Plasmatic homocysteine response to vitamin supplementation in elderly people

Homocysteine (Hcy) increase is now widely accepted as a risk factor for vas cular disease. The effects of folic acid (FA) and vitamins B-12 and B-6 in lowering Hey have been extensively studied, but there is still little data on the response to FA dietary administration. Our purpose was to evaluate t he impact of the diet and the degree of response to different doses of phar macological FA supplementation. In a prospective, randomized, and simple bl ind study, 50 elderly subjects were given a 400-mug/day FA diet and were ra ndomly assigned to one of the following treatments: Group I = placebo table t; Group II = tablet containing 1-mg folic acid, 1-mg B-12, and 25-mg B-6; and Group III = tablet containing 2.5-mg folic acid and same B-6 and B-12 d oses as Group II. Forty-four subjects completed the study, and their plasma s were evaluated. Hcy concentration significantly decreased even in patient s with normal basal values, and there were no differences in the response b etween individuals receiving diet plus placebo and those receiving diet plu s pharmacological supplementation. After the treatment, the mean decrease o f plasmatic Hey levels was 10.8 (9.4, 12.5) mu mol/l, geometric mean [95% c onfidence interval (95% CI)], and particularly, the values for Group I were 10.6 (7.4, 14.8) mu mol/l. In 31% of the subjects, the post-treatment Hey levels were less than or equal to5 mu mol/l. These results show that a spec ial diet, with or without pharmacological FA and B-12 and B-6 supplementati on, significantly decreases the Hey levels in elderly people. Therefore, a diet with high contents of FA might have an enormous impact on the morbidit y and mortality of atherothrombosis. (C) 2000 Elsevier Science Ltd. All rig hts reserved.