Plasma homocysteine and markers for oxidative stress and inflammation in patients with coronary artery disease – a prospective randomized study of vitamin supplementation
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Torfi Jonasson
Abstract
Background: Elevated plasma levels of total homocysteine (tHcy) are associated with an increased risk of developing occlusive vascular diseases. To better illustrate the relationship between plasma tHcy concentration, oxidative stress, and inflammation in patients with coronary artery disease (CAD), we measured plasma 8-isoprostane-prostaglandin F 2 (Iso-P), plasma malondialdehyde (MDA), and several markers of inflammation. We also aimed to demonstrate the effects of vitamin supplementation on these markers.
Methods: A total of 93 patients with ischemic heart disease were investigated. Of these, 34 had plasma tHcy ≤8μmol/L, while 59 had plasma tHcy ≥15.0 μmol/L. The 59 patients were randomized to open therapy with folic acid, 5mg, pyridoxine, 40mg, and cyancobalamin, 1mg once daily for 3months (n=29) or to no vitamin treatment (n=30). Blood samples were obtained from both groups before randomization and 3months later. A sample was also obtained from the remaining 34 patients.
Results: Plasma Iso-P, serum amyloid A (S-AA), and plasma intercellular adhesion molecule-1 (ICAM-1) concentrations were higher in patients with high plasma tHcy levels than in patients with low to normal tHcy levels. Plasma levels of P-, L-, E-selectins, MDA, C-reactive protein (CRP), and orosomucoid did not differ between the groups. Vitamin therapy reduced plasma tHcy from 17.4 (15.3/20.1) to 9.2 (8.3/10.3)μmol/L (25th and 75th percentiles in parentheses) (p<0.0001). Plasma levels of Iso-P remained unchanged and, of all inflammatory markers, only the S-AA concentrations were slightly reduced by the vitamin treatment, from 5.3 (2.2/7.0)ng/L at baseline to 4.6 (2.1/6.9)ng/L (p<0.05) after 3months of vitamin supplementation.
Conclusion: Patients with CAD and high plasma tHcy levels had elevated plasma levels of Iso-P. The increase remained unaffected by plasma tHcy-lowering therapy, suggesting that homocysteine per se does not cause increased lipid peroxidation. Levels of plasma ICAM-1 and S-AA were increased in patients with high plasma tHcy, suggesting an association between homocysteinemia and low-grade inflammation.
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Artikel in diesem Heft
- Spectrophotometric determination of urinary iodine by the Sandell-Kolthoff reaction subsequent to dry alkaline ashing. Results from the Czech Republic in the period 1994–2002
- Comparison of iodine contents in gastric cancer and surrounding normal tissues
- Effects of urine dilution on quantity, size and aggregation of calcium oxalate crystals induced in vitro by an oxalate load
- Is idiopathic recurrent calcium urolithiasis in males a cellular disease? Laboratory findings in plasma, urine and erythrocytes, emphasizing the absence and presence of stones, oxidative and mineral metabolism: an observational study
- Circulating levels of nitrated apolipoprotein A-I are increased in type 2 diabetic patients
- Apolipoprotein A5 gene polymorphism –1131T→C: association with plasma lipids and type 2 diabetes mellitus with coronary heart disease in Chinese
- A simple method for estimating equilibrium constants for serum testosterone binding resulting in an optimal free testosterone index for use in elderly men
- Standardized quantification of circulating peripheral tumor cells from lung and breast cancer
- Plasma homocysteine and markers for oxidative stress and inflammation in patients with coronary artery disease – a prospective randomized study of vitamin supplementation
- Comparison of methods for calculating serum osmolality: multivariate linear regression analysis
- Radioimmunoassay for plasma C-type natriuretic peptide determination: a methodological evaluation
- Evaluation of the Konelab 20XT clinical chemistry analyzer
- A guide to defining the competence required of a consultant in clinical chemistry and laboratory medicine
- Time course of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in patients presenting with acute coronary syndrome
- Screening for gestational diabetes mellitus
- Systematic terminology for specialities and disciplines related to clinical laboratory
