Ethnicity does not affect the homocysteine-lowering effect of B-vitamin therapy in Singaporean stroke patients.
OBJECTIVE
Increased total homocysteine (tHcy) is a risk factor for stroke. This study examines whether the efficacy of B-vitamins in reducing tHcy is modified by ethnicity in a Singaporean ischemic stroke population.


METHODS
505 patients (419 Chinese, 41 Malays and 45 Indians) with ischemic stroke were randomized to receive placebo or B-vitamins. Fasting blood samples collected at baseline and 1 year were assayed for tHcy. MTHFR polymorphisms were genotyped.


RESULTS
Ethnicity did not independently determine tHcy at baseline. The magnitude of tHcy reduction by B-vitamin treatment was consistent across ethnic groups (Chinese -3.8+/-4.5, Malay -4.9+/-4.2, and Indian -3.3+/-3.6 micromol/L) despite ethnic differences in MTHFR genotype and baseline folic acid (FA) and vitamin B(12) (vitB(12)) concentrations.


CONCLUSIONS
Ethnicity does not appear to affect the tHcy-lowering effect of B-vitamins, despite differences in dietary intake and prevalence of MTHFR polymorphisms. This suggests that the effect of B-vitamins in lowering tHcy is generalizable across Asian populations. However, due to relatively small numbers of non-Chinese studied, confirmation in other populations is required.
Katherine
K
Kasiman
John W
JW
Eikelboom
Graeme J
GJ
Hankey
Samantha P-K
SP
Lee
Joanna P-Z
JP
Lim
Jasinda H-Q
JH
Lee
Hui-Meng
HM
Chang
Meng-Cheong
MC
Wong
Christopher P L-H
CP
Chen
D000368:Aged; D002681:China / Q000208:ethnology; D004032:Diet; D005006:Ethnicity; D005260:Female; D005492:Folic Acid / Q000097:blood; D005787:Gene Frequency; D005838:Genotype; D006710:Homocysteine / Q000037:antagonists & inhibitors* / Q000097:blood*; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D020521:Stroke / Q000097:blood*; D014803:Vitamin B Complex / Q000627:therapeutic use*
D006710:Homocysteine; D014803:Vitamin B Complex; D005492:Folic Acid; D042965:Methylenetetrahydrofolate Reductase (NADPH2)