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Elevated plasma homocysteine and low vitamin B-6 status in nonsupplementing older women with rheumatoid arthritis.

Abstract

OBJECTIVE

The purpose of this study was to determine if nonsupplementing older women (aged >or=55 years) with rheumatoid arthritis had higher plasma homocysteine and lower B-vitamin status compared to healthy controls. Elevated plasma homocysteine, a risk factor for cardiovascular disease, may help explain why individuals with rheumatoid arthritis have an increased risk of cardiovascular disease.

METHODS

Older, free-living women were classified as rheumatoid arthritis (n=18) or healthy control (n=33). Participants were not using B-vitamin supplements. Fasting blood samples were measured for pyridoxal 5'phosphate (PLP) (the metabolically active coenzyme form of vitamin B-6), folate, red blood cell folate, vitamin B-12, transcobalamin II, homocysteine, C-reactive protein, and lipid concentrations. Participants completed 7-day weighed food records, the Stanford Health Assessment Questionnaire (HAQ), and a visual analog pain scale.

RESULTS

PLP concentrations were lower in the rheumatoid arthritis vs healthy control participants (4.93+/-3.85 vs 11.35+/-7.11 ng/mL [20+/-16 vs 46+/-29 nmol/L]; P<0.01) whereas plasma homocysteine was higher in the rheumatoid arthritis group (1.63+/-0.74 vs 1.15+/-0.38 mg/L [12.1+/-5.5 vs 8.5+/-2.8 micromol/L]; P=0.02). Red blood cell folate concentrations were lower in the rheumatoid arthritis vs healthy control participants [414+/-141 vs 525+/-172 ng/mL [938+/-320 vs 1,190+/-390 nmol/L]; P=0.02). No significant differences were found for plasma folate, vitamin B-12, and transcobalamin II. An inverse correlation was found between PLP concentrations and the HAQ disability index (r=-0.37; P<0.01). A positive correlation was found between homocysteine concentrations and the HAQ disability index (r=0.36; P=0.01). Total cholesterol and low-density lipoprotein cholesterol levels were lower in the rheumatoid arthritis group (cholesterol 191+/-43 vs 218+/-33 mg/dL [4.95+/-1.11 vs 5.65+/-0.85 mmol/L]; P=0.02; low-density lipoprotein cholesterol 110+/-36 vs 137+/-29 mg/dL [2.85+/-0.93 vs 3.55+/-0.75 mmol/L]; P<0.01). No significant differences were seen between groups for protein (g/day), fat (g/day), cholesterol (mg/day), folate (microg/day), vitamin B-12 (microg/day), and vitamin B-6 (mg/day) dietary intakes.

CONCLUSIONS

Poor vitamin B-6 status and elevated plasma homocysteine concentrations were seen in older women with rheumatoid arthritis compared to healthy controls and may contribute to their increased risk of cardiovascular disease.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Arizona State University Department of Nutrition, 6950 E Williams Field Rd, Mesa, AZ 85212, USA. kathleen.woolf@asu.edu

    Source

    Journal of the American Dietetic Association 108:3 2008 Mar pg 443-53; discussion 454

    MeSH

    Aged
    Arthritis, Rheumatoid
    C-Reactive Protein
    Cardiovascular Diseases
    Case-Control Studies
    Cross-Sectional Studies
    Diet Records
    Erythrocytes
    Female
    Folic Acid
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Lipids
    Middle Aged
    Nutritional Status
    Pyridoxal Phosphate
    Risk Factors
    Transcobalamins
    Vitamin B 12
    Vitamin B 6
    Vitamin B 6 Deficiency
    Vitamin B Complex

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    18313425

    Citation

    Woolf, Kathleen, and Melinda M. Manore. "Elevated Plasma Homocysteine and Low Vitamin B-6 Status in Nonsupplementing Older Women With Rheumatoid Arthritis." Journal of the American Dietetic Association, vol. 108, no. 3, 2008, pp. 443-53; discussion 454.
    Woolf K, Manore MM. Elevated plasma homocysteine and low vitamin B-6 status in nonsupplementing older women with rheumatoid arthritis. J Am Diet Assoc. 2008;108(3):443-53; discussion 454.
    Woolf, K., & Manore, M. M. (2008). Elevated plasma homocysteine and low vitamin B-6 status in nonsupplementing older women with rheumatoid arthritis. Journal of the American Dietetic Association, 108(3), pp. 443-53; discussion 454. doi:10.1016/j.jada.2007.12.001.
    Woolf K, Manore MM. Elevated Plasma Homocysteine and Low Vitamin B-6 Status in Nonsupplementing Older Women With Rheumatoid Arthritis. J Am Diet Assoc. 2008;108(3):443-53; discussion 454. PubMed PMID: 18313425.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Elevated plasma homocysteine and low vitamin B-6 status in nonsupplementing older women with rheumatoid arthritis. AU - Woolf,Kathleen, AU - Manore,Melinda M, PY - 2005/07/26/received PY - 2008/3/4/pubmed PY - 2008/4/30/medline PY - 2008/3/4/entrez SP - 443-53; discussion 454 JF - Journal of the American Dietetic Association JO - J Am Diet Assoc VL - 108 IS - 3 N2 - OBJECTIVE: The purpose of this study was to determine if nonsupplementing older women (aged >or=55 years) with rheumatoid arthritis had higher plasma homocysteine and lower B-vitamin status compared to healthy controls. Elevated plasma homocysteine, a risk factor for cardiovascular disease, may help explain why individuals with rheumatoid arthritis have an increased risk of cardiovascular disease. METHODS: Older, free-living women were classified as rheumatoid arthritis (n=18) or healthy control (n=33). Participants were not using B-vitamin supplements. Fasting blood samples were measured for pyridoxal 5'phosphate (PLP) (the metabolically active coenzyme form of vitamin B-6), folate, red blood cell folate, vitamin B-12, transcobalamin II, homocysteine, C-reactive protein, and lipid concentrations. Participants completed 7-day weighed food records, the Stanford Health Assessment Questionnaire (HAQ), and a visual analog pain scale. RESULTS: PLP concentrations were lower in the rheumatoid arthritis vs healthy control participants (4.93+/-3.85 vs 11.35+/-7.11 ng/mL [20+/-16 vs 46+/-29 nmol/L]; P<0.01) whereas plasma homocysteine was higher in the rheumatoid arthritis group (1.63+/-0.74 vs 1.15+/-0.38 mg/L [12.1+/-5.5 vs 8.5+/-2.8 micromol/L]; P=0.02). Red blood cell folate concentrations were lower in the rheumatoid arthritis vs healthy control participants [414+/-141 vs 525+/-172 ng/mL [938+/-320 vs 1,190+/-390 nmol/L]; P=0.02). No significant differences were found for plasma folate, vitamin B-12, and transcobalamin II. An inverse correlation was found between PLP concentrations and the HAQ disability index (r=-0.37; P<0.01). A positive correlation was found between homocysteine concentrations and the HAQ disability index (r=0.36; P=0.01). Total cholesterol and low-density lipoprotein cholesterol levels were lower in the rheumatoid arthritis group (cholesterol 191+/-43 vs 218+/-33 mg/dL [4.95+/-1.11 vs 5.65+/-0.85 mmol/L]; P=0.02; low-density lipoprotein cholesterol 110+/-36 vs 137+/-29 mg/dL [2.85+/-0.93 vs 3.55+/-0.75 mmol/L]; P<0.01). No significant differences were seen between groups for protein (g/day), fat (g/day), cholesterol (mg/day), folate (microg/day), vitamin B-12 (microg/day), and vitamin B-6 (mg/day) dietary intakes. CONCLUSIONS: Poor vitamin B-6 status and elevated plasma homocysteine concentrations were seen in older women with rheumatoid arthritis compared to healthy controls and may contribute to their increased risk of cardiovascular disease. SN - 0002-8223 UR - https://www.unboundmedicine.com/medline/citation/18313425/Elevated_plasma_homocysteine_and_low_vitamin_B_6_status_in_nonsupplementing_older_women_with_rheumatoid_arthritis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8223(07)02202-X DB - PRIME DP - Unbound Medicine ER -