Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial

JV Woodside, JWG Yarnell, D McMaster, IS Young, DL Harmon, EE McCrum, CC Patterson, KF Gey, AS Whitehead, A Evans

    Research output: Contribution to journalArticle

    Abstract

    Mild hyperhomocysteinemia is accepted as a risk factor for premature cardiovascular disease. In a population with a high prevalence of cardiovascular disease, we screened a group of clinically healthy working men aged 30-49 y (n = 509) for plasma homocysteine and 5,10-methylene tetrahydrofolate reductase (MTHFR) genotype status. Those with mildly elevated homocysteine concentrations (greater than or equal to 8.34 mu mol/L) were selected for intervention. In a randomized, factorial-design. controlled trial we assessed the effects of B-group vitamins and antioxidant vitamin supplementation on homocysteine concentrations. The 132 men were randomly assigned to one of four groups: supplementation with B-group vitamins alone (1 mg folic acid, 7.2 mg pyridoxine, and 0.02 mg cyanocobalamin), antioxidant vitamins alone (150 mg ascorbic acid, 67 mg RRR-alpha-tocopherol, and 9 mg beta-carotene), B-group vitamins with antioxidant vitamins, or placebo. Intervention was double-blind. A total of 101 men completed the 8-wk intervention. When homocysteine concentrations were analyzed by group, significant (P < 0.001) decreases (32.0% and 30.0%, respectively) were observed in both groups receiving B-group vitamins either with or without antioxidants. The effect of B-group vitamins alone over 8 wk was a reduction in homocysteine concentrations of 27.9% (95% CI: 22.0%, 33.3%: P < 0.001) whereas antioxidants alone produced a nonsignificant increase of 5.1% (95% CI: -2.8%, 13.6%; P = 0.21). There was no evidence of any interaction between the two groups of vitamins. The effect of B-group vitamin supplementation seemed to depend on MTHFR genotype. Supple mentation with the B-group vitamins with or without antioxidants reduced homocysteine in the men with mildly elevated concentrations, and hence may be effective in reducing cardiovascular risk.
    LanguageEnglish
    Pages858-866
    JournalAmerican Journal of Clinical Nutrition
    Volume67
    Issue number5
    Publication statusPublished - May 1998

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    Vitamin B Complex
    Hyperhomocysteinemia
    Vitamins
    Homocysteine
    Antioxidants
    Methylenetetrahydrofolate Reductase (NADPH2)
    Cardiovascular Diseases
    Genotype
    Pyridoxine
    beta Carotene
    alpha-Tocopherol
    Vitamin B 12
    Folic Acid
    Ascorbic Acid
    Placebos
    Population

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    Cite this

    Woodside, JV., Yarnell, JWG., McMaster, D., Young, IS., Harmon, DL., McCrum, EE., ... Evans, A. (1998). Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial. American Journal of Clinical Nutrition, 67(5), 858-866.
    Woodside, JV ; Yarnell, JWG ; McMaster, D ; Young, IS ; Harmon, DL ; McCrum, EE ; Patterson, CC ; Gey, KF ; Whitehead, AS ; Evans, A. / Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial. In: American Journal of Clinical Nutrition. 1998 ; Vol. 67, No. 5. pp. 858-866.
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    abstract = "Mild hyperhomocysteinemia is accepted as a risk factor for premature cardiovascular disease. In a population with a high prevalence of cardiovascular disease, we screened a group of clinically healthy working men aged 30-49 y (n = 509) for plasma homocysteine and 5,10-methylene tetrahydrofolate reductase (MTHFR) genotype status. Those with mildly elevated homocysteine concentrations (greater than or equal to 8.34 mu mol/L) were selected for intervention. In a randomized, factorial-design. controlled trial we assessed the effects of B-group vitamins and antioxidant vitamin supplementation on homocysteine concentrations. The 132 men were randomly assigned to one of four groups: supplementation with B-group vitamins alone (1 mg folic acid, 7.2 mg pyridoxine, and 0.02 mg cyanocobalamin), antioxidant vitamins alone (150 mg ascorbic acid, 67 mg RRR-alpha-tocopherol, and 9 mg beta-carotene), B-group vitamins with antioxidant vitamins, or placebo. Intervention was double-blind. A total of 101 men completed the 8-wk intervention. When homocysteine concentrations were analyzed by group, significant (P < 0.001) decreases (32.0{\%} and 30.0{\%}, respectively) were observed in both groups receiving B-group vitamins either with or without antioxidants. The effect of B-group vitamins alone over 8 wk was a reduction in homocysteine concentrations of 27.9{\%} (95{\%} CI: 22.0{\%}, 33.3{\%}: P < 0.001) whereas antioxidants alone produced a nonsignificant increase of 5.1{\%} (95{\%} CI: -2.8{\%}, 13.6{\%}; P = 0.21). There was no evidence of any interaction between the two groups of vitamins. The effect of B-group vitamin supplementation seemed to depend on MTHFR genotype. Supple mentation with the B-group vitamins with or without antioxidants reduced homocysteine in the men with mildly elevated concentrations, and hence may be effective in reducing cardiovascular risk.",
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    Woodside, JV, Yarnell, JWG, McMaster, D, Young, IS, Harmon, DL, McCrum, EE, Patterson, CC, Gey, KF, Whitehead, AS & Evans, A 1998, 'Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial', American Journal of Clinical Nutrition, vol. 67, no. 5, pp. 858-866.

    Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial. / Woodside, JV; Yarnell, JWG; McMaster, D; Young, IS; Harmon, DL; McCrum, EE; Patterson, CC; Gey, KF; Whitehead, AS; Evans, A.

    In: American Journal of Clinical Nutrition, Vol. 67, No. 5, 05.1998, p. 858-866.

    Research output: Contribution to journalArticle

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    T1 - Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial

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    AU - Yarnell, JWG

    AU - McMaster, D

    AU - Young, IS

    AU - Harmon, DL

    AU - McCrum, EE

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    AU - Gey, KF

    AU - Whitehead, AS

    AU - Evans, A

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    N2 - Mild hyperhomocysteinemia is accepted as a risk factor for premature cardiovascular disease. In a population with a high prevalence of cardiovascular disease, we screened a group of clinically healthy working men aged 30-49 y (n = 509) for plasma homocysteine and 5,10-methylene tetrahydrofolate reductase (MTHFR) genotype status. Those with mildly elevated homocysteine concentrations (greater than or equal to 8.34 mu mol/L) were selected for intervention. In a randomized, factorial-design. controlled trial we assessed the effects of B-group vitamins and antioxidant vitamin supplementation on homocysteine concentrations. The 132 men were randomly assigned to one of four groups: supplementation with B-group vitamins alone (1 mg folic acid, 7.2 mg pyridoxine, and 0.02 mg cyanocobalamin), antioxidant vitamins alone (150 mg ascorbic acid, 67 mg RRR-alpha-tocopherol, and 9 mg beta-carotene), B-group vitamins with antioxidant vitamins, or placebo. Intervention was double-blind. A total of 101 men completed the 8-wk intervention. When homocysteine concentrations were analyzed by group, significant (P < 0.001) decreases (32.0% and 30.0%, respectively) were observed in both groups receiving B-group vitamins either with or without antioxidants. The effect of B-group vitamins alone over 8 wk was a reduction in homocysteine concentrations of 27.9% (95% CI: 22.0%, 33.3%: P < 0.001) whereas antioxidants alone produced a nonsignificant increase of 5.1% (95% CI: -2.8%, 13.6%; P = 0.21). There was no evidence of any interaction between the two groups of vitamins. The effect of B-group vitamin supplementation seemed to depend on MTHFR genotype. Supple mentation with the B-group vitamins with or without antioxidants reduced homocysteine in the men with mildly elevated concentrations, and hence may be effective in reducing cardiovascular risk.

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