PMID- 17704338
OWN - NLM
STAT- MEDLINE
DCOM- 20071018
LR  - 20161124
IS  - 1538-5744 (Print)
IS  - 1538-5744 (Linking)
VI  - 41
IP  - 4
DP  - 2007 Aug-Sep
TI  - Effect of folic acid and vitamins B6 and B12 on microcirculatory vasoreactivity 
      in patients with hyperhomocysteinemia.
PG  - 339-45
AB  - OBJECTIVE: Hyperhomocysteinemia (HHcy) has been identified as an independent risk 
      factor for atherosclerotic vascular disease. The effect of high-dose folic acid 
      or combination vitamin therapy for the treatment of HHcy on the microcirculation 
      is unknown. The purpose of this study was to evaluate the effect of a combination 
      of folic acid, vitamin B6, and vitamin B12 on endothelium-dependent and 
      endothelium-independent vasoreactivity in patientswith HHcy. METHODS: Baseline 
      cutaneous microvascular vasoreactivity was measured in 20 patients with HHcy and 
      18 patients with normohomocysteinemia (NHcy). Laser Doppler scan imaging before 
      and after iontophoresis of 1% acetylcholine chloride (endothelium-dependent 
      response) and 1% sodium nitroprusside (endothelium-independent response) was 
      performed for the measurement of forearm skin vasodilatation. Patients were then 
      treated with 10 mg folic acid, 100 mg vitamin B6, and 1 mg vitamin B12 orally 
      once a day for 6 months. Follow-up fasting serum homocysteine and cutaneous Laser 
      Doppler scan imaging before and after iontophoresis were performed at 1, 2, 3, 
      and 6 months. Statistical analysis was performed using Fisher's exact test, 
      paired t test, and Wilcoxon matched-pairs signed-ranks test, with significance 
      set at P < .05. RESULTS: The HHcy group was older than the NHcy group (70.89 +/- 
      1.95 vs 61.78 +/- 2.73 years, P = .02). Otherwise the groups were similar in 
      terms of race, tobacco use, comorbid diseases, and serum lipoproteins. Over the 
      6-month period, fasting serum homocysteine levels decreased significantly in both 
      the NHcy group (10.40 +/- 0.59 micromol/L vs 8.97 +/- 0.84 micromol/L, P = .01) 
      and the HHcy group (19.80 +/- 1.06 micromol/L vs 13.40 +/- 0.86 micromol/L, P = 
      .0002). There were no statistically significant changes in 
      endothelium-independent vasoreactivity (voltage change from baseline) in either 
      group. Endothelium-independent vasore activity decreased over the 6-month period 
      in the HHcy group (0.20 +/- 0.04 V vs 0.11 +/- 0.03 V, P = .03). Subanalysis of 
      HHcy with diabetes or age greater than 65 years both showed worsening trends in 
      endothelium-independent vasoreactivity (P = .05 for both groups). There were no 
      statistically significant changes in endothelium-independent vasoreactivity in 
      the NHcy group. CONCLUSIONS: High doses of folic acid and vitamins B6 and B12 
      lower fasting serum homocysteine levels in patients with HHcy. Older and diabetic 
      patients with HHcy tend to do worse possibly because of long-term fixed 
      microvascular insult secondary to multiple sustained comorbidities.
FAU - Abularrage, Christopher J
AU  - Abularrage CJ
AD  - Departments of Surgery, Veterans Affairs, Georgetown University, USA. 
      chrisabularrage@yahoo.com
FAU - Sidawy, Anton N
AU  - Sidawy AN
FAU - White, Paul W
AU  - White PW
FAU - Aidinian, Gilbert
AU  - Aidinian G
FAU - Dezee, Kent J
AU  - Dezee KJ
FAU - Weiswasser, Jonathan M
AU  - Weiswasser JM
FAU - Arora, Subodh
AU  - Arora S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Vasc Endovascular Surg
JT  - Vascular and endovascular surgery
JID - 101136421
RN  - 8059-24-3 (Vitamin B 6)
RN  - 935E97BOY8 (Folic Acid)
RN  - P6YC3EG204 (Vitamin B 12)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Drug Therapy, Combination
MH  - Female
MH  - Folic Acid/*therapeutic use
MH  - Forearm/blood supply/diagnostic imaging
MH  - Humans
MH  - Hyperhomocysteinemia/*drug therapy
MH  - Iontophoresis
MH  - Male
MH  - Microcirculation/*drug effects
MH  - Middle Aged
MH  - Statistics, Nonparametric
MH  - Treatment Outcome
MH  - Ultrasonography, Doppler
MH  - Vitamin B 12/*therapeutic use
MH  - Vitamin B 6/*therapeutic use
EDAT- 2007/08/21 09:00
MHDA- 2007/10/19 09:00
CRDT- 2007/08/21 09:00
PHST- 2007/08/21 09:00 [pubmed]
PHST- 2007/10/19 09:00 [medline]
PHST- 2007/08/21 09:00 [entrez]
AID - 41/4/339 [pii]
AID - 10.1177/1538574407301692 [doi]
PST - ppublish
SO  - Vasc Endovascular Surg. 2007 Aug-Sep;41(4):339-45. doi: 10.1177/1538574407301692.