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Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease

World Journal of Gastroenterology 2009年第8期15卷 955-960页

作者： Muhammed Hadithi Chris JJ Mulder frank stam Joshan Azizi J Bart A Crusius Amado Salvador Pea Coen DA Stehouwer Yvo M Smulders Department of Gastroenterology VUmc University Medical Center Amsterdam PO Box 7057 Amsterdam 1007 MB The Netherlands Department of Internal Medicine VUmc University Medical Center Amsterdam PO Box 7057 Amsterdam 1007 MB The Netherlands Laboratory of Immunogenetics Department of Pathology VUmc University Medical Center Amsterdam PO Box 7057 Amsterdam 1007 MB The Netherlands Department of Internal Medicine Academic Hospital Maastricht P. Debyelaan 25 6229 HX Maastricht The Netherlands

AIM: 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-methylene tetrahydrofolate 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). CONCLUSION: 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.

关键词：血浆同型半胱氨酸维生素B6 水平测定腹腔疾病甲基四氢叶酸还原酶维生素B12 MTHFR基因健康对照组

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