Azadibakhsh Nassim, Hosseini Rahebeh Shaker, Atabak Shahnaz, Nateghiyan Navid, Golestan Banafsheh, Rad Anahita Hooshyar
Department of Human Nutrition, National Nutrition and Food Technology Research Institute, Tehran, Iran.
Saudi J Kidney Dis Transpl. 2009 Sep;20(5):779-88.
To evaluate the efficacy of supplementation with high dose folic acid with and without vitamin B 12 in lowering plasma total homocysteine (tHcy) concentrations in hemodialysis (HD) patients, we studied 36 HD patients randomized into four groups according to the received therapeutic regimen: group I (only folic acid (FA), 5 mg/day), group II (FA, 5 mg/day + vitamin B 12 , 1 mg/day) group III (only FA, 15 mg/day), group IV (FA, 15 mg/day, vitamin B 12 , 1 mg/day) for a period of 8 weeks. Plasma tHcy and serum FA and vitamin B 12 levels were measured at baseline and after the supplementation period. Dietary intakes were assessed during the study period. At baseline, 27.8% of the patients had normal levels of tHcy and 72.2% had hyperhomocysteinemia. After supplementation, plasma tHcy increased by 1.35% in group I and decreased by 6.99%, 14.54% and 30.09% in groups II, III and IV respectively, which was only significant in group IV (P= 0.014). The patients did not show any significant changes in serum folic acid, but a significant change in serum vitamin B 12 in group IV (P= 0.006). Percentage of patients reaching normal levels of plasma tHcy was 5.6 fold higher in group IV than in the reference group (group I). No correlations were found between changes of plasma tHcy levels and dietary intakes. We conclude that oral supplementation with 15 mg/day folic acid together with 1 mg/day of vitamin B 12 is effective in reducing tHcy levels in HD patients. These supplements also have a desirable effect on serum folic acid and vitamin B12.
为评估补充高剂量叶酸（无论是否联合维生素B12）对降低血液透析（HD）患者血浆总同型半胱氨酸（tHcy）浓度的疗效，我们根据所接受的治疗方案，将36例HD患者随机分为四组：第一组（仅服用叶酸（FA），5毫克/天），第二组（FA，5毫克/天 + 维生素B12，1毫克/天），第三组（仅FA，15毫克/天），第四组（FA，15毫克/天 + 维生素B12，1毫克/天），为期8周。在基线期和补充期结束后，测定血浆tHcy以及血清叶酸和维生素B12水平。在研究期间评估饮食摄入量。基线时，27.8%的患者tHcy水平正常，72.2%患有高同型半胱氨酸血症。补充后，第一组血浆tHcy升高了1.35%，第二、三、四组分别降低了6.99%、14.54%和30.09%，仅第四组差异有统计学意义（P = 0.014）。患者血清叶酸无显著变化，但第四组血清维生素B12有显著变化（P = 0.006）。达到血浆tHcy正常水平的患者百分比，第四组比参照组（第一组）高5.6倍。血浆tHcy水平变化与饮食摄入量之间未发现相关性。我们得出结论，每天口服15毫克叶酸联合1毫克维生素B12可有效降低HD患者的tHcy水平。这些补充剂对血清叶酸和维生素B12也有良好作用。
