Elevated Plasma Homocysteine and Low Vitamin B-6 Status in Nonsupplementing Older Women with Rheumatoid Arthritis

Kathleen Woolf, Melinda M. Manore

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The purpose of this study was to determine if nonsupplementing older women (aged ≥55 years) with rheumatoid arthritis had higher plasma homocysteine and lower B-vitamin status compared to healthy controls. Elevated plasma homocysteine, a risk factor for cardiovascular disease, may help explain why individuals with rheumatoid arthritis have an increased risk of cardiovascular disease. Methods: Older, free-living women were classified as rheumatoid arthritis (n=18) or healthy control (n=33). Participants were not using B-vitamin supplements. Fasting blood samples were measured for pyridoxal 5′phosphate (PLP) (the metabolically active coenzyme form of vitamin B-6), folate, red blood cell folate, vitamin B-12, transcobalamin II, homocysteine, C-reactive protein, and lipid concentrations. Participants completed 7-day weighed food records, the Stanford Health Assessment Questionnaire (HAQ), and a visual analog pain scale. Results: PLP concentrations were lower in the rheumatoid arthritis vs healthy control participants (4.93±3.85 vs 11.35±7.11 ng/mL [20±16 vs 46±29 nmol/L]; P<0.01) whereas plasma homocysteine was higher in the rheumatoid arthritis group (1.63±0.74 vs 1.15±0.38 mg/L [12.1±5.5 vs 8.5±2.8 μmol/L]; P=0.02). Red blood cell folate concentrations were lower in the rheumatoid arthritis vs healthy control participants [414±141 vs 525±172 ng/mL [938±320 vs 1,190±390 nmol/L]; P=0.02). No significant differences were found for plasma folate, vitamin B-12, and transcobalamin II. An inverse correlation was found between PLP concentrations and the HAQ disability index (r=-0.37; P<0.01). A positive correlation was found between homocysteine concentrations and the HAQ disability index (r=0.36; P=0.01). Total cholesterol and low-density lipoprotein cholesterol levels were lower in the rheumatoid arthritis group (cholesterol 191±43 vs 218±33 mg/dL [4.95±1.11 vs 5.65±0.85 mmol/L]; P=0.02; low-density lipoprotein cholesterol 110±36 vs 137±29 mg/dL [2.85±0.93 vs 3.55±0.75 mmol/L]; P<0.01). No significant differences were seen between groups for protein (g/day), fat (g/day), cholesterol (mg/day), folate (μg/day), vitamin B-12 (μg/day), and vitamin B-6 (mg/day) dietary intakes. Conclusions: Poor vitamin B-6 status and elevated plasma homocysteine concentrations were seen in older women with rheumatoid arthritis compared to healthy controls and may contribute to their increased risk of cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)443-453
Number of pages11
JournalJournal of the American Dietetic Association
Volume108
Issue number3
DOIs
StatePublished - Mar 2008

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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