 versus 0.07 +/- 0.25 mm, P = 0.019). Multiple regression analysis revealed that the observed effect on IMT depended only on medication.


CONCLUSIONS
Vitamin supplementation significantly reduces IMT in patients at risk. This effect is independent of Hcy concentration.
Till
Uwe
U
Institute of Pathobiochemistry, Friedrich-Schiller-University, Postfach, Jena, Germany. till@mti.uni-jena.de
Röhl
Peter
P
Jentsch
Almut
A
Till
Heiko
H
Müller
Andreas
A
Bellstedt
Klaus
K
Plonné
Dietmar
D
Fink
Horst S
HS
Vollandt
Rüdiger
R
Sliwka
Ulrich
U
Herrmann
Falko H
FH
Petermann
Henning
H
Riezler
Reiner
R
D000368:Aged; D002545:Brain Ischemia / Q000517:prevention & control*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014805:Vitamin B 12 / Q000627:therapeutic use*; D025101:Vitamin B 6 / Q000627:therapeutic use*
D006710:Homocysteine; D025101:Vitamin B 6; D005492:Folic Acid; D014805:Vitamin B 12