Folic Acid and Vitamins D and B12 Correlate With Homocysteine in Chinese Patients With Type-2 Diabetes Mellitus, Hypertension, or Cardiovascular Disease

Abstract

Elevated serum homocysteine has been shown to be a risk factor for hypertension, cardiovascular disease (CVD), and type-2 diabetes mellitus (T2DM).We characterized the relationships between the serum levels of homocysteine, folic acid, and vitamins D2, D3, and B12 in patients with T2DM, CVD, and hypertension in Shanghai, China. The levels of these serum biochemical markers were determined for 9311 Chinese patients (mean age: 79.50 ± 13.26 years) with T2DM (N = 839), hypertension (N = 490), or CVD (N = 7925). The demographic and serum biochemical data were compared using an analysis of variance. We performed stratified analyses using Pearson linear regression to investigate correlations between the different variables in the T2DM, CVD, and hypertension groups and in patients aged < 50, 50 to 64, 65 to 80, and ≥80 years. A subgroup analysis was also performed to identify correlations between the serum biochemical markers. Stratified chi-squared analyses were performed based on the levels of folic acid and total vitamin D.In all 3 patient groups, elevated levels of vitamin D2 and homocysteine were observed, whereas the levels of folic acid and vitamins D3 and B12 were lower than the reference range for each serum marker (P < 0.05 for all). The linear regression and stratified analyses showed that the highest levels of folic acid and vitamins D2 and D3 correlated with the lowest level of homocysteine in T2DM, CVD, and hypertension patients (P < 0.05 for all), whereas the highest level of vitamin B12 correlated with a lowest level of homocysteine in CVD patients only (P < 0.05).Our results indicate that the contributions of both vitamin D2 and vitamin D3 should be considered in investigations of the effects of vitamin D supplements in T2DM, CVD, and hypertension patients. Our findings warrant future studies of the benefits of vitamin D and folic acid supplements for reducing the risk of T2DM, CVD, and hypertension in elderly Chinese people, as well as the benefits of vitamin B12 supplements for reducing the risk of CVD alone.

Environmental UVR Levels and Skin Pigmentation Gene Variants Associated with Folate and Homocysteine Levels in an Elderly Cohort

“…This suggests homocysteine may be decreased by processes which are upregulated following UVR exposure. Vitamin D, which is consistently inversely associated with homocysteine levels [50][51][52][53][54], may be involved in this process or may be a marker of sun-exposure, supporting this hypothesis. Increased oxidative stress following UVR exposure may also influence homocysteine levels, by promoting homocysteine auto-oxidization and the formation of homocysteine into another oxidant not detected by homocysteine assays [55].…”

Influence of food groups on plasma total homocysteine for specific MTHFR C677T genotypes in Chinese population

“…This genetic risk can be influenced by folate, with the highest risk at the lowest levels of folate intake . In China, the average folate intake is far below the recommended level, which means that additional folate supplementation is very necessary .…”

Prediction model for the efficacy of folic acid therapy on hyperhomocysteinaemia based on genetic risk score methods

“…At home and abroad, the results of the study on supplementation of folic acid to reduce Hcy concentration were inconsistent (13)(14)(15) . A previous study found that more than 40 % patients with HHcy failed to reach the normal level after folic acid supplementation (16) .…”