High dose-B-vitamin treatment of hyperhomocysteinemia in dialysis patients.

High dose-B-vitamin treatment of hyperhomocysteinemia in dialysis patients.
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高剂量 B 族维生素治疗透析患者高同型半胱氨酸血症。

DOI:
10.1038/ki.1996.19
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发表时间:
1996
影响因子:
19.6
通讯作者:
I. Rosenberg
I. Rosenberg
中科院分区:
医学1区
文献类型:
--
作者:
A. Bostom;D. Shemin;D. Shemin;D. Shemin;K. Lapane;K. Lapane;K. Lapane;A. Hume;A. Hume;A. Hume;D. Yoburn;D. Yoburn;D. Yoburn;M. Nadeau;M. Nadeau;M. Nadeau;A. Bendich;A. Bendich;A. Bendich;J. Selhub;J. Selhub;J. Selhub;I. Rosenberg;I. Rosenberg;I. Rosenberg

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高同型半胱氨酸血症是动脉硬化的危险因素,尽管常规低剂量补充b族维生素辅助因子/同型半胱氨酸(Hcy)代谢底物,以及这些维生素的正常或超正常血浆状态,75%的透析患者仍存在高同型半胱氨酸血症(动脉粥样硬化114:93,1995)。我们对27例高同型半胱氨酸透析患者进行了为期8周的安慰剂对照试验,观察在常规每日剂量为1毫克叶酸、10毫克B-6和12微克B-12的基础上,添加超生理剂量叶酸(15毫克/天)、B-6(100毫克/天)和B-12(1毫克/天)对血浆同型半胱氨酸的影响。在基线、4周和8周后测量血浆总同型半胱氨酸。盲法分析显示,在随机分配到超生理剂量补充b族维生素的组中没有毒性的证据。血浆同型半胱氨酸在治疗4周(-29.8% vs -2.0%, P = 0.0024)和8周(-25.8% vs +0.6%, P = 0.0009)后均显著降低。此外,15名接受治疗的患者中有5名血浆Hcy降至标准范围内(< 15 μ mol/l),而12名安慰剂组患者中0名。可能需要超生理剂量的b族维生素来纠正透析患者高同型半胱氨酸血症。
Hyperhomocysteinemia, an arteriosclerotic risk factor, persists in 75% of dialysis patients despite routine low dose supplementation with the B-vitamin co-factors/substrates for homocysteine (Hcy) metabolism, and normal or supernormal plasma status of these vitamins (Atherosclerosis 114:93, 1995). We conducted a placebo-controlled eight-week trial of the effect on plasma homocysteine of adding supraphysiologic dose folic acid (15 mg/day), B-6 (100 mg/day), and B-12 (1 mg/day) to the usual daily dosing of 1 mg folic acid, 10 mg B-6, and 12 micrograms B-12, in 27 hyperhomocysteinemic dialysis patients. Total plasma homocysteine was measured at baseline, and after four and eight weeks. Blinded analyses revealed no evidence of toxicity in the group randomized to supraphysiologic dose B-vitamin supplementation. Plasma homocysteine was significantly reduced after both four weeks (-29.8% vs. -2.0%; P = 0.0024) and eight weeks (-25.8% vs. +0.6%; P = 0.0009) of active versus placebo treatment. Also, 5 of 15 treated versus 0 of 12 placebo group patients had their plasma Hcy reduced to within the normative range (< 15 mumol/liter). Supraphysiologic doses of B-vitamins may be required to correct hyperhomocysteinemia in dialysis patients.
DOI: 10.1093/clinchem/34.11.2357
发表时间: 1988-11
期刊: Clinical chemistry
影响因子: 9.3
作者:
D W Horne;D. Patterson
通讯作者: D W Horne;D. Patterson
DOI: 10.1056/nejm199502023320502
发表时间: 1995-02-02
影响因子: 158.5
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DOI: 10.1073/pnas.89.21.10193
发表时间: 1992
影响因子: 11.1
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DOI: 10.1016/s0021-9258(18)61082-8
发表时间: 1987-07
期刊: The Journal of biological chemistry
影响因子: --
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