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Folate and vitamin B6 rapidly normalize endothelial dysfunction in children with type 1 diabetes mellitus

Karen E MacKenzie1, Esko J Wiltshire, Roger Gent

  • 1Department of Diabetes and Endocrinology, Children, Youth, and Women's Health Service, Adelaide, Australia. karen.mackenzie@adelaide.edu.au

Pediatrics
|July 5, 2006
PubMed

Insights

High-dose folate and vitamin B6 significantly improved endothelial dysfunction in children with type 1 diabetes, with effects sustained for 8 weeks. These vitamins normalized vascular function, independent of other metabolic markers.

Area of Science:

  • Vascular Biology
  • Pediatric Endocrinology
  • Nutritional Science

Background:

  • Endothelial dysfunction is an early complication in type 1 diabetes mellitus, preceding overt vascular disease.
  • Folate status is implicated in the development of endothelial dysfunction in diabetic patients.

Purpose of the Study:

  • To investigate the effects of high-dose folate and vitamin B6 on endothelial function in children with type 1 diabetes.
  • To determine the immediate and sustained effects of folate and vitamin B6, alone and in combination, on vascular health.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 124 children with type 1 diabetes.
  • Vitamins (folate 5 mg/day, vitamin B6 100 mg/day) were administered alone or combined, with endothelial function assessed via brachial artery ultrasound (flow-mediated and glyceryltrinitrate-induced dilation).
  • Measurements were taken at baseline, 2-4 hours post-dose, and at 4 and 8 weeks of treatment.

Main Results:

  • Flow-mediated dilation (FMD) normalized in all treatment groups, improving significantly from baseline to 8 weeks with folate, vitamin B6, and combination therapy.
  • Improvements in FMD were observed within 2 hours and maintained for 8 weeks; placebo and glyceryltrinitrate-induced dilation showed no significant changes.
  • Increased serum folate, red cell folate, and vitamin B6 levels correlated with FMD improvements, independent of homocysteine, glucose, HbA1c, or CRP levels.

Conclusions:

  • High-dose folate and vitamin B6 effectively normalized endothelial dysfunction in children with type 1 diabetes.
  • The positive effects on endothelial function were sustained over 8 weeks.
  • Combination therapy offered no additional benefit over monotherapy with either folate or vitamin B6.
Abstract

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