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The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs.

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.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Rogaland Central Hospital, 4011 Stavanger, Norway. apeland@online.no

    , , , ,

    Source

    Epilepsy research 51:3 2002 Oct pg 237-47

    MeSH

    Adult
    Anticonvulsants
    Cholesterol
    Cholesterol, HDL
    Cholesterol, LDL
    Epilepsy
    Fasting
    Female
    Folic Acid
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Intercellular Adhesion Molecule-1
    Male
    Malondialdehyde
    Methionine
    Middle Aged
    Pyridoxic Acid
    Riboflavin
    Selectins
    Vascular Cell Adhesion Molecule-1
    Vitamin B 12
    Vitamin B 6
    Vitamin B Complex

    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 -