EFFECT OF FOLIC ACID SUPPLEMENTATION ON HOMOCYSTEINE LEVEL IN POSTMENOPAUSAL WOMEN

Noreen Sultan, Mudassir Ahmad Khan, Salman Malik

Abstract


BACKGROUND: Hyperhomocysteinemia is an independent risk factor for atherosclerotic
diseases including Ischaemic heart disease, stroke and peripheral vascular disease. Homocysteine
(Hcy) is an intermediate formed during the catabolism of essential sulphur containing amino acid
methionine, increased Hcy is associated with endothelial dysfunctions in healthy human. Plasma
Hcy is significantly lower in premenopausal women than young men but after menopause basal
homocysteinemia increases significantly in women approaching those in men. Several studies
showed that hyperhomocysteinemia to be stronger risk factor for CHD (Coronary Heart Disease)
in women than men. It seems likely that altered hormonal status and age related low folate intake
are responsible for this. The present study was designed to evaluate the effect of folic acid
supplements for six months, on Hcy level in postmenopausal women. Methods: Hcy was
estimated by Flourescence Polarization Immunoassay (FPIA). Results: There was a significant
(p<0.001) decrease in Hcy level after six months of folic acid supplements. Conclusion: Hcy is an
independent risk factor for atherosclerotic disease, this study favours the view that after
menopause Hcy level increases significantly and a simple non Toxic and relatively inexpensive
vitamin (folic acid) intervention might be useful in primary cardiovascular prevention in this high
risk group because Hcy is a stronger risk factor for CHD in postmenopausal women than men.
Keywords: Menopause, Homocysteine, Folic acid.

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References


Moustapha A and Robinson K. Homocysteine: an emerging

age-related cardiovascular risk factor. Geriatrics 1999;

:44–51.

Virdis A, Ghiadoni L, Salvetti G, Versari D, Taddei S and

Salvett A. Hyperhomocysteinaemia: is the novel risk factor in

hypertention. J. Nephrol 2002;15:414–21.

Ceperkovic Z. The role of increased levels of homocysteine

in the development of cardiovascular diseases. Med Preg

Mar-April;59(3-4):143–7.

Kang SS, Wong PW, Cook HY, Norusis M and Messer JV.

Protein-bound homocysteine. A possible risk factor for

coronary artery disease.J Clin Invest 1998;77:1482–6

Wouters MG, Moorees MT, Van der Mooren MJ, Bloom HJ,

Boers GH, Schellekens LA et al. Plasma homocysteine and

menopausal status. Eur J Invest 1995;25:801–5.

Anker G, Lonning PE, Ueland PM, Refsum H and Lien EA.

Plasma levels of atherogenic amino acid homocysteine in

postmenopausal women with breast cancer treated with

tamoxifen. Int J Cancer 1995;60:365–8.

Stanger O, Semmelrock HJ, Wonisch W, Bos U, Pabst E,

Wascher TC. Effects of folate treatment and homocysteine

lowering on resistance vessel reactivity in atherosclerotic

subjects. J Pharmacol Exp Ther 2002 Oct;303(1):158–62.

Mijatovic V and Van der Mooren MJ. Homocysteine in post

menopausal and the importance of hormone replacement

therapy. Clin Chem Lab Med 2002;39:764–7.

Pines A, Bornstein NM and Shapira I. Menopause and

ischaemic stroke: basic, clinical and epidemiological

considerations. The role of hormone replacement. Hum

Period Update 2002;8:161–8.

Weiss N, Keller C, Hoffmann U and Loscalzo J. Endothelial

dysfynction and atherothrombosis in mild

hyperhomocysteinaemia. Vasc Med 2002;7:227–39.

Tofler GH, D’Agostino RB, Jacques PF, Bostom AG, Wilson

PW, Lipinska I et al. Association between increased

homocysteine levels and impaired fibrinolytic potential:

Potential mechanism for cardiovascular risk. Thromb

Haemost 2002;88:799–804.

Austin RC, Lentz SR and Werstuck GH. Role of hyperhomocysteinemia in endothelial dyafunction and atherothrombotic

disaese. Cell Death Differ. 2004 Jul;11 Suppl 1:s56-64.

Walsh BW, Paul S, Wild RA, Dean RA, Tracy RP, Cox DX

et al. The effects of hormone replacement therapy and

raloxifene on C-reactive protein and homocysteine in healthy

postmenopausal women: a randomized, controlled trial. J

Clin Endocrinol Metab 2000;85:214-8.

J Ayub Med Coll Abbottabad;19(4)

El-Swefy SA, Ali ST, Asker ME and Mohamed HE.

Hyperhomocysteinaemia and cardiovascular risk in female

ovariectomized rats: role of folic acid and hormone

replacement therapy. J Pharm Pharmacol 2002;54:391–7.

Laraqui A, Bennouar N, Meggouh F, Allami A, Kadri NE,

Benkuoka F et al. Homocysteine, lipoprotein (a): risk factors for

coronary heart disease. Ann Biol Clin Paris 2002;60:549–57.

Ridker PM, Manson JE, Buring JE, Shih J, Matias M and

Hennekens CH. Homocysteine and risk of cardiovascular

disease among postmenopausal women. JAMA

;281:1817–21.

Knopp RH. Risk factors for coronary artery disease in

women. Am J Cardiol 2002;89:34–5.

Verhoef P. Hyperhomocysteinemia and risk of vascular

disease in women. Semin Thromb Hemost 2000;26:325–34.

Reiss RP, Azinheira J, Reiss HP, Pina JE, Correia Jm and

Luis AS. The effect of sex and menopause on basal blood

levels of homocysteine and after methionine loading. Rev

Port Cardiol 1999;18:155–9.

Godsland IF, Wynn V, Crook D and Miller NE. Sex, plasma

lipoproteins, and atherosclerosis: prevailing assumptions and

outstanding questions. Am Heart J 1987;114:1467–1503.

Fernandez-Miranda C, De la Calle M, Manuel Bris J, Muelas

M, Gomez P and Diaz-Rubio P. Influence of menopausal

status in homocysteine plasma levels. Med Clin Barc

;116:206–8.

Wald DS, Law M, Morris JK. The dose response relation

between between serum homocysteine and cardiovascular

disease: implications for treatment and screening. Eur J

Cardiovasc Prev Rehabil 2004 Jun;11(3):250–3.

Araki R, Maruyama C, Igarashi S and Yoshida M. Effect of

short-term folic acid and/or riboflavin supplementation on

serum folate and plasma total homocysteine concentrations in

young Japanese male subjects. Eur J Clin Nutr 2006

May;60(5):573–9.

Bloom HJ, Boers GH, Van den Elzen JP, Van Roessel JJ,

Trijbels JM and Tangerman A. Difference between

premenopausal women and young men in the transamination

pathway of methionine catabolism and the protection against

vascular disease. Eur J Clin 1988;Invest.18:633–8.

Hak AE, Polderman KH, Westendrop IC, Jakobs C, Hofman

A, Witteman JC et al. Increased plasma homocysteine after

menopause. Atherosclerosis 2000;149:163–8.

Christodoulakos G, Panoulis C, Rizos D, Moustakarias T,

Phocas I and Creatsas G. Homocysteine and folate levels in

postmenopausal women. Maturitas 2001;39:161–7.

Madsen JS, Kristensen SR, Klitgaard NA, Bladbjerg EM,

Abrahamsen B, Stilgren L et al. Effects of long-term

hormone replacement therapy on plasma homocysteine in

post menopausal women: a randomized controlled study. Am

J Obset Gynecol 2002;87:33–9.

Zak A, Zeman M. Consequences of moderate hyperhomocysteinemia in the internal medicine. Cas Lek Cesk

;143(6):367–74.

Lonn E, Yusuf S, Arnold MJ, Sheridan P and Pogue J.

Homocysteine lowering with folic acid and B Vitamins in

vascular disease. N England J Med 2006 Apr

;354(15):1567–77.

Connor JJ., Meurer LN. Should Practice with coronary

disease and high homocysteine take folic acid? J Fam Pract

Jan;52(1):16–8.

Neal B., MacMahon S., Ohkubo T., Tonkin A., Wilcken D.

Dose-dependent effects of folic acid on plasma homocysteine

in a randomized trial conducted among 723 individuals with

coronary heart disease. Eur Heart J 2002 Oct;23(19):1509–15.


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