Re: Homocysteine reduction has no effect on inflammatory markers

Juhana Harju wrote:
:: Robert wrote:
:::: "Jim Chinnis" <jchinnis@xxxxxxxxxxxxxxxx> wrote in message
:::: news:olfmc1ti7avqi3b41hlecbsgfmiejpl5th@xxxxxxxxxx
::::: "Robert" <Robertitsme@xxxxxxxxxxx> wrote in part:
:::::
:::::: Vitamine supplementation is indicated when homocysteine is high
:::::: unless you are happy with living in a deficient state.
:::::
::::: Even if research continues to show that it does not improve
::::: outcomes? The evidence seems to be building.
::::: --
::::: Jim Chinnis Warrenton, Virginia, USA
::::
:::: I am not referring to outcomes of CAD. I am referring to the fact
:::: that it may be a folate or B12 deficiency.
:::: An elevated level indicates a deficiency which has clinical
:::: implications in pregnancy and in neurological deficits.
::::
:::: Half of the homocysteins levels that I perform are either for CAD
:::: in which a lipid panel is also ordered or in patients with a
:::: folate and B12 level.
::::
:::: There are many medications out there like oral contraceptives and
:::: diseases out there that impact the folate and B12 levels. Vit B12
:::: is itself an inflammatory protein (transport protein).
::::
:::: A high homocysteine reflects a low folate and or B12 and should
:::: have treatment with folate and B12.
::::
:::: It's everybody choice but it is not just a marker and forget it
:::: because reduction of that marker did not translate to CAD
:::: reduction. You should reduce it because the person is folate or
:::: B12 deficient.
::
:: Actually there *are* studies showing that reducing homocysteine by
:: vitamin therapy reduces CAD risk in secundary prevention. There are
:: couple of Swiss studies and few of other studies also. But the
:: vitamin therapy has not been shown to be effective in reducing
:: stroke risk although high homocysteine is also a marker of elevated
:: stroke risk. Vitamin therapy is also used in clinical practise with
:: people diagnosed with CAD if they have elevated homocysteine.

(1) Schnyder G et al, Effect of homocysteine-lowering therapy with folic
acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous
coronary intervention: the Swiss Heart study: a randomized controlled
trial. JAMA. 2002 Aug 28;288(8):973-9.


"Homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin
B6 significantly decreases the incidence of major adverse events after
percutaneous coronary intervention."


http://www.ncbi.nlm.nih.gov/en­trez/query.fcgi?cmd=Retrieve&d­b=pubmed&;...


(2) Schnyder G at al, Decreased Rate of Coronary Restenosis after
Lowering of Plasma Homocysteine Levels. New England Journal of Medicine
2001;345:1593-1600


"Treatment with a combination of folic acid, vitamin B12, and pyridoxine
significantly reduces homocysteine levels and decreases the rate of
restenosis and the need for revascularization of the target lesion after
coronary angioplasty. This inexpensive treatment, which has minimal side
effects, should be considered as adjunctive therapy for patients
undergoing coronary angioplasty."


http://www.ncbi.nlm.nih.gov/en­trez/query.fcgi?cmd=Retrieve&d­b=pubmed&;...


(3)Vermeulen EG et al, Effect of homocysteine-lowering treatment with
folic acid plus vitamin B6 on progression of subclinical
atherosclerosis: a randomised, placebo-controlled trial. Lancet. 2000
Feb 12;355(9203):517-22.


"Homocysteine-lowering treatment with folic acid plus vitamin B6 in
healthy siblings of patients with premature atherothrombotic disease is
associated with a decreased occurrence of abnormal exercise
electrocardiography tests, which is consistent with a decreased risk of
atherosclerotic coronary events."


http://www.ncbi.nlm.nih.gov/en­trez/query.fcgi?cmd=Retrieve&d­b=PubMed&;...


(4) Chambers JC et al, Improved vascular endothelial function after oral
B vitamins: An effect mediated through reduced concentrations of free
plasma homocysteine. Circulation. 2000 Nov 14;102(20):2479-83.


"Folic acid and vitamin B(12) supplementation improves vascular
endothelial function in patients with CHD, and this effect is likely to
be mediated through reduced concentrations of free plasma homocysteine
concentrations. Our data support the view that lowering homocysteine,
through B vitamin supplementation, may reduce cardiovascular risk."


http://www.ncbi.nlm.nih.gov/en­trez/query.fcgi?cmd=Retrieve&d­b=PubMed&;...




--
Juhana


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