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Role of folic acid depletion on homocysteine serum level in children and adolescents with epilepsy and different MTHFR C677T genotypes.
Seizure 2012; 21(5):340-3S

Abstract

Homocysteine (Hcy) is a sulfur-containing amino acid involved in methionine metabolism. An elevated total plasma Hcy concentration (tHcy) is a risk factor for vascular disease. The present study aimed to assess the role of antiepileptic drugs (AEDs) and C677T methylenetetrahydrofolate (MTHFR) polymorphisms on tHcy in pediatric patients with epilepsy treated for at least 6 months with various treatment regimens protocols including the newer AEDs. The study group was recruited from children and adolescents with epilepsy followed up in the Child Neuropsychiatry Clinic of the Second University of Naples, between January 2007 and March 2008. Inclusion criteria were: (1) patients with epilepsy, treated with one or more anticonvulsant drugs for at least 6 months; (2) age between 2 and 16 years. Plasma tHcy concentrations were considered elevated when they exceeded 10.4 μmol/L, and folate concentrations <3 ng/mL were considered deficient. Serum vitamin B12 levels were considered normal between 230 and 1,200 pg/mL. The study group was composed of 78 patients (35 males, 43 females), aged between 3 and 15 years (mean 8.9 years). Thirty-five patients were taking AED monotherapy, 43 polytherapy. Sixty-three healthy sex- and age-matched children and adolescents served as controls. The mean tHcy value in the patient group was higher than the mean value in the control group (12.11 ± 7.68 μmol/L vs 7.4±4.01 μmol/L; p<0.01). DNA analysis for the MTHFR C677T polymorphism showed the CT genotype in 46%, CC in 35% and TT in 17.8% of cases. Decreased folic acid serum levels significantly correlated with increased tHcy levels (p<0.003). Female sex was a less significant risk factor for increased tHcy levels (p=0.039). Our study confirms the association between hyperhomocysteinemia and epilepsy. The elevation of tHcy is essentially related to low folate levels. Correction of poor folate status, through supplementation, remains the most effective approach to normalize tHcy levels in patients on AED mono- or polytherapy.

Authors+Show Affiliations

Clinic of Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy. gcoppola@unisa.itNo 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

Language

eng

PubMed ID

22425007

Citation

Coppola, Giangennaro, et al. "Role of Folic Acid Depletion On Homocysteine Serum Level in Children and Adolescents With Epilepsy and Different MTHFR C677T Genotypes." Seizure, vol. 21, no. 5, 2012, pp. 340-3.
Coppola G, Ingrosso D, Operto FF, et al. Role of folic acid depletion on homocysteine serum level in children and adolescents with epilepsy and different MTHFR C677T genotypes. Seizure. 2012;21(5):340-3.
Coppola, G., Ingrosso, D., Operto, F. F., Signoriello, G., Lattanzio, F., Barone, E., ... Verrotti, A. (2012). Role of folic acid depletion on homocysteine serum level in children and adolescents with epilepsy and different MTHFR C677T genotypes. Seizure, 21(5), pp. 340-3. doi:10.1016/j.seizure.2012.02.011.
Coppola G, et al. Role of Folic Acid Depletion On Homocysteine Serum Level in Children and Adolescents With Epilepsy and Different MTHFR C677T Genotypes. Seizure. 2012;21(5):340-3. PubMed PMID: 22425007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of folic acid depletion on homocysteine serum level in children and adolescents with epilepsy and different MTHFR C677T genotypes. AU - Coppola,Giangennaro, AU - Ingrosso,Diego, AU - Operto,Francesca Felicia, AU - Signoriello,Giuseppe, AU - Lattanzio,Francamaria, AU - Barone,Eugenia, AU - Matera,Sabino, AU - Verrotti,Alberto, Y1 - 2012/03/16/ PY - 2011/12/11/received PY - 2012/02/22/revised PY - 2012/02/23/accepted PY - 2012/3/20/entrez PY - 2012/3/20/pubmed PY - 2012/8/31/medline SP - 340 EP - 3 JF - Seizure JO - Seizure VL - 21 IS - 5 N2 - Homocysteine (Hcy) is a sulfur-containing amino acid involved in methionine metabolism. An elevated total plasma Hcy concentration (tHcy) is a risk factor for vascular disease. The present study aimed to assess the role of antiepileptic drugs (AEDs) and C677T methylenetetrahydrofolate (MTHFR) polymorphisms on tHcy in pediatric patients with epilepsy treated for at least 6 months with various treatment regimens protocols including the newer AEDs. The study group was recruited from children and adolescents with epilepsy followed up in the Child Neuropsychiatry Clinic of the Second University of Naples, between January 2007 and March 2008. Inclusion criteria were: (1) patients with epilepsy, treated with one or more anticonvulsant drugs for at least 6 months; (2) age between 2 and 16 years. Plasma tHcy concentrations were considered elevated when they exceeded 10.4 μmol/L, and folate concentrations <3 ng/mL were considered deficient. Serum vitamin B12 levels were considered normal between 230 and 1,200 pg/mL. The study group was composed of 78 patients (35 males, 43 females), aged between 3 and 15 years (mean 8.9 years). Thirty-five patients were taking AED monotherapy, 43 polytherapy. Sixty-three healthy sex- and age-matched children and adolescents served as controls. The mean tHcy value in the patient group was higher than the mean value in the control group (12.11 ± 7.68 μmol/L vs 7.4±4.01 μmol/L; p<0.01). DNA analysis for the MTHFR C677T polymorphism showed the CT genotype in 46%, CC in 35% and TT in 17.8% of cases. Decreased folic acid serum levels significantly correlated with increased tHcy levels (p<0.003). Female sex was a less significant risk factor for increased tHcy levels (p=0.039). Our study confirms the association between hyperhomocysteinemia and epilepsy. The elevation of tHcy is essentially related to low folate levels. Correction of poor folate status, through supplementation, remains the most effective approach to normalize tHcy levels in patients on AED mono- or polytherapy. SN - 1532-2688 UR - https://www.unboundmedicine.com/medline/citation/22425007/Role_of_folic_acid_depletion_on_homocysteine_serum_level_in_children_and_adolescents_with_epilepsy_and_different_MTHFR_C677T_genotypes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1059-1311(12)00056-8 DB - PRIME DP - Unbound Medicine ER -