vitamin-b-12 and Aortic-Aneurysm--Abdominal

To summarize the association of vitamins (B6, B12, C, D, and E) and abdominal aortic aneurysm (AAA), we reviewed clinical studies with a comprehensive literature research and meta-analytic estimates.. To identify all clinical studies evaluating the association of vitamins B6/B12/C/D/E and AAA, databases including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through April 2015, using Web-based search engines (PubMed and OVID). For each case-control study, data regarding vitamin levels in both the AAA and control groups were used to generate standardized mean differences (SMDs) and 95% confidence intervals (CIs).. Pooled analyses of the 4 case-control studies demonstrated significantly lower circulating vitamin B6 levels (SMD, -0.33; 95% CI, -0.55 to -0.11; P=0.003) but non-significantly lower vitamin B12 levels (SMD, -0.42; 95% CI, -1.09 to 0.25; P=0.22) in patients with AAA than subjects without AAA. Pooled analyses of the 2 case-control studies demonstrated significantly lower levels of circulating vitamins C (SMD, -0.71; 95% CI, -1.23 to -0.19; P=0.007) and E (SMD, -1.76; 95% CI, -2.93 to 0.60; P=0.003) in patients with AAA than subjects without AAA. Another pooled analysis of the 3 case-control studies demonstrated significantly lower circulating vitamin D (25-hydroxyvitamin D) levels (SMD, -0.25; 95% CI, -0.50 to -0.01; P=0.04) in patients with AAA than subjects without AAA. In a double-blind controlled trial, 4.0-year treatment with a high-dose folic acid and vitamin B6/B12 multivitamin in kidney transplant recipients did not reduce a rate of AAA repair despite significant reduction in homocysteine level. In another randomized, double-blind, placebo-controlled trial, 5.8-year supplementation with α-tocopherol (vitamin E) had no preventive effect on large AAA among male smokers.. In clinical setting, although low circulating vitamins B6/C/D/E (not B12) levels are associated with AAA presence, vitamins B6/B12/E supplementation may not reduce AAA incidence.

Topics: Aortic Aneurysm, Abdominal; Ascorbic Acid; Dietary Supplements; Folic Acid; Humans; Incidence; Randomized Controlled Trials as Topic; Vitamin B 12; Vitamin B 6; Vitamin D; Vitamin E; Vitamins

Homocysteine (Hcy) has been implicated in abdominal aortic aneurysm (AAA). However, the association of Hcy, vitamin B12, and folate in patients with AAA has not been studied in China. This study was conducted with the aim to evaluate the relationship of vitamin B12, folic acid, and Hcy levels in AAA.. 463 patients who had AAA were included in this study. 463 control subjects were age- and sex-matched with the patients. In all of the subjects, we evaluated total plasma levels Hcy, vitamin B12, folic acid and the distribution of the C677T methylenetetrahydrofolate reductase (MTHFR) gene mutation.. The mean plasma Hcy levels were significantly higher in patients with AAA compared with controls (18.37 ± 6.97 vs. 12.89 ± 4.08 μmol/L, P < 0.001). The frequency of homozygous (TT) genotype in MTHFR C677T mutation was significantly higher in patients with AAA than that in control subjects (19.4 % vs. 11.9 %, P = 0.002). The fasting Hcy correlated negatively with folate (AAA: r = - 0.311, P < 0.01;. r = - 0.348, P < 0.01). The aneurysm size was significantly greater (P < 0.001) in patients with hyperhomocysteinemia than that in patients with normal Hcy plasma levels. The size of the AAA had a linear correlation with the plasma Hcy level (r = 0.286; P< 0.001).. Serum folate deficiency and hyperhomocysteinemia were associated with an increased risk of AAA in Northeast China. The homozygous (TT) genotype of MTHFR gene mutation may be a crucial hereditary risk factor in AAA.. Hintergrund: Homocystein (Hcy) wurde mit dem Bauchaortenaneurysma (AAA) in Verbindung gebracht. Allerdings wurde der Zusammenhang von Hcy, Vitamin B12 und Folsäure bei Patienten mit AAA bislang nicht in unserer Population untersucht. Patienten und Methoden: 463 Patienten mit einem AAA wurden in die Studie eingeschlossen. 463 Probanden waren nach Alter und Geschlecht mit den Patienten abgestimmt. Wir untersuchten bei allen den Plasmaspiegel von Hcy, Vitamin B12, Folsäure und die Verteilung der C677T Methylentetrahydrofolat Reduktase (MTHFR) Gen-Mutation. Ergebnisse: Die mittlere Plasma- Hcy Konzentrationen waren bei Patienten mit AAA im Vergleich zur Kontrollgruppe signifikant höher (18,37 ± 6,97 vs 12,89 ± 4,08 umol/l, P < 0,001). Die Häufigkeit des homozygoten (TT) Genotyps der MTHFR C677T Mutation war bei Patienten mit AAA signifikant höher als in der Kontrollgruppe (19,4 % vs 11,9 %, P = 0,002). Nüchtern Hcy korrelierte negativ mit Folsäure (AAA: r = - 0,311, P < 0,01; Kontrolle: r = - 0,348, P < 0,01). Die Aneurysmen waren signifikant größer (p < 0,001) bei Patienten mit Hyperhomocysteinämie als bei Patienten mit normalen Hcy Plasmaspiegel. Die Größe des AAA korrelierte linear mit dem Plasma- Hcy Spiegel (r = 0,286, p < 0,001). Schlussfolgerungen: Serum Folsäuremangel und Hyperhomocysteinämie waren mit einem erhöhten Risiko von AAA assoziiert. Der homozygote (TT) Genotyp des MTHFR Genmutation kann ein entscheidender erblicher Risikofaktor für AAA sein.

Topics: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Aortography; Biomarkers; Case-Control Studies; China; Female; Folic Acid; Folic Acid Deficiency; Gene Frequency; Genetic Predisposition to Disease; Heterozygote; Homozygote; Humans; Hyperhomocysteinemia; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Mutation; Phenotype; Risk Factors; Tomography, X-Ray Computed; Vitamin B 12

Hyperhomocysteinemia has been associated with vascular disease in many epidemiologic studies, but only a few have reported on the relation between hyperhomocysteinemia and aneurysms of the abdominal aorta (AAAs). Although these studies showed higher homocysteine concentrations in patients with AAA than in controls, little attention had been given to possible confounding factors. Most patients with AAA are of older age, have an impaired renal function, and have other risk factors for cardiovascular disease. This matched case-control study investigated the relation between homocysteine concentration (before and after methionine loading) and AAA, taking into account possible confounders such as age, sex, and concentrations of creatinine and B vitamins.. Patients with a history of AAA were recruited from the outpatient clinic; 60% had already undergone surgery for their AAA. They were asked to invite a friend or neighbor to participate as a control subject (age-matched and sex-matched). Concentrations of homocysteine, vitamin B6, vitamin B12, folate, and creatinine were determined in the fasting state, and blood was taken for methylenetetrahydrofolate reductase (MTHFR) mutation analysis. Six hours after oral methionine loading, the postmethionine load homocysteine concentration was determined.. Univariate analysis showed an odds ratio (OR) of 2.2 (95% confidence interval (CI), 0.9 to 5.5) for the risk of AAA for the highest quartile of homocysteine concentration. After adjustment for creatinine, the OR was markedly reduced to 1.24 (95% CI, 0.42 to 3.66), and this risk further attenuated in the multivariate analysis. Univariate analysis of the B vitamins showed an increased risk of AAA for the bottom quartile of vitamin B6 (OR, 3.75; 95% CI, 1.22 to 11.54), which even increased after adjustments. The relative risk associated with the MTHFR 677TT polymorphism was 2.1 (95% CI, 0.9 to 5.3).. Vitamin B6, but not homocysteine, is an independent risk factor for AAA. The role of vitamin B6 in the pathogenesis of AAA needs to be further elucidated.

Topics: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Case-Control Studies; Creatinine; DNA Mutational Analysis; Fasting; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Male; Methionine; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Odds Ratio; Polymorphism, Genetic; Retrospective Studies; Risk Assessment; Risk Factors; Vitamin B 12; Vitamin B 6; Vitamin B 6 Deficiency

Topics: Aged; Aortic Aneurysm, Abdominal; Atherosclerosis; Carotid Artery Diseases; Folic Acid; Genotype; Homocysteine; Humans; Ischemia; Leg; Male; Methylenetetrahydrofolate Reductase (NADPH2); Peripheral Vascular Diseases; Risk Factors; Vitamin B 12

Hyperhomocysteinemia is a recognised independent risk factor in the genesis of atherosclerotic diseases. However, very little is known about the relationship between homocysteine and abdominal aortic aneurysm (AAA). Vitamins, namely B12 and folic acid have been implicated in the regulation of plasma homocysteine levels. However, there has been no prospective study that has analysed the relationship of AAA and plasma homocysteine in light of serum vitamin levels.. To study the relationship between plasma homocysteine, serum B12 and folic acid levels, and AAA.. Case control study including 38 AAA patients and 36 controls. Fasting homocysteine, B12 and folic acid were determined in serum separated within 1 h of blood collection using a fluorescence polarisation immunoassay technique (FPIA).. Twenty-six (68%) of the AAA patients had elevated levels of homocysteine compared to 2 (6%) in the case control group. The mean homocysteine level in the AAA group was 19.4 micromol/L (SE +/- 1.1) (95% CI 17.17-21.65) and in the control group was 10.9 micromol/L (SE +/- 1) (95% CI 9.95-11.88) (p<0.001). Mean vitamin B12 levels in the AAA and the controls was 332.11 pg/L (SE +/- 16.44) and 414.33 pg/L (SE +/- 19.72), respectively (p<0.004). Mean folic acid in the AAA was 8.02 (SE +/- 0.71) and the control was 9.8 etagm/L (SE +/- 0.69), (ns).. This study confirms significantly higher levels of plasma homocysteine in AAA patients but lower levels of B12. Use of supplemental vitamins that should lower plasma homocysteine may modify vascular disease progression. Clinical trials in this direction are warranted.

Topics: Aged; Aortic Aneurysm, Abdominal; Case-Control Studies; Folic Acid; Homocysteine; Humans; Middle Aged; Vitamin B 12

Hyperhomocysteinaemia has recently been identified as an important risk factor for atherosclerotic vascular disease. Screening for hyperhomocysteinaemia has been recommended, however, the incidence of hyperhomocysteinaemia in vascular patients is not known.. To determine the incidence of hyperhomocysteinaemia in vascular patients, to determine the relation of hyperhomocysteinaemia with folate, vitamin B12 levels and lipid profiles in vascular patients. To examine if there is a relationship between the degree of vascular injury and homocysteine concentration.. New vascular patients at The Queen Elizabeth Hospital were recruited and divided into peripheral, and aneurysmal presentations. Patients demographics were recorded, blood samples were taken for fasting lipid profile, and homocysteine concentration. Samples were also taken for vitamin B12, plasma and red cell folate levels. Sixty age and sex matched controls were included for comparison.. One hundred and twenty-six patients have been recruited, (95 men and 31 women) with a median age of 68 years (61-74 years). The incidence of elevated homocysteine, and cholesterol levels was 33, 47 and 24%. The levels of vitamin B12 and folate were normal in all patients. Homocysteine was elevated in 27% of claudicants, 50% of patients with rest pain and 53% of patients with an aortic aneurysm.. There is a high rate of hyperhomocysteinaemia in vascular patients with a higher incidence in patients with rest pain. There was also a high incidence of elevated homocysteine levels in patients with an abdominal aortic aneurysm. The rate of growth of these aneurysms is currently under review. Low folate or B12 concentrations is not the cause of raised homocysteine levels.

Topics: Aged; Aortic Aneurysm, Abdominal; Chronic Disease; Female; Folic Acid; Humans; Hyperhomocysteinemia; Intermittent Claudication; Ischemia; Leg; Lipids; Male; Middle Aged; Vascular Diseases; Vitamin B 12