THE EVALUATION OF FOLATE STATUS USING TOTAL HOMOCYSTEINE IN HYPERTENSIVE PATIENTS

A large number of studies have established a link between the progression of arterial hypertension (AH) and folic acid (FA) deficiency. Due to the deficiency of FA, an increase in the level of total homocysteine (tHcy) is observed. The cut-off point for total homocysteine (tHcy), which is not associated with the toxic effect of Hcy itself, indicating the increase in FA deficient state, has not been clearly defined to date. The purpose of this work was to assess the cutoff value of tHcy applied to assesment of functional FA deficiency in hypertensive patients, including group with chronic kidney disease (CKD). Material and methods. The study included blood samples from 60 hypertensive patients aged 61 (45-70) without (N=31) and with (N=29) diagnosed kidney disease and also samples from 30 healthy donors. Clinical and biochemical data, including tHcy, FA and vitamin B12 of blood plasma were assessed. Results and conclusion. Hyperhomocysteinemia in patients with CKD was significantly higher than in patients without CKD. The level of tHcy in all patients was inversely correlated with the level of FA in the blood plasma. Some patients without a deficiency of FA and B12 had an increased level of tHcy, which indicated a functional deficiency of FA. Another situation in few patients without functional deficiency of FA was observed, in which the decreased FA level without increasing level of tHcy established. Frequently used cutoff point for hyperhomocysteinemia above 15 μM indicates the starting point of tHcy concentrations associated with the toxic effects of Hcy by itself. To determine the functional deficiency of FA in the absence of its deficiency in the plasma, the cutoff level of tHcy from 10.9 µM should be used.