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Hyperhomocysteinemia and B-vitamin deficiencies in infants and children

Per Magne Ueland1, Anne Lise Bjørke Monsen

  • 1LOCUS for Homocysteine and Related Vitamins, Armauer Hansens hus, University of Bergen, Bergen, Norway. per.ueland@ikb.uib.no

Clinical Chemistry and Laboratory Medicine
|December 6, 2003
PubMed

Insights

Total homocysteine (tHcy) levels in children vary with age and B-vitamin status. Elevated tHcy in infants linked to cobalamin, while folate impacts older children, indicating potential deficiencies.

Area of Science:

  • Pediatric diagnostics
  • Nutritional biochemistry
  • Vitamins and metabolism

Background:

  • Total homocysteine (tHcy) is a valuable marker in pediatric research and diagnostics.
  • Understanding tHcy determinants in children is crucial for identifying health risks.
  • Cobalamin (vitamin B12) status is particularly important in infants.

Purpose of the Study:

  • To review novel data on tHcy in infants, children, and adolescents.
  • To emphasize the relationship between tHcy and cobalamin status in infants.
  • To discuss factors influencing tHcy levels and their clinical implications in pediatric populations.

Main Methods:

  • Review of existing pediatric data on total homocysteine.
  • Analysis of factors affecting tHcy, including age, gender, nutrition, and B-vitamin status.
  • Focus on cobalamin and folate status in relation to tHcy in different pediatric age groups.

Main Results:

  • In infants (<1 year), tHcy is moderately elevated and correlated with serum cobalamin.
  • In older children, plasma tHcy is lower and strongly influenced by folate status.
  • Hyperhomocysteinemia in childhood is a risk factor for stroke; folate-responsive cases noted in renal failure.
  • tHcy indicates folate deficiency in specific pediatric groups (poor diet, HIV, anti-folate therapy).
  • tHcy and methylmalonic acid are sensitive indicators of cobalamin deficiency in at-risk infants.
  • Infants born to mothers with adequate nutrition can show low cobalamin and elevated tHcy/methylmalonic acid, responsive to supplementation.

Conclusions:

  • tHcy levels and their determinants differ between infants and older children.
  • Cobalamin deficiency may be underdiagnosed in infants, even those born to non-vegetarian mothers on Western diets.
  • tHcy serves as a sensitive indicator for both cobalamin and folate deficiencies in various pediatric contexts.

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