Randomized Trial of Methylcobalamin and Folate Effects on Homocysteine in Hemodialysis Patients
| Autor: | Amalia Schiel, Marisa Luisa Díaz, Emilio Freixas, Hernán Trimarchi |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Hyperhomocysteinemia medicine.medical_specialty Homocysteine Methylation Gastroenterology chemistry.chemical_compound Folic Acid Double-Blind Method Renal Dialysis Oral administration Internal medicine medicine Humans Prospective Studies Cyanocobalamin Methionine synthase Vitamin B12 Aged Aged 80 and over Methionine biology business.industry Middle Aged medicine.disease Vitamin B 12 Biochemistry chemistry Methylcobalamin biology.protein Female business medicine.drug |
| Zdroj: | Nephron. 91:58-63 |
| ISSN: | 2235-3186 1660-8151 |
| Popis: | Background: There are no data available on the effects of intravenous (i.v.) methylcobalamin (Me-Cbl), the coenzymatically active form of vitamin B12 that acts as a cofactor for methionine synthase in the conversion of total homocysteine (tHcy) to methionine, with or without oral folic acid (FA) supplementation, on fasting tHcy levels in hemodialysis (HD) patients. Methods: We performed a prospective randomized trial in which 62 chronic HD patients without previous vitamin supplementation were divided into four groups. Group A received Me-Cbl 500 µg twice/week plus FA 10 mg/day; group B received FA 10 mg/day alone; group C received no vitamin supplementation, and group D was on Me-Cbl 500 µg twice/week alone. Fasting tHcy, vitamin B12, serum (s) FA and erythrocytic (e) FA were measured predialysis before and after 4 months of therapy. Results: Final tHcy levels were significantly lower in group A (10.2 ± 3.1 µmol/l) compared to groups C (27.3 ± 9.7 µmol/l, p < 0.001) and group D (24.3 ± 11.8 µmol/l, p < 0.001) and similar to group B (11.2 ± 1.9 µmol/l, p = n.s.). Mean tHcy levels showed a significant decrease in group A from 22.5 ± 15.6 to 10.2 ± 3.1 µmol/l (p = 0.003) and in group B from 19.9 ± 4.0 to 11.2 ± 1.9 µmol/l (p = 0.012), while no significant changes were observed in groups C (25.9 ± 9.3 vs. 27.3 ± 9.7 µmol/l, p = n.s.) and D (26.6 ± 14.3 vs. 24.3 ± 11.8 µmol/l, p = n.s.). Conclusion: Oral FA (10 mg/day) supplementation appears to be an effective approach to normalize plasma tHcy in chronic HD patients; the addition of i.v. Me-Cbl (500 µg twice/week) to this regimen showed no benefit. Separately, FA corrected hyperhomocysteinemia (HtHcy), while Me-Cbl showed no change. |
| Databáze: | OpenAIRE |
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