Serum Homocysteine, Vitamin B12 and Folic Acid Levels in Patients with Metabolic Syndrome

To study alterations in and factors affecting blood levels of homocysteine and its related vitamins (B12 and folic acid) in patients with metabolic syndrome. Methods: In this case-control study, conducted in a referral hospital in north India, blood levels of vitamin B12, folic acid and homocysteine were compared and also correlated with anthropometric parameters, blood sugar, lipids (total, LDL and HDL cholesterol) and hematological variables.

Seventy five subjects (50 patients and 25 controls; mean age 48.6±11.5 years; 57% males) were studied. As compared to controls, patients with metabolic syndrome had higher blood levels of homocysteine (16.77±6.6 vs 6.48±0.87 units; P<0.0001), lower levels of B12 (183.7±37 vs 346.4±74.4 units; P<0.0001) and lower levels of folic acid (3.25±1.9 vs 5.31±0.75 units; P<0.0001). All 3 levels were abnormal in 64% patients and none of controls (P<0.0001). Blood levels of homocysteine, folic acid and vitamin B12 correlated with weight, waist circumference, body mass index, fasting blood sugar and lipid levels. These levels also correlated with hematological parameters (hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration).

Indian patients with metabolic syndrome have a strong association with elevated blood levels of homocysteine and reduced levels of vitamin B12 and folic acid. Further studies are needed to test the hypotheses that these metabolites have a greater role in Asians and there may be a greater beneficial role of folic acid supplementation.