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Hyperhomocysteinaemia: a critical review of old and new aspects

Wolfgang Herrmann1, Markus Herrmann, Rima Obeid

  • 1Clinical Chemistry and Laboratory Medicine/Central Laboratory, Saarland University Medical School, 66421 Homburg, Germany. kchwher@uniklinikum-saarland.de

Current Drug Metabolism
|February 3, 2007
PubMed

Insights

High homocysteine (HHCY) is linked to cardiovascular disease, stroke, and cognitive decline. B-vitamin supplementation effectively reduces stroke risk by approximately 20% and may lower fracture and pregnancy complication risks.

Area of Science:

  • Biochemistry
  • Cardiovascular Medicine
  • Neurology

Background:

  • Hyperhomocysteinemia (HHCY), often due to B-vitamin deficiency, is a significant risk factor for cardiovascular diseases (CVD), neurodegenerative disorders, osteoporotic fractures, and pregnancy complications.
  • While some vitamin intervention trials have yielded inconclusive results for CVD risk reduction, confounding factors and limited statistical power have been noted.

Purpose of the Study:

  • To evaluate the effectiveness of B-vitamin supplementation in mitigating risks associated with Hyperhomocysteinemia.
  • To clarify the role of B-vitamins in preventing stroke, fractures, cognitive decline, and pregnancy complications.

Main Methods:

  • Re-analysis of existing studies, such as the VISP trial, excluding confounding variables.
  • Examination of data from large-scale trials and population-based observations, including the HOPE 2 trial and effects of grain fortification.

Main Results:

  • Re-analysis of the VISP study indicated a 21% reduction in stroke risk after adjustments.
  • The HOPE 2 trial and folate fortification in grain products demonstrated significant reductions in stroke mortality (8-16%).
  • Evidence suggests B-vitamin supplementation can lower stroke risk by approximately 20%, reduce osteoporotic fracture risk, and decrease pregnancy complications.

Conclusions:

  • B-vitamin supplementation, particularly with folate, is effective in reducing stroke risk and mortality.
  • Addressing Hyperhomocysteinemia through vitamin supplementation offers potential benefits for reducing osteoporotic fractures, mitigating cognitive decline, and preventing pregnancy complications.

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