Folic Acid and vitamin B12 supplementation improves coronary flow reserve in elderly subjects with vitamin B12 deficiency.
OBJECTIVE
Major cardiovascular risk factors including hyperhomocysteinemia are frequently associated with decreased coronary flow reserve (CFR), an important physiological parameter of the coronary circulation. This study was designed to determine whether folate (5 mg) and vitamin B12 (500 μg) supplementation in elderly patients with vitamin B12 deficiency improved CFR, while reducing homocysteine levels.


METHODS
Forty-four patients aged >65 years showing serum vitamin B12 concentrations <180 mg/dL were randomized to take either oral folate (5 mg) plus vitamin B12 (500 μg) supplementation (n = 24) or placebo (n = 20) for 8 weeks. The study course consisted of two visits: visit 1 (pretreatment) included the baseline assessment of laboratory profile and CFR values with trans-thoracic Doppler echocardiography. Visit 2 was scheduled 8 weeks later to repeat CFR and laboratory tests after therapy.


RESULTS
In the treatment arm, oral supplementation with folate and vitamin B12 significantly improved total cholesterol, serum folate, serum vitamin B12, homocysteine, and insulin resistance. At 8 weeks, the treatment group had a significant increase from baseline in CFR values (baseline: 1.7 ± 0.2; postttreatment: 2.1 ± 0.2, p <0.001) that was not seen in the placebo group (baseline: 1.6 ± 0.2; posttreatment: 1.6 ± 0.2; P = ns).


CONCLUSIONS
In this study of elderly subjects with vitamin B12 deficiency, supplementation with folate and vitamin B12 was associated with a significant improvement in CFR values.
Kurt
Ramazan
R
Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.
Yilmaz
Yusuf
Y
Ermis
Fatih
F
Kalayoglu Besisik
Sevgi
S
Polat
Nihat
N
Elitok
Ali
A
Oflaz
Huseyin
H
Karan
Mehmet Akif
MA
D000368:Aged; D003331:Coronary Vessels / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy / Q000503:physiopathology*
D010919:Placebos; D005492:Folic Acid; D014805:Vitamin B 12