Coeliac disease is a typical example of a malabsorption syndrome conferring increased risk for various deficiency states, including folate and vitamin B12. Hyperhomocysteinemia is significantly more frequent in patients with newly diagnosed coeliac disease than healthy controls.
A research team led by Dr. Muhammed Hadithi from Netherlands investigated the effect of vitamin B6, folate, and vitamin B12 daily supplements on homocysteine levels in patients with coeliac disease. Their study will be published on February 28, 2009 in the World Journal of Gastroenterology.
In their study, vitamin B6, folate, vitamin B12, and fasting plasma homocysteine levels were investigated in 51 consecutive adults with coeliac disease and 50 healthy control individuals matched for age and sex.
They found that patients with celiac disease and using vitamin supplements had higher serum vitamin B6 (P = 0.003), folate (P < 0.001), and vitamin B12 (P = 0.012) levels than patients who did not or healthy controls (P = 0.035, P < 0.001, P = 0.007, for vitamin B6, folate, and vitamin B12, respectively). Lower plasma homocysteine levels were found in patients using vitamin supplements than in patients who did not (P = 0.001) or healthy controls (P = 0.003). However, vitamin B6 and folate, not vitamin B12, were significantly and independently associated with homocysteine levels. Twenty-four (48%) of 50 controls and 23 (50%) of 46 patients with celiac disease carried the MTHFR thermolabile variant T-allele (P = 0.89).
They concluded that Homocysteine levels are dependent on Marsh classification and the regular use of B-vitamin supplements is effective in reduction of homocysteine levels in patients with celiac disease.
The study demonstrates in agreement with earlier findings, that both the presence and the severity of coeliac disease were determinants of homocysteine levels. The regular use of B vitamin supplements was associated with higher serum vitamin B6, folate, and vitamin B12 and lower plasma homocysteine levels in patients with coeliac disease. Furthermore, B vitamin supplements seem to have a protective role against the effect of villous atrophy on homocysteine levels, irrespective to the genetic susceptibility status as manifested by carrying the C677T polymorphism of 5,10-methylenetetrahydrofolate reductase.
Reference: Hadithi M, Mulder CJJ, Stam F, Azizi J, Crusius JBA, Peña AS, Stehouwer CDA, Smulders YM. Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease. World J Gastroenterol 2009; 15(8): 955-960
Correspondence to: Dr. Muhammed Hadithi, Department of Gastroenterology, VUmc University Medical Center, PO Box 9119, 3007 AC Rotterdam, The Netherlands. email@example.com
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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