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Increased plasma homocysteine levels without signs of vitamin B12 deficiency in patients with multiple sclerosis assessed by blood and cerebrospinal fluid homocysteine and methylmalonic acid.
Mult Scler 2003; 9(3):239-45MS

Abstract

OBJECTIVE

The aim of this study was to evaluate if multiple sclerosis (MS) is associated with vitamin B12 (cobalamin) deficiency.

METHODS

We measured serum vitamin B12, plasma folate, serum methylmalonic acid (MMA), plasma homocysteine (tHcy) and also cerebrospinal fluid (CSF) MMA and tHcy in 72 patients with MS and 23 controls.

RESULTS

The mean plasma tHcy level was significantly increased in MS patients (11.6 micromol/L) compared with controls (7.4 micromol/L) (P = 0.002). Seven patients showed low serum vitamin B12 levels but only one of them had concomitant high plasma tHcy. None of them showed high serum MMA. Plasma or blood folate levels did not differ between MS patients and controls. We found no significant differences in mean values or frequency of pathological tests of serum B12, serum MMA, mean corpuscular volume (MCV), haemoglobin concentration, CSF tHcy or CSF MMA between patients and healthy subjects. There were no correlations between CSF and serum/plasma levels of MMA or tHcy. Serum vitamin B12, serum MMA, plasma tHcy, CSF Hcy or CSF MMA were not correlated to disability status, activity of disease, duration of disease or age.

CONCLUSIONS

The relevance of the increased mean value of plasma tHcy thus seems uncertain and does not indicate functional vitamin B12 deficiency. We can not, however, exclude the possibility of a genetically induced dysfunction of the homocysteine metabolism relevant for the development of neuroinflammation/degeneration. Our findings indicate that, regardless of a significant increase in plasma tHcy in MS patients, the MS disease is not generally associated with vitamin B12 deficiency since we did not find any other factors indicating vitamin B12 deficiency. Analysis of CSF MMA and CSF tHcy, which probably reflects the brain vitamin B12 status better than serum, are not warranted in MS. We conclude that B12 deficiency, in general, is not associated with MS.

Authors+Show Affiliations

Department of Neuroscience and Locomotion, Division of Neurology and Neurophysiology, University Hospital, Linköping, Sweden. magnus.vrethem@lio.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

12814169

Citation

Vrethem, M, et al. "Increased Plasma Homocysteine Levels Without Signs of Vitamin B12 Deficiency in Patients With Multiple Sclerosis Assessed By Blood and Cerebrospinal Fluid Homocysteine and Methylmalonic Acid." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 9, no. 3, 2003, pp. 239-45.
Vrethem M, Mattsson E, Hebelka H, et al. Increased plasma homocysteine levels without signs of vitamin B12 deficiency in patients with multiple sclerosis assessed by blood and cerebrospinal fluid homocysteine and methylmalonic acid. Mult Scler. 2003;9(3):239-45.
Vrethem, M., Mattsson, E., Hebelka, H., Leerbeck, K., Osterberg, A., Landtblom, A. M., ... Kågedal, B. (2003). Increased plasma homocysteine levels without signs of vitamin B12 deficiency in patients with multiple sclerosis assessed by blood and cerebrospinal fluid homocysteine and methylmalonic acid. Multiple Sclerosis (Houndmills, Basingstoke, England), 9(3), pp. 239-45.
Vrethem M, et al. Increased Plasma Homocysteine Levels Without Signs of Vitamin B12 Deficiency in Patients With Multiple Sclerosis Assessed By Blood and Cerebrospinal Fluid Homocysteine and Methylmalonic Acid. Mult Scler. 2003;9(3):239-45. PubMed PMID: 12814169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased plasma homocysteine levels without signs of vitamin B12 deficiency in patients with multiple sclerosis assessed by blood and cerebrospinal fluid homocysteine and methylmalonic acid. AU - Vrethem,M, AU - Mattsson,E, AU - Hebelka,H, AU - Leerbeck,K, AU - Osterberg,A, AU - Landtblom,A M, AU - Balla,B, AU - Nilsson,H, AU - Hultgren,M, AU - Brattström,L, AU - Kågedal,B, PY - 2003/6/20/pubmed PY - 2004/1/15/medline PY - 2003/6/20/entrez SP - 239 EP - 45 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult. Scler. VL - 9 IS - 3 N2 - OBJECTIVE: The aim of this study was to evaluate if multiple sclerosis (MS) is associated with vitamin B12 (cobalamin) deficiency. METHODS: We measured serum vitamin B12, plasma folate, serum methylmalonic acid (MMA), plasma homocysteine (tHcy) and also cerebrospinal fluid (CSF) MMA and tHcy in 72 patients with MS and 23 controls. RESULTS: The mean plasma tHcy level was significantly increased in MS patients (11.6 micromol/L) compared with controls (7.4 micromol/L) (P = 0.002). Seven patients showed low serum vitamin B12 levels but only one of them had concomitant high plasma tHcy. None of them showed high serum MMA. Plasma or blood folate levels did not differ between MS patients and controls. We found no significant differences in mean values or frequency of pathological tests of serum B12, serum MMA, mean corpuscular volume (MCV), haemoglobin concentration, CSF tHcy or CSF MMA between patients and healthy subjects. There were no correlations between CSF and serum/plasma levels of MMA or tHcy. Serum vitamin B12, serum MMA, plasma tHcy, CSF Hcy or CSF MMA were not correlated to disability status, activity of disease, duration of disease or age. CONCLUSIONS: The relevance of the increased mean value of plasma tHcy thus seems uncertain and does not indicate functional vitamin B12 deficiency. We can not, however, exclude the possibility of a genetically induced dysfunction of the homocysteine metabolism relevant for the development of neuroinflammation/degeneration. Our findings indicate that, regardless of a significant increase in plasma tHcy in MS patients, the MS disease is not generally associated with vitamin B12 deficiency since we did not find any other factors indicating vitamin B12 deficiency. Analysis of CSF MMA and CSF tHcy, which probably reflects the brain vitamin B12 status better than serum, are not warranted in MS. We conclude that B12 deficiency, in general, is not associated with MS. SN - 1352-4585 UR - https://www.unboundmedicine.com/medline/citation/12814169/Increased_plasma_homocysteine_levels_without_signs_of_vitamin_B12_deficiency_in_patients_with_multiple_sclerosis_assessed_by_blood_and_cerebrospinal_fluid_homocysteine_and_methylmalonic_acid_ L2 - http://journals.sagepub.com/doi/full/10.1191/1352458503ms918oa?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -