Effect of folate supplementation on N-terminal pro-brain natriuretic peptide.
BACKGROUND
Increased plasma homocysteine (HCY) has been suggested as a novel risk factor for chronic heart failure (CHF). This study investigated the effect of a HCY lowering therapy by folic acid (FA) supplementation on N-terminal pro-brain natriuretic peptide (NT-proBNP) in healthy subjects.


METHODS
We treated 61 healthy individuals (median age [25th-75th percentile]: 57 [53-69] years with placebo, 0.4, 1.0 or 5.0 mg FA daily for 2 months. Fasting blood samples were taken after 0, 4 and 8 weeks. Serum HCY, folate, vitamin B12 and NT-proBNP were studied.


RESULTS
Baseline HCY, folate and NT-proBNP levels were 13.6 (10.0-16.4) micromol/L, 5.0 (3.8-6.4) microg/L and 40.4 (21.8-67.3) ng/L, respectively. Serum folate increased during supplementation (4 weeks of placebo, 0.4, 1.0, 5.0 mg of FA: -9%, +131%, +150%, +314%; 8 weeks: -72%, +152%, +185%, +62%) and HCY decreased (4 weeks: +2%, -12%, -20%, -15%; 8 weeks: -2%, -9%, -17%, -15%) in the treatment groups. NT-proBNP did not change within groups. Pooling FA treated subjects, individuals with a baseline NT-proBNP above the median of 40 ng/L exhibited a 20% decrease of NT-proBNP (significant on a 10% level) while HCY decreased by 15%.


CONCLUSIONS
FA supplementation with doses between 0.4 and 5 mg does not affect NT-proBNP in healthy subjects with an NT-proBNP concentration <40 ng/L, but possibly lowers NT-proBNP in individuals with NT-proBNP levels >40 ng/L.
Herrmann
Markus
M
Stanger
Olaf
O
Paulweber
Bernhard
B
Hufnagl
Clemens
C
Herrmann
Wolfgang
W
D000368:Aged; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D006710:Homocysteine / Q000097:blood / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000187:drug effects*; D010446:Peptide Fragments / Q000187:drug effects*; D012737:Sex Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D006710:Homocysteine; D020097:Natriuretic Peptide, Brain; D005492:Folic Acid