Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease.
OBJECTIVE
To investigate the effect of vitamin supplements on homocysteine levels in patients with celiac disease.


METHODS
Vitamin B6, folate, vitamin B12, and fasting plasma homocysteine levels were measured in 51 consecutive adults with celiac disease [median (range) age 56 (18-63) years; 40% men, 26 (51%) had villous atrophy, and 25 (49%) used B-vitamin supplements] and 50 healthy control individuals matched for age and sex. Finally, the C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) was evaluated in 46 patients with celiac disease and all control individuals.


RESULTS
Patients with celiac disease and using vitamin supplements had higher serum vitamin B6 (P = 0.003), folate (P < 0.001), and vitamin B12 (P = 0.012) levels than patients who did not or healthy controls (P = 0.035, P < 0.001, P = 0.007, for vitamin B6, folate, and vitamin B12, respectively). Lower plasma homocysteine levels were found in patients using vitamin supplements than in patients who did not (P = 0.001) or healthy controls (P = 0.003). However, vitamin B6 and folate, not vitamin B12, were significantly and independently associated with homocysteine levels. Twenty-four (48%) of 50 controls and 23 (50%) of 46 patients with celiac disease carried the MTHFR thermolabile variant T-allele (P = 0.89).


CONCLUSIONS
Homocysteine levels are dependent on Marsh classification and the regular use of B-vitamin supplements is effective in reduction of homocysteine levels in patients with celiac disease and should be considered in disease management.
Hadithi
Muhammed
M
Department of Gastroenterology, VUmc University Medical Center, Rotterdam, The Netherlands. hadithim@maasstadziekenhuis.nl
Mulder
Chris J J
CJ
Stam
Frank
F
Azizi
Joshan
J
Crusius
J Bart A
JB
Peña
Amado Salvador
AS
Stehouwer
Coen D A
CD
Smulders
Yvo M
YM
D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000097:blood* / Q000188:drug therapy*; D003404:Creatinine / Q000378:metabolism; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D010205:Pantothenic Acid / Q000097:blood; D020641:Polymorphism, Single Nucleotide; D014805:Vitamin B 12 / Q000097:blood; D014803:Vitamin B Complex / Q000627:therapeutic use*; D055815:Young Adult
D006710:Homocysteine; D014803:Vitamin B Complex; D010205:Pantothenic Acid; D005492:Folic Acid; D003404:Creatinine; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D014805:Vitamin B 12