Department of Laboratory, Foundation of Research and Care, John Paul II, Catholic University of Sacred Heart, Campobasso 86100, Italy.
Nutrients. 2013 May 8;5(5):1531-43. doi: 10.3390/nu5051531.
BACKGROUND/OBJECTIVES: To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocols in subjects with "moderate" hyperhomocysteinemia, also taking into account C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene.
SUBJECTS/METHODS: We performed a 13 week open, randomized, double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia, with daily 200 μg from a natural folate-rich diet, 200 μg [6S]5-methyltetrahydrofolate (5-MTHF), 200 μg folic acid or placebo. Participants were stratified according to their MTHFR genotype.
Homocysteine (Hcy) levels were reduced after folate enriched diet, 5-MTHF or folic acid supplementation respectively by 20.1% (p < 0.002), 19.4% (p < 0.001) and 21.9% (p < 0.001), as compared to baseline levels and significantly as compared to placebo (p < 0.001, p < 0.002 and p < 0.001, respectively for enriched diet, 5-MTHF and folic acid). After this enriched diet and the folic acid supplementation, Hcy in both genotype groups decreased approximately to the same level, with higher percentage decreases observed for the TT group because of their higher pre-treatment value. Similar results were not seen by genotype for 5-MTHF. A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations, as compared to placebo.
Supplementation with natural folate-rich foods, folic acid and 5-MTHF reached a similar reduction in Hcy concentrations.
背景/目的：比较富含天然叶酸的饮食与两种不同叶酸补充方案在“中度”高同型半胱氨酸血症患者中的疗效，同时考虑到 5,10-亚甲基四氢叶酸还原酶（MTHFR）基因 C677T 多态性。
受试者/方法：我们对 149 名轻度高同型半胱氨酸血症的自由生活者进行了为期 13 周的开放性、随机、双盲临床试验，每天给予 200μg 天然叶酸丰富的饮食、200μg [6S]5-甲基四氢叶酸（5-MTHF）、200μg 叶酸或安慰剂。根据 MTHFR 基因型对参与者进行分层。
与基线水平相比，富含叶酸的饮食、5-MTHF 或叶酸补充分别使同型半胱氨酸（Hcy）水平降低 20.1%（p<0.002）、19.4%（p<0.001）和 21.9%（p<0.001），与安慰剂相比差异具有统计学意义（p<0.001，p<0.002 和 p<0.001，分别为富含叶酸的饮食、5-MTHF 和叶酸）。在这种富含叶酸的饮食和叶酸补充后，两种基因型组的 Hcy 均降低到大致相同的水平，由于 TT 组的初始值较高，其下降幅度较大。对于 5-MTHF，基因型之间没有观察到相似的结果。与安慰剂相比，叶酸和富含天然叶酸的食物补充后红细胞叶酸浓度显著增加。
补充富含天然叶酸的食物、叶酸和 5-MTHF 均可使 Hcy 浓度降低。
