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- Title
The effect of different treatment regimens in reducing fasting and postmethionine-load homocysteine concentrations.
- Authors
Van Der Griend, R.; Biesma, D. H.; Haas, F. J. L. M.; Faber, J. A. J.; Duran, M.; Meuwissen, O. J. A. TH.; Banga, J.-D.; Haas, F J; Faber, J A; Meuwissen, O J
- Abstract
Abstract. van der Griend R, Biesma DH, Haas FJLM, Faber JAJ, Duran M, Meuwissen OJATh, Banga J-D (Sint Antonius Hospital, Nieuwegein; University of Utrecht, Utrecht; and the University Medical Center Utrecht, The Netherlands). The effect of different treatment regimens in reducing fasting and post-methionine-load homocysteine concentrations. J Intern Med 2000; 248: 223–229. Objectives. To determine the homocysteine-lowering effect of different treatment regimens on both fasting and postmethionine-load plasma total homocysteine (tHcy) concentrations. Design. Descriptive study of consecutive hyperhomocysteinaemic subjects per treatment regimen. Homocysteine was measured in the fasting state and 6 h after methionine loading, both before and after 8 weeks of vitamin therapy. Hyperhomocysteinaemia was defined as a fasting tHcy and/or increase in tHcy (postmethionine-load minus fasting tHcy concentration) exceeding the 95th percentile of local controls. Setting. Outpatient clinic of internal medicine of a large non-academic teaching hospital. Subjects. One hundred and seventeen hyperhomocysteinaemic subjects (vascular patients and first-degree relatives). Interventions. There were four regimens: pyridoxine, 200 mg; folic acid, 5 mg; combination of folic acid 0.5 mg and pyridoxine 100 mg; and folic acid, 0.5 mg daily. Results. All regimens, except pyridoxine 200 mg, significantly reduced fasting tHcy without differences in the percentage reduction (32–38%). All regimens produced a significant reduction in the increase in tHcy and postmethionine-load tHcy. The reduction in postmethionine-load tHcy was smaller for pyridoxine 200 mg than for combination therapy. No differences were found in the percentage reduction (for both increase in tHcy and postmethionine-load tHcy) between folic acid 5 mg and folic acid 0.5 mg. Conclusions. Monotherapy folic acid (0.5 mg daily) is the lowest effective therapy for reducing both fasting and postmethionine-load tHcy concentrations, with the same results as high-dose folic acid (5 mg daily). Pyridoxine has no additional value.
- Subjects
THERAPEUTICS; FASTING; HOMOCYSTEINE; BLOOD plasma; ANALYSIS of variance; COMBINATION drug therapy; CHI-squared test; FOLIC acid; HIGH performance liquid chromatography; VITAMIN B6; HYPERHOMOCYSTEINEMIA
- Publication
Journal of Internal Medicine, 2000, Vol 248, Issue 3, p223
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1046/j.1365-2796.2000.00726.x