Although increased intake of folic acid and vitamin B_twelve is effective in decreasing homocysteine levels, the combined intervention of these B vitamins did not lower risk for CVD. Indeed, several randomized https://datingranking.net/escort-directory/murrieta/, placebo-controlled trials have been conducted to determine whether homocysteine-lowering through folic acid, vitamin B₁₂, and vitamin B_six supplementation reduces the incidence of CVD. A recent meta-analysis of data from 11 trials, including nearly 45,000 participants at risk of CVD, showed that B-vitamin supplementation had no significant effect on risk of myocardial infarction (heart attack) or stroke, nor did it modify the risk of all-cause mortality (25). Other meta-analyses that included patients with chronic kidney disease have confirmed the lack of effect of homocysteine-lowering on risk of myocardial infarction and death. However, stroke risk was significantly reduced by 7%-12% with the B-vitamin supplementation (26, 27). Another meta-analysis of 12 clinical trials measuring flow-mediated vasodilation (FMD; a surrogate marker of vascular health) in response to homocysteine reduction revealed that B-vitamin supplementation was accompanied by an improved FMD in short-term <8 weeks) but not in long-term studies conducted in subjects with preexisting vascular diseases (28). Yet, some of the studies included in these meta-analyses did not use vitamin B₁₂, and folate administration on its own has shown a protective role on vascular function and stroke risk (29). Besides, the high prevalence of malabsorption disorders and vitamin B₁₂ deficiency in elderly individuals might warrant the use of higher doses of vitamin B₁₂ than those used in these trials (30); in cases of malabsorption, only high-dose oral therapy or intramuscular injections can overcome vitamin B₁₂ deficiency (4).

Disease

Folate is required for synthesis of DNA, and there is evidence that decreased availability of folate results in strands of DNA that are more susceptible to damage. (more…)

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