title: Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease.
abstract: 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.
authors.affiliation: Department of Gastroenterology, VUmc University Medical Center, Rotterdam, The Netherlands. hadithim@maasstadziekenhuis.nl
authors.forename: Muhammed
authors.initials: M
authors.lastname: Hadithi
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: Frank
authors.initials: F
authors.lastname: Stam
authors.forename: Joshan
authors.initials: J
authors.lastname: Azizi
authors.forename: J Bart A
authors.initials: JB
authors.lastname: Crusius
authors.forename: Amado Salvador
authors.initials: AS
authors.lastname: Peña
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Yvo M
authors.initials: YM
authors.lastname: Smulders
mesh_terms: 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
chemical_list: D006710:Homocysteine; D014803:Vitamin B Complex; D010205:Pantothenic Acid; D005492:Folic Acid; D003404:Creatinine; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D014805:Vitamin B 12