Total Homocysteine Concentration and Associated Cardiovascular and Renal Implications in Adults

Abstract

Hyperhomocysteinemia has been linked to an increased risk for cardiovascular (CV) disease since 1969. Recent epidemiological and cohort observations continue to confirm this relationship, provided the homocysteine concentration is elevated. This elevation in homocysteine concentration and increased CV disease risk are particularly strong in patients with renal disease. Hyperhomocysteinemia is also related to declining status of vitamins B6 and B12, folate, and in some cases riboflavin. This relationship between vitamins and homocysteine concentration has provided the basis for clinical trials targeting CV risk reduction by vitamin supplementation. This review describes the evidence behind vitamin supplementation as it pertains to homocysteine status and make recommendations for vitamin intake management in patients with hyperhomocysteinemia, including those patients with renal disease.

The <b><i>MTHFR</i></b> C677T Polymorphism Is Related to Plasma Concentration of Oxidized Low-Density Lipoprotein in Adolescents with Cardiovascular Risk Factors

“…Despite the undeniable importance of adequate supply of these vitamins, reference intervals for this age group are controversial [22]. Most studies reveal the need of folic acid supplementation in order to control hyperhomocysteinemia, mainly in groups vulnerable to this deficiency [32,33,34]. However, complex B vitamin supplementation is still unjustified in the literature for CVD prevention [35].…”

Impact of type 2 Diabetes and Metformin use on Vitamin B12 Associated Biomarkers - an Observational Study

“…Clinically, VB12 deficiency in adults may result in nonspecific symptoms such as tiredness, loss of appetite, hematologic manifestations (megaloblastic anemia), neurologic symptoms (e. g., polyneuropathy, ataxia), as well as symptoms of a psychiatric nature (e. g., depression) [2,3]. Additionally, cardiovascular manifestations associated with hyperhomocysteinemia were mentioned [4][5][6][7].…”

Early biomarker response and patient preferences to oral and intramuscular vitamin B12 substitution in primary care: a randomised parallel-group trial

“…Besides nonspecific symptoms such as tiredness and a loss of appetite, haematological manifestations (megaloblastic anaemia), neurological disorders (e.g., polyneuropathy, ataxia) and symptoms of a psychiatric nature (e.g., depression) are possible [8,12]. Additionally, cardiovascular manifestations, which accompany hyperhomocysteinaemia, are described [13][14][15][16]. Because VB12 deficiency is a reversible cause of demyelinating nervous system disease and bone marrow failure, its early detection and treatment are important [12].…”