Increased levels of homocysteine in patients with Crohn's disease are related to folate levels

OBJECTIVES: The risk for thrombotic events is increased in inflammatory bow el disease. The factors responsible for such a risk are poorly defined. Rec ently, an elevated homocysteine level is emerging as a risk factor for thro mbosis. The aim of this study was to determine the levels of homocysteine i n a well-characterized population of patients with Crohn's disease and to c ompare it to controls. METHODS: The levels of homocysteine were determined in 105 well-characteriz ed patients with Crohn's disease and 106 controls. The levels of folate and B12, which are involved in the metabolism of homocysteine were determined as well. Patients were treated with steroid preparations only. RESULTS: Homocysteine levels were significantly elevated in the patient pop ulation. Elevated levels were correlated with both low B12 and folate level s, but folate deficiency turned out to be a more important factor. Low B12 levels were in correlation with the involvement of the terminal ileum. No c orrelation was found between homocysteine levels and either disease activit y or involvement of the terminal ileum. CONCLUSIONS: Homocysteine levels are increased in patients with Crohn's dis ease and this finding is inversely correlated with folate levels. Supplemen tation of folate to patients with Crohn's disease may be warranted. (C) 200 0 by Am. Cell. of Gastroenterology.