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The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs.
Epilepsy Res 2002; 51(3):237-47ER

Abstract

Patients on antiepileptic drugs (AEDs) may have elevated levels of plasma total homocysteine (p-tHcy). The aim of this study was to assess the effect of B-vitamin supplementation on the levels of p-tHcy and markers of endothelial activation and lipid peroxidation. A total of 33 adult patients on AEDs were identified with either fasting (Group 1, n=23) or post methionine load (PML) (Group 2, n=10) hyperhomocysteinemia. Subjects were supplemented with B-vitamins for 30 days: folic acid 0.4 mg, pyridoxine 120 mg and riboflavin 75 mg per day. After supplementation, serum folate and pyridoxal phosphate had increased, while fasting and PML p-tHcy had decreased (P<0.0001) by 36 and 26%, respectively. Prior to supplementation, the Group 1 patients had elevated levels of P-selectin and von Willebrand factor (vWF) (P=0.05 and 0.03, respectively). After supplementation, the levels of intercellular cell adhesion molecules had decreased (P=0.01) and E-selectin decreased nonsignificantly (P=0.07). However, the levels of vascular cell adhesion molecules had increased (P<0.0001), while lipid peroxidation were unchanged. In conclusion, the combined supplementation with folic acid, pyridoxine and riboflavin reduced fasting and PML hyperhomocysteinemia in patients on AEDs. Patients with fasting hyperhomocysteinemia had elevated levels of P-selectin and vWF, which may indicate an increased risk of cardiovascular disease. Furthermore, B-vitamin supplementation influenced endothelial activation, although the clinical implication is uncertain.

Authors+Show Affiliations

Department of Internal Medicine, Rogaland Central Hospital, 4011 Stavanger, Norway. apeland@online.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12399074

Citation

Apeland, Terje, et al. "The Effect of B-vitamins On Hyperhomocysteinemia in Patients On Antiepileptic Drugs." Epilepsy Research, vol. 51, no. 3, 2002, pp. 237-47.
Apeland T, Mansoor MA, Pentieva K, et al. The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs. Epilepsy Res. 2002;51(3):237-47.
Apeland, T., Mansoor, M. A., Pentieva, K., McNulty, H., Seljeflot, I., & Strandjord, R. E. (2002). The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs. Epilepsy Research, 51(3), pp. 237-47.
Apeland T, et al. The Effect of B-vitamins On Hyperhomocysteinemia in Patients On Antiepileptic Drugs. Epilepsy Res. 2002;51(3):237-47. PubMed PMID: 12399074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs. AU - Apeland,Terje, AU - Mansoor,Mohammad A, AU - Pentieva,Kristina, AU - McNulty,Helene, AU - Seljeflot,Ingebjørg, AU - Strandjord,Roald E, PY - 2002/10/26/pubmed PY - 2003/1/14/medline PY - 2002/10/26/entrez SP - 237 EP - 47 JF - Epilepsy research JO - Epilepsy Res. VL - 51 IS - 3 N2 - Patients on antiepileptic drugs (AEDs) may have elevated levels of plasma total homocysteine (p-tHcy). The aim of this study was to assess the effect of B-vitamin supplementation on the levels of p-tHcy and markers of endothelial activation and lipid peroxidation. A total of 33 adult patients on AEDs were identified with either fasting (Group 1, n=23) or post methionine load (PML) (Group 2, n=10) hyperhomocysteinemia. Subjects were supplemented with B-vitamins for 30 days: folic acid 0.4 mg, pyridoxine 120 mg and riboflavin 75 mg per day. After supplementation, serum folate and pyridoxal phosphate had increased, while fasting and PML p-tHcy had decreased (P<0.0001) by 36 and 26%, respectively. Prior to supplementation, the Group 1 patients had elevated levels of P-selectin and von Willebrand factor (vWF) (P=0.05 and 0.03, respectively). After supplementation, the levels of intercellular cell adhesion molecules had decreased (P=0.01) and E-selectin decreased nonsignificantly (P=0.07). However, the levels of vascular cell adhesion molecules had increased (P<0.0001), while lipid peroxidation were unchanged. In conclusion, the combined supplementation with folic acid, pyridoxine and riboflavin reduced fasting and PML hyperhomocysteinemia in patients on AEDs. Patients with fasting hyperhomocysteinemia had elevated levels of P-selectin and vWF, which may indicate an increased risk of cardiovascular disease. Furthermore, B-vitamin supplementation influenced endothelial activation, although the clinical implication is uncertain. SN - 0920-1211 UR - https://www.unboundmedicine.com/medline/citation/12399074/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0920121102001535 DB - PRIME DP - Unbound Medicine ER -