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B-vitamins, homocysteine metabolism and CVD

Published online by Cambridge University Press:  07 March 2007

J. J. Strain ,
L. Dowey ,
M. Ward ,
K. Pentieva  and
H. McNulty
J. J. Strain*
Affiliation:
Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, BT52 1SA, UK
L. Dowey
Affiliation:
Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, BT52 1SA, UK
M. Ward
Affiliation:
Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, BT52 1SA, UK
K. Pentieva
Affiliation:
Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, BT52 1SA, UK
H. McNulty
Affiliation:
Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, BT52 1SA, UK
*
*Corresponding author: Professor J. J. Strain, fax +44 28 70324965, email JJ.Strain@ulster.ac.uk
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Abstract

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The present review focuses on the B-vitamins, i.e. folate, vitamin B12, vitamin B6 and riboflavin, that are involved in homocysteine metabolism. Homocysteine is a S-containing amino acid and its plasma concentrations can be raised by various constitutive, genetic and lifestyle factors, by inadequate nutrient status and as a result of systemic disease and various drugs. Hyperhomocysteinaemia is a modest independent predictor of CVD and stroke, but causality and the precise pathophysiological mechanism(s) of homocysteine action remain unproven. The predominant nutritional cause of raised plasma homocysteine in most healthy populations is folate insufficiency. Vitamin B12 and, to a lesser extent, vitamin B6 are also effective at lowering plasma homocysteine, especially after homocysteine lowering by folic acid in those individuals presenting with raised plasma homocysteine. However, riboflavin supplementation appears to be effective at lowering plasma homocysteine only in those individuals homozygous for the T allele of the C677 T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene. This gene codes for the MTHFR enzyme that produces methyltetrahydrofolate, which, in turn, is a substrate for the remethylation of homocysteine by the vitamin B12-dependent enzyme methionine synthase. Individuals with the MTHFR 677 TT genotype are genetically predisposed to elevated plasma homocysteine, and in most populations have a markedly higher risk of CVD.

Keywords

HomocysteineFolateVitamin B12Vitamin B6Riboflavin
Type
Symposium on ‘Micronutrient interactions and public health’
Information
Proceedings of the Nutrition Society , Volume 63 , Issue 4 , November 2004 , pp. 597 - 603
Copyright
Copyright © The Nutrition Society 2004

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