TY - JOUR

T1 - A micronutrient supplement modulates homocysteine levels regardless of vitamin B biostatus in elderly subjects

AU - Savic-Hartwig, Marija

AU - Kerlikowsky, Felix

AU - van de Flierdt, Edda

AU - Hahn, Andreas

AU - Schuchardt, Jan Philipp

N1 - Funding Information: This research was partially funded by the Food Federation, Germany, Claire-Waldoff-Straße 7, 10117, Berlin. The authors declare that they have no competing interests. The authors are solely responsible for the design and implementation of the study and collection, management, analysis, and interpretation of the data, as well as preparation of the manuscript.

PY - 2024/4/1

Y1 - 2024/4/1

N2 - Elevated homocysteine (Hcy) levels (≥15 μmol/L) in the elderly are frequently associated with a higher risk of cardiovascular disease and cognitive decline. Several studies have already shown an Hcy-lowering effect of B vitamin supplementation in cohorts deficient in these nutrients. The aim of this randomized, double-blinded 12-week intervention study was to investigate whether Hcy levels in healthy elderly subjects (75.4±4.5 years, n=133) could be lowered with a micronutrient supplement (i.e., 400 μg folic acid, 100 μg cobalamin). Difference in mean initial Hcy levels between intervention (17.6±7.1 μmol/L, n=65) and placebo group (18.9±6.1 μmol/L, n=68) was not significant. The prevalence of cobalamin and folate deficiency in the total study population was low: 27% had serum-cobalamin levels ≤150 pmol/L, 12% holo-transcobalamin (Holo-TC) levels ≤50 pmol/L, 13% low cobalamin status using the aggregated cobalamin marker 4cB12 and 10% red blood cell (RBC) folate ≤570 nmol/L. Nevertheless, the treated subjects still showed improved cobalamin and folate biostatus (serum cobalamin Δt 12-t 0: 63±48 pmol/L; Holo-TC Δt 12-t 0: 17±19 pmol/L; RBC folate Δt 12-t 0: 326±253 nmol/L) and Hcy levels (Δt 12-t 0: -3.6±5.7 μmol/L). The effects were statistically significant compared to the placebo group with p=0.005 (serum cobalamin), p=0.021 (Holo-TC), p=0.014 (RBC-folate) and p<0.001 (Hcy). The Hcy-lowering effect was dependent on the initial Hcy levels (p<0.001). Our findings suggest that elevated Hcy levels in elderly subjects can be lowered regardless of the initial cobalamin and folate biostatus.

AB - Elevated homocysteine (Hcy) levels (≥15 μmol/L) in the elderly are frequently associated with a higher risk of cardiovascular disease and cognitive decline. Several studies have already shown an Hcy-lowering effect of B vitamin supplementation in cohorts deficient in these nutrients. The aim of this randomized, double-blinded 12-week intervention study was to investigate whether Hcy levels in healthy elderly subjects (75.4±4.5 years, n=133) could be lowered with a micronutrient supplement (i.e., 400 μg folic acid, 100 μg cobalamin). Difference in mean initial Hcy levels between intervention (17.6±7.1 μmol/L, n=65) and placebo group (18.9±6.1 μmol/L, n=68) was not significant. The prevalence of cobalamin and folate deficiency in the total study population was low: 27% had serum-cobalamin levels ≤150 pmol/L, 12% holo-transcobalamin (Holo-TC) levels ≤50 pmol/L, 13% low cobalamin status using the aggregated cobalamin marker 4cB12 and 10% red blood cell (RBC) folate ≤570 nmol/L. Nevertheless, the treated subjects still showed improved cobalamin and folate biostatus (serum cobalamin Δt 12-t 0: 63±48 pmol/L; Holo-TC Δt 12-t 0: 17±19 pmol/L; RBC folate Δt 12-t 0: 326±253 nmol/L) and Hcy levels (Δt 12-t 0: -3.6±5.7 μmol/L). The effects were statistically significant compared to the placebo group with p=0.005 (serum cobalamin), p=0.021 (Holo-TC), p=0.014 (RBC-folate) and p<0.001 (Hcy). The Hcy-lowering effect was dependent on the initial Hcy levels (p<0.001). Our findings suggest that elevated Hcy levels in elderly subjects can be lowered regardless of the initial cobalamin and folate biostatus.

KW - folate

KW - homocysteine

KW - hyperhomocysteinemia

KW - multivitamin

KW - vitamin B12

UR - http://www.scopus.com/inward/record.url?scp=85147350007&partnerID=8YFLogxK

U2 - 10.1024/0300-9831/a000777

DO - 10.1024/0300-9831/a000777

M3 - Article

C2 - 36715360

VL - 94

SP - 120

EP - 132

JO - International Journal for Vitamin and Nutrition Research

JF - International Journal for Vitamin and Nutrition Research

SN - 0300-9831

IS - 2

ER -