PMID- 10782453
OWN - NLM
STAT- MEDLINE
DCOM- 20000626
LR  - 20190822
IS  - 0025-7753 (Print)
IS  - 0025-7753 (Linking)
VI  - 114
IP  - 1
DP  - 2000 Jan 15
TI  - [Lowering high levels of fasting total homocysteine with folic acid and vitamins 
      B in patients with venous thromboembolism: relationship between response and the 
      C677T methylenetetrahydrofolate reductase (MTHRF) genotype].
PG  - 7-12
AB  - BACKGROUND: High levels of plasma total homocysteine (tHcy) are involved in 
      arterial or venous occlusive diseases. It essentially depends on the nutritional 
      status of folic acid (FA) and vitamins B12 or B6, but also on the 
      methylenetetrahydrofolate reductase (MTHFR) enzymatic activity. We aim to 
      evaluate the response of the hyperhomocysteinemia (HHcy) to a standard schedule 
      of vitamin supplementation, according with the MTHFR genotype. PATIENTS AND 
      METHODS: 227 patients, diagnosed with venous thromboembolism (VTE) were analysed 
      for tHcy (in fasting conditions), and for the MTHFR-C677T gene polymorphism. When 
      the tHcy exceeded the cut-off point (men = 16, women = 15 mumol/l), the patients 
      were supplemented with a dose equivalent to 1 mg FA, 0.2 mg B12 and 100 mg of B6, 
      daily by 6 weeks. Afterwards they were reanalysed and the reduction was 
      stratified by MTHFR genotype, looking for any difference in the response. 
      RESULTS: The mean fasting tHcy was 12.3 mumol/l (SD = 8). The 51 
      hyperhomocysteinemic patients (22%) were older (65.1 y) than the normal ones 
      (55.0 y) (p = 0.0001). The treatment was carried out properly in 46 patients 
      (90%). The pre-treatment mean Hcy was 23.2 (SD = 10.5) mumol/l, and it was 
      reduced to 13.0 (SD = 5.9) (p = 0.0001) (mean reduction = 42.1%). By genotype, 
      the C/C reduced from 21.0 to 13.2 mumol/l (37%) (n = 18), the C/T from 25.0 to 
      12.6 mumol/l (46%) (n = 24), and the abnormal homozygotes T/T from 22.7 to 14.5 
      mumol/l (39%) (n = 4), although no statistical significant differences were 
      found. In 80% of cases (37/46), tHcy values normalised. A negative correlation (r 
      = -0.471) (p = 0.005) was observed between age and response. CONCLUSIONS: The 
      FA/B6/B12 based therapy reduces in a simple, quick and effective way (> 40% in 6 
      weeks) the pathologic tHcy levels on a VTE population and this is not influenced 
      by the MTHFR genotype. As HHcy seems related with recurrences of venous 
      thrombosis, we could speculate if it would be useful to analyse routinely the 
      tHcy, attempting reduction in selected cases.
FAU - Gonzalez Ordonez, A J
AU  - Gonzalez Ordonez AJ
AD  - Servicio de Hematologia, Hospital San Agustin, Aviles. jagonzalez@medynet.com
FAU - Medina Rodriguez, J M
AU  - Medina Rodriguez JM
FAU - Fernandez Alvarez, C R
AU  - Fernandez Alvarez CR
FAU - Sanchez Garcia, J
AU  - Sanchez Garcia J
FAU - Fernandez Carreira, J M
AU  - Fernandez Carreira JM
FAU - Alvarez Martinez, M V
AU  - Alvarez Martinez MV
FAU - Coto Garcia, E
AU  - Coto Garcia E
LA  - spa
PT  - English Abstract
PT  - Journal Article
TT  - Reduccion de concentraciones elevadas de homocisteina con acido folico y 
      vitaminas B en pacientes con tromboembolia venosa: relacion entre respuesta y 
      genotipo C677T de la metilen tetrahidrofolico reductasa (MTHFR).
PL  - Spain
TA  - Med Clin (Barc)
JT  - Medicina clinica
JID - 0376377
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 935E97BOY8 (Folic Acid)
RN  - EC 1.5.1.5 (Methylenetetrahydrofolate Dehydrogenase (NADP))
RN  - KV2JZ1BI6Z (Pyridoxine)
RN  - P6YC3EG204 (Vitamin B 12)
SB  - IM
MH  - Adult
MH  - Electrophoresis/methods
MH  - Female
MH  - Folic Acid/*pharmacology/*therapeutic use
MH  - Gene Expression/*genetics
MH  - Genotype
MH  - Homocysteine/*blood/*metabolism
MH  - Humans
MH  - Male
MH  - Methylenetetrahydrofolate Dehydrogenase (NADP)/*genetics/*metabolism
MH  - Middle Aged
MH  - Polymerase Chain Reaction
MH  - Polymorphism, Genetic/genetics
MH  - Pyridoxine/*pharmacology/*therapeutic use
MH  - Recurrence
MH  - *Thrombophlebitis/drug therapy/enzymology/genetics
MH  - Vitamin B 12/*pharmacology/*therapeutic use
EDAT- 2000/04/27 09:00
MHDA- 2000/07/06 11:00
CRDT- 2000/04/27 09:00
PHST- 2000/04/27 09:00 [pubmed]
PHST- 2000/07/06 11:00 [medline]
PHST- 2000/04/27 09:00 [entrez]
AID - S0025-7753(00)71172-9 [pii]
AID - 10.1016/s0025-7753(00)71172-9 [doi]
PST - ppublish
SO  - Med Clin (Barc). 2000 Jan 15;114(1):7-12. doi: 10.1016/s0025-7753(00)71172-9.