Deenanath Mangeshkar Hospital and Research Center, Biochemistry Section, Department of Pathology, Erandawane, Pune, India.
J Cardiol. 2013 Apr;61(4):289-94. doi: 10.1016/j.jjcc.2012.11.009. Epub 2013 Mar 6.
Folate and vitamin B12 are essential components in the metabolism of homocysteine (Hcy). Hyperhomocysteinemia has been implicated in endothelial dysfunction and cardiovascular disease. However, the association of Hcy, vitamin B12, and folic acid with cardiovascular risk factors in patients with coronary artery disease (CAD) has not been studied in Indian patients. This study was conducted with the aim to evaluate the relationship of vitamin B12, folic acid, and Hcy levels with cardiovascular risk factors in subjects with known CAD.
Three hundred patients (216 men; 84 women; aged 25-92 years) who had CAD on angiography were included in this study consecutively. All patients were evaluated for anthropometry and cardiovascular risk factors, and blood samples were collected for biochemical, nutritional, and inflammatory markers.
Percentage of vitamin B12 and folate deficiency was 86.7% and 2.7%, respectively. Hyperhomocysteinemia was present in 95.3% patients. Vitamin B12 levels were significantly lower and Hcy levels were significantly higher in subjects with dyslipidemia, DM, and/or hypertension. Serum vitamin B12 was inversely associated with triglyceride and very low-density lipoprotein (VLDL) and positively with high-density lipoprotein (HDL). Hcy was positively associated with triglyceride and VLDL and negatively with HDL. Vitamin B12 was inversely correlated with inflammatory markers (high-sensitivity C-reactive protein and interleukin-6) directly related to insulin resistance whereas Hcy showed the opposite pattern.
Serum vitamin B12 deficiency and hyperhomocysteinemia are related with cardiovascular risk factors in Indian patients with CAD.
叶酸和维生素 B12 是同型半胱氨酸（Hcy）代谢所必需的成分。高同型半胱氨酸血症与血管内皮功能障碍和心血管疾病有关。然而，在印度患者中，尚未研究 Hcy、维生素 B12 和叶酸与冠心病（CAD）患者心血管危险因素的关系。本研究旨在评估已知 CAD 患者中维生素 B12、叶酸和 Hcy 水平与心血管危险因素的关系。
本研究连续纳入了 300 名经血管造影证实为 CAD 的患者（216 名男性；84 名女性；年龄 25-92 岁）。所有患者均接受了人体测量和心血管危险因素评估，并采集了血液样本以检测生化、营养和炎症标志物。
维生素 B12 和叶酸缺乏的比例分别为 86.7%和 2.7%。95.3%的患者存在高同型半胱氨酸血症。血脂异常、糖尿病和/或高血压患者的维生素 B12 水平显著降低，Hcy 水平显著升高。血清维生素 B12 与甘油三酯和极低密度脂蛋白（VLDL）呈负相关，与高密度脂蛋白（HDL）呈正相关。Hcy 与甘油三酯和 VLDL 呈正相关，与 HDL 呈负相关。维生素 B12 与与胰岛素抵抗直接相关的炎症标志物（高敏 C 反应蛋白和白细胞介素-6）呈负相关，而 Hcy 则呈相反的模式。
血清维生素 B12 缺乏和高同型半胱氨酸血症与印度 CAD 患者的心血管危险因素有关。
