The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs
The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs
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DOI：
10.1016/s0920-1211(02)00153-5
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发表时间：
2002-10-01
影响因子：
2.2
通讯作者：
Strandjord, RE
中科院分区：
文献类型：
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作者：
Apeland, T;Mansoor, MA;Strandjord, RE
服用抗癫痫药物 (AED) 的患者血浆总同型半胱氨酸 (p-tHcy) 水平可能升高。本研究的目的是评估补充 B 族维生素对 p-tHcy 水平以及内皮活化和脂质过氧化标志物的影响。总共 33 名服用 AED 的成年患者被确定患有禁食（第 1 组，n = 23）或甲硫氨酸负荷后 (PML)（第 2 组，n = 10）高同型半胱氨酸血症。受试者补充 B 族维生素 30 天：每天 0.4 毫克叶酸、120 毫克吡哆醇和 75 毫克核黄素。补充后，血清叶酸和磷酸吡哆醛增加，而空腹和 PML p-tHcy 分别降低 (P < 0.0001) 36% 和 29%。在补充之前，第 1 组患者的 P-选择素和冯维勒布兰德因子 (vWF) 水平升高（分别为 P = 0.05 和 0.03）。补充后，细胞间细胞粘附分子水平下降（P = 0.01），E-选择素水平无显着下降（P = 0.07）。然而，血管细胞粘附分子的水平增加了（P < 0.0001），而脂质过氧化水平没有变化。总之，联合补充叶酸、吡哆醇和核黄素可减少服用 AED 的患者的禁食和 PML 高同型半胱氨酸血症。空腹高同型半胱氨酸血症患者的 P-选择素和 vWF 水平升高，这可能表明心血管疾病的风险增加。此外，补充 B 族维生素会影响内皮活化，尽管其临床意义尚不确定。 © 2002 Elsevier Science B.V. 保留所有权利。
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 29%, 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. © 2002 Elsevier Science B.V. All rights reserved.