Effects of levofolinic acid on plasma homocysteine concentrations in healthy and young women in preconceptional care

BACKGROUND: Increases in total plasmatic homocysteine (tHcy) represents a r isk factor for neural tube defects. We studied the effects of levofolinic a cid (l,5-formyl-tetrahydrofolic) on the plasmatic tHcy levels in women of c hild-bearing age. MATERIALS AND METHOD: Healthy women aged 18-35 years (n = 30) received levo folinic acid, 5 mg/day, orally for 30 days. Both tHcy and intraerythrocytic folate levels were measured before treatment (day 0), on days 2, 5, 10 and 30 within the treatment period and on days 30 (day 60) and 60 (day 90) aft er the treatment was finished. Plasmatic tHcy was measured by fluorescence polarisation immunoassay and intraerythrocytic folates by chemiluminescent immunoassay. RESULTS; Plasmatic tHcy decreased from the second day of treatment onwards (day 0 vs. 2: mean of difference: -1.24 mu mol/l; CI 95% = -0.84 to -1.63; p < 0.001). The maximum decline (32.3%) was observed after 30 days (mean of difference = -2.72 <mu>mol/l; CI 95% = -2.20 to -3.24; p < 0.001). After f inishing the treatment, the hypohomocysteinic effect persisted up to days 6 0 (mean of difference = -2.67 <mu>mol/l; CI 95% = -2.07 to -3.26; p < 0.001 ) and 90 (mean of difference = -1.49 <mu>mol/l; CI 95% = -0.94 to -2.03; p < 0.001). The response was greater when the plasmatic tHcy concentration wa s <greater than or equal to> 9 mu mol/l. CONCLUSIONS: Levofolinic acid leads to a earlier, intense and persistent dr op of the plasmatic tHcy levels.