Premium
Higher Plasma Homocysteine Is Associated With Lower Vitamin B 6 Status in Critically Ill Surgical Patients
Author(s) -
Hou ChenTai,
Wu YingHsun,
Cheng ChienHsiang,
Huang PeiNing,
Huang YiChia
Publication year - 2012
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533612449654
Subject(s) - medicine , homocysteine , hyperhomocysteinemia , confounding , gastroenterology , plasma homocysteine , b vitamins , endocrinology
Background : Hyperhomocysteinemia might be at least partially due to compromised B vitamin status in critically ill patients and has been linked with critical illness. This study was conducted to examine the association between plasma homocysteine with B vitamins and clinical outcomes in critically ill surgical patients. Methods : Thirty‐two patients in the surgical intensive care unit (SICU) were enrolled. Disease severity (Acute Physiology and Chronic Health Evaluation II score), hematological values, serum and erythrocyte folate, serum vitamin B 12 , plasma, and erythrocyte pyridoxal 5′‐phosphate (PLP) were determined within 24 hours of admission and again after 7 days. Results : The prevalence of hyperhomocysteinemia in the patients was either 46.9% (plasma homocysteine ≥12 µmol/L) or 31.3% (plasma homocysteine ≥15 µmol/L) on day 1 in the SICU and increased to 62.5% (plasma homocysteine ≥12 µmol/L) and 37.5% (plasma homocysteine ≥15 µmol/L) on day 7 after admission to the SICU. Plasma homocysteine, serum folate, and vitamin B 12 significantly increased by day 7, whereas plasma and erythrocyte PLP remained constant throughout the study. Plasma homocysteine was not correlated with serum folate and vitamin B 12 . However, plasma and erythrocyte PLP on day 1 were adversely associated with day 1 levels of plasma homocysteine after adjusting for potential confounders. Plasma homocysteine on day 1 or changes (Δ day 7 – day 1) did not show any association with clinical outcomes. Conclusions : Lower plasma PLP might be a significant factor for increased plasma homocysteine in critically ill surgical patients. The association between plasma homocysteine and clinical outcomes was not found.