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葉酸は血のホモシステインを低下させ,腎不全前の透析患者の内皮機能を改善しますか?

J Thambyrajah1, M J Landray, F J McGlynn

  • 1Division of Medical Sciences (Cardiology), University of Birmingham Birmingham, UK. J.Thambyrajah@bham.ac.uk

Circulation
|August 23, 2000
PubMed
まとめ
この要約は機械生成です。

高用量の葉酸は,慢性腎不全患者の高ホモシステイン血症を低下させましたが,内皮機能を改善することはありませんでした. これは,葉酸が尿病における血管疾患の負担を軽減しない可能性があることを示唆しています.

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科学分野:

  • ネフロロジーは腎臓科
  • 心血管医学は,心臓血管医学である.
  • 栄養科学とは,栄養科学である.

背景:

  • ハイパーホモキステン血症は,動脈硬化症と内皮機能不全に関連した独立した血管リスク因子です.
  • 慢性腎不全 (CRF) は,ハイパーホモシステイン血症と動脈硬化症の両方に関連しています.
  • CRF患者における血管疾患に対する葉酸の影響は不明である.

研究 の 目的:

  • 透析前の慢性腎不全患者の内皮機能に対する葉酸の効果を調査する.
  • 葉酸のサプリメントが,この患者集団における血管の健康マーカーを改善できるかどうかを判断する.

主な方法:

  • 100人のCRF患者を対象とした前向きな,ダブルブラインド,プラセボ対照試験です.
  • 患者は12週間にわたって毎日5mgの葉酸またはプラセボを投与されました.
  • 内皮機能は,腕動脈の拡張,血清の窒素酸塩/窒素酸塩濃度,および血のフォン・ウィレブランド因子濃度によって評価されました.

主要な成果:

  • 葉酸サプリメントは,プラセボと比較して葉酸のレベルを有意に上昇させ,ハイパーホモキステインエミアを減少させた.
  • 葉酸依存の膨張,血清のニートリート/ニートレート,またはプラズマのフォン・ウィレブランド因子において,葉酸とプラセボ群の間で有意な差異は観察されなかった.
  • 葉酸治療は高ホモキシステイン血症のレベルを低下させましたが,正常化させませんでした.

結論:

  • 高用量の葉酸は,分析前のCRF患者におけるハイパーホモシスタインエミアを効果的に低下させますが,正常化させることはありません.
  • 葉酸サプリメントは,このコホートにおける内皮機能を改善しませんでした.
  • これらの発見は,葉酸治療が尿血症に関連する血管疾患の負担を軽減しない可能性があることを示唆しています.