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Diet and Lifestyle Role in Homocysteine Metabolism in Turner Syndrome.
Calcaterra, V, Larizza, D, De Giuseppe, R, De Liso, F, Klersy, C, Albertini, R, Pozzebon, I, Princis, MP, Montalbano, C, Madè, A, et al
Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2019;(1):48-55
Abstract
OBJECTIVE Patients with Turner syndrome (TS) have an unfavorable cardiometabolic profile. Hyperhomocysteinemia is a potential cardiovascular risk factor influenced by genetic and environmental factors, therapies, unbalanced diets and other lifestyle factors. We retrospectively studied the relationship between total plasma homocysteine (Hcy), serum vitamin B12 (B12) and folate concentration in TS patients, taking into account the genetic profile, diet, smoking habits, hormonal therapies and dietary supplements of the subjects. PATIENTS AND METHODS We evaluated 50 TS patients (31.5 ± 12.5 years). Medication, including vitamin supplementation, was obtained. Eating habits, cigarette smoking, alcohol and coffee consumption were investigated using phone interviews. Levels of Hcy metabolism parameters were classified by using the relevant cutoff value for an adult population and compared with a reference sample drawn from the general population. RESULTS Inadequate Hcy and B12 levels were noted, despite vitamin supplementation. Holotranscobalamin (HoloTC) was above the relevant cutoff in the population, and supplemented subjects showed mean levels lower than nonsupplemented subjects (p = 0.005). Dietary supplementation (p = 0.038), lifestyle (coffee consumption, p = 0.01) and hormonal replacement therapy (p = 0.02) are important factors for Hcy metabolism. No genetic influence on Hcy levels was noted. Multivariable regression analysis identified vitamin supplementation (p = 0.045) as the only independent predictor of increased Hcy levels. CONCLUSION Cardiovascular risk in TS can be reduced using educational approaches to a healthy lifestyle with dietary guidelines. Besides this, we also recommend measuring HoloTC for the prompt detection of B12 deficiency and to consider hormone replacement therapy in the biochemical assessment of homocysteine in TS.
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Implication of homocysteine in diabetes and impact of folate and vitamin B12 in diabetic population.
Mursleen, MT, Riaz, S
Diabetes & metabolic syndrome. 2017;:S141-S146
Abstract
Diabetes mellitus is an acutely debilitating ailment affecting a large population of the world. At present, over 415 million people around the world including 7 million people in Pakistan suffering from diabetes. Homocysteine is an amino acid that is inversely related to vitamin B12 and folate, and raised level of homocysteine is implicated in many adverse health conditions. In this study, the potential role of homocysteine in diabetes and the epidemiology of hyperhomocysteinaemia, and vitamin B12 and folate deficiency is reviewed along with the impact of folate and vitamin B12 in regulation of homocysteine level. Deficiency of vitamin B12 and folate is rare in developed countries and the countries which adopted fortification programs, but deficiency of these vitamins is found to be highly prevalent in developing world, particularly in Pakistan. Several studies have found an association of high homocysteine levels and diabetes, but a few studies found contrary results. Hence, further epidemiological studies are recommended for homocysteine involvement in diabetes and vitamin B12 and folate deficiency, so that an urgent action can be taken to control the hyperhomocysteinaemia and consequently the ever increasing burden of disease and specifically diabetes.
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Does genistein lower plasma lipids and homocysteine levels in postmenopausal women? A meta-analysis.
Li, J, Liu, Y, Wang, T, Zhao, L, Feng, W
Climacteric : the journal of the International Menopause Society. 2016;(5):440-7
Abstract
OBJECTIVE To perform a meta-analysis examining the effects of genistein on homocysteine and lipid levels in postmenopausal women. METHODS We systematically searched the PubMed, MEDLINE, and Cochrane Library databases and the ClinicalTrials.gov website for studies. We performed a meta-analysis using weighted mean differences (WMD) and 95% confidence intervals in a random-effects model. We assessed between-study heterogeneity using the Cochran's Q and I(2) statistics. RESULTS Eight randomized, controlled trials with a total of 476 subjects were included in the meta-analysis. Compared with placebos, genistein was effective in reducing plasma levels of homocysteine (WMD, -0.58 μmol/l; p = 0.001), and increasing high density lipoprotein (HDL) cholesterol levels (WMD, 4.9 mg/dl; p = 0.0002). Subgroup analyses revealed that genistein significantly decreased the levels of low density lipoprotein (LDL) cholesterol (WMD, -16.90 mg/dl; p = 0.01), total cholesterol (WMD, -15.83 mg/dl; p = 0.008), and triglycerides (WMD, -46.58 mg/dl; p = 0.03) in postmenopausal women with metabolic syndrome, but had no significant effects in those with no metabolic syndrome. CONCLUSIONS Our meta-analysis demonstrates that genistein significantly reduces homocysteine levels and increases HDL cholesterol levels in postmenopausal women. Genistein also significantly decreases LDL cholesterol, total cholesterol and triglyceride levels in postmenopausal women with metabolic syndrome.
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Elevated Homocysteine Levels Are Associated With the Metabolic Syndrome and Cardiovascular Events in Hypertensive Patients.
Catena, C, Colussi, G, Nait, F, Capobianco, F, Sechi, LA
American journal of hypertension. 2015;(7):943-50
Abstract
BACKGROUND Hyperhomocysteinemia and the metabolic syndrome are established cardiovascular risk factors and are frequently associated with hypertension. The relationship of plasma homocysteine (Hcy) with the metabolic syndrome and insulin resistance, however, is debated and studies in hypertensive patients are limited. In this study, we have investigated the association of Hcy with the metabolic syndrome and cerebro- cardiovascular events in hypertension. METHODS In 562 essential hypertensive patients who underwent accurate assessment of fasting and postload glucose metabolism, insulin sensitivity, and renal function, we measured plasma levels of Hcy, vitamin B12, folate, and fibrinogen and assessed the prevalence of the metabolic syndrome and of coronary heart and cerebrovascular disease (CVD). RESULTS Patients with the metabolic syndrome had significantly higher plasma Hcy levels. After correction for covariates, increasing Hcy levels were associated with an increasing prevalence of the metabolic syndrome, coronary heart disease, and CVD. Plasma Hcy was directly correlated with age, waist circumference, fasting glucose, triglyceride, uric acid, and fibrinogen levels, and homeostatic model assessment index and inversely with creatinine clearance and high-density lipoprotein cholesterol, vitamin B12, and folate levels. Logistic regression analysis showed an independent association of Hcy levels with age, male gender, vitamin B12 and folate levels, and the metabolic syndrome. Logistic regression indicated also an independent association of Hcy with cerebro-cardiovascular disease that was independent of the metabolic syndrome. CONCLUSIONS Elevated plasma Hcy is associated with the metabolic syndrome in hypertensive patients. Prevalence of events increases with increasing plasma Hcy levels suggesting a contribution of Hcy to cerebro-cardiovascular diseases in these patients.
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[Evaluation of the relationships between plasma homocysteine level and selected low-grade inflammation indices according to the prevalence of metabolic syndrome in men].
Herman, WA, Krzoska, A, Łacka, K, Bugaj, R, Dorszewska, J
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2013;(204):320-4
Abstract
UNLABELLED Metabolic syndrome (MS) is associated with low-grade systemic inflammation. Hyperhomocysteinemia is considered recently as a consequence of immune activation. Acute phase proteins, proinflammatory cytokines and probably homocysteine (hHcy) are involved in the pathogenesis of MS, atherosclerosis and ageing. The aim of our study was to investigate the reciprocal links between hHcy and selected negative and positive acute phase reactants as well as interleukin-18 in men over 40 years of age suffering from MS compared to healthy subjects. MATERIAL AND METHODS In 160 randomly selected men aged 40 to 70 years hHcy, C-reactive protein, transferrin, alpha1-antichymotrypsin and IL-18 were evaluated and features of MS using IDF (International Diabetes Federation-2005) criteria were estimated. RESULTS Hcy plasma levels are not correlated with age. Men suffering from MS revealed significantly higher serum hHcy levels than healthy subjects (11.52 +/- 6.87 microM/L vs 10.08 +/- 5.44 microM/L, p = 0.0074). A weak but positive (r = 0.099; p = 0.014) correlation between hHcy and the numbers of MS traits is shown. However, the plasma hHcy level is correlated only with HDL-cholesterol serum levels (r = -0.132; p = 0.035) and fasting blood glucose (r = 0.164; p = 0.009). hHcy concentration is strongly positively correlated with IL-18 (r = 0.276; p = 0.005), although not with CRP, alpha1-ACT and transferrin. CONCLUSIONS In men over 40 years of age suffering from MS significant higher serum Hcy levels than healthy subjects are presented, but hHcy (as opposed to acute phase reactants) correlates only with IL-18 plasma concentrations.
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Reduced-energy cranberry juice increases folic acid and adiponectin and reduces homocysteine and oxidative stress in patients with the metabolic syndrome.
Simão, TN, Lozovoy, MA, Simão, AN, Oliveira, SR, Venturini, D, Morimoto, HK, Miglioranza, LH, Dichi, I
The British journal of nutrition. 2013;(10):1885-94
Abstract
The metabolic syndrome (MetS) comprises pathological conditions that include insulin resistance, arterial hypertension, visceral adiposity and dyslipidaemia, which favour the development of CVD. Some reports have shown that cranberry ingestion reduces cardiovascular risk factors. However, few studies have evaluated the effect of this fruit in subjects with the MetS. The objective of the present study was to assess the effect of reduced-energy cranberry juice consumption on metabolic and inflammatory biomarkers in patients with the MetS, and to verify the effects of cranberry juice concomitantly on homocysteine and adiponectin levels in patients with the MetS. For this purpose, fifty-six individuals with the MetS were selected and divided into two groups: control group (n 36) and cranberry-treated group (n 20). After consuming reduced-energy cranberry juice (0·7 litres/d) containing 0·4mg folic acid for 60 d, the cranberry-treated group showed an increase in adiponectin (P=0·010) and folic acid (P=0·033) and a decrease in homocysteine (P<0·001) in relation to baseline values and also in comparison with the controls (P<0·05). There was no significant change in the pro-inflammatory cytokines TNF-a, IL-1 and IL-6. In relation to oxidative stress measurements, decreased (P<0·05) lipoperoxidation and protein oxidation levels assessed by advanced oxidation protein products were found in the cranberry-treated group when compared with the control group. In conclusion, the consumption of cranberry juice for 60 d was able to improve some cardiovascular risk factors. The present data reinforce the importance of the inverse association between homocysteine and adiponectin and the need for more specifically designed studies on MetS patients.
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Long-term effect of betaine on risk factors associated with the metabolic syndrome in healthy subjects.
Schwab, U, Alfthan, G, Aro, A, Uusitupa, M
European journal of clinical nutrition. 2011;(1):70-6
Abstract
BACKGROUND/OBJECTIVES To examine the effects of betaine on serum lipid profile, plasma homocysteine concentration and hemostatic factors in healthy subjects. SUBJECTS/METHODS Altogether, 63 volunteers (27 ± 8 years, body mass index 22.6 ± 2.4 kg/m(2)) participated in a placebo-controlled, randomized, parallel double-blinded study. The intervention lasted for 6 months during which the subjects consumed mineral water 500 ml/day with (betaine group, n = 32) or without (control group, n = 31) a 4-g betaine supplementation. RESULTS There was a significant interaction of time and group (general linear model) in serum total and low-density lipoprotein (LDL)-cholesterol concentrations and total-to-high-density lipoprotein (HDL)-cholesterol ratio without a significant difference between or within the groups. Concentrations of serum HDL-cholesterol, triglycerides or oxidized LDL did not change during the study. Plasma homocysteine concentration did not change in either of the groups. Plasma plasminogen activator inhibitor 1 concentration increased in the betaine group (P = 0.028) and decreased in the control group (P = 0.006). There was a significant interaction of time and group (general linear model) in plasma fibrinogen and blood hemoglobin concentration without a significant difference between or within the groups. There were no changes in parameters regarding the function of the liver or kidney. CONCLUSIONS Betaine had no effect on serum lipid profile in long term in young healthy subjects. The lowering effect on plasma homocysteine concentration was weak.
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Effects of metformin with or without supplementation with folate on homocysteine levels and vascular endothelium of women with polycystic ovary syndrome.
Palomba, S, Falbo, A, Giallauria, F, Russo, T, Tolino, A, Zullo, F, Colao, A, Orio, F
Diabetes care. 2010;(2):246-51
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Abstract
OBJECTIVE To evaluate whether the administration of metformin exerts any effects on serum homocysteine (Hcy) levels in patients with polycystic ovary syndrome (PCOS) and whether supplementation with folate enhances the positive effects of metformin on the structure and function of the vascular endothelium. RESEARCH DESIGN AND METHODS A total of 50 patients affected by PCOS, without additional metabolic or cardiovascular diseases, were enrolled in a prospective nonrandomized placebo-controlled double-blind clinical study. They were grouped into two treatment arms that were matched for age and BMI. Patients were treated with a 6-month course of metformin (1,700 mg daily) plus folic acid (400 microg daily; experimental group, n = 25) or placebo (control group, n = 25). Complete hormonal and metabolic patterns, serum Hcy, folate, vitamin B12, endothelin-1 levels, brachial artery diameter at the baseline (BAD-B) and after reactive hyperemia (BAD-RH), flow-mediated dilation, and intima-media thickness in both common carotid arteries were evaluated. RESULTS After treatment, a significant increase in serum Hcy levels was observed in the control group compared with the baseline values and the experimental group. A beneficial effect was observed in the concentrations of BAD-B, BAD-RH, flow-mediated dilation, intima-media thickness, and serum endothelin-1 in both groups. However, the results were improved more significantly in the experimental group than in the control subjects. CONCLUSIONS Metformin exerts a slight but significant deleterious effect on serum Hcy levels in patients with PCOS, and supplementation with folate is useful to increase the beneficial effect of metformin on the vascular endothelium.
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Homocysteine and lipids: S-adenosyl methionine as a key intermediate.
Obeid, R, Herrmann, W
FEBS letters. 2009;(8):1215-25
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Abstract
An association between hyperlipidemia and hyperhomocysteinemia (HHCY) has been suggested. This link is clinically important in management of vascular risk factors especially in elderly people and patients with metabolic syndrome. Higher plasma homocysteine (Hcy) was associated with lower high-density lipoprotein (HDL)-cholesterol level. Moreover, HHCY was associated with disturbed plasma lipids or fatty liver. It seems that hypomethylation associated with HHCY is responsible for lipid accumulation in tissues. Decreased methyl group will decrease the synthesis of phosphatidylcholine, a major phospholipid required for very low-density lipoprotein (VLDL) assembly and homeostasis. The effect of Hcy on HDL-cholesterol is probably related to inhibiting enzymes or molecules participating in HDL-particle assembly.
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The complex relationship between folate/homocysteine metabolism and risk of Down syndrome.
Coppedè, F
Mutation research. 2009;(1):54-70
Abstract
Folates are essential nutrients that are required for one-carbon biosynthetic and epigenetic processes. A deficiency in cellular folates results in aberrant DNA methylation, point mutations, chromosome breakage, defective chromosome recombination and aneuploidy. In 1999 it was first reported that impairments in folate/homocysteine metabolism, due to genetic polymorphisms of metabolic enzymes, could increase the risk for having an infant with Down syndrome (DS). That paper stimulated considerable investigation into the possible role of folate/homocysteine metabolism in the risk of having a DS child and several studies have been performed so far in different countries to better address this issue. However, despite 10 years of active research, the question is still unsolved. Overall, both in vitro and in vivo studies indicate that an impaired folate/homocysteine metabolism can result in chromosome 21 nondisjunction; however, the birth of a DS child seems to be the result of the interplay of several factors of genetic, epigenetic, environmental, and stochastic origin, making it difficult to discriminate the single contribution of each of them. My opinion is that it is now time for the design of a collaborative study large enough to have the power to separate trisomy 21 into all its component parts and to test for the contribution of folate/homocysteine gene polymorphisms to each of them. This study should be paralleled by in vitro and in vivo studies aimed at clarifying the contribution, if any, of folate/homocysteine metabolism to the methylation pattern of regions involved in recombination and segregation of chromosome 21. Further studies are also required to address the possible contribution of both the paternal diet and the maternal grandmother dietary habits to chromosome 21 nondisjunction events.