University :King Saud University
College: College of Applied Medical Sciences
Department: Community Health Sciences
Branch/Track: Clinical Nutrition
Title of Thesis:
The Effect of Folic acid , Vitamin B12 Supplementation and Protein Intake on Plasma Homocystien level in Patients with Heart Diseases at Security Forces Hospital in Riyadh.
Name of Researcher: Ghada Saleh AL-Medaimeegh
Date of Discussion:1st of December/2008
This interventional study was carried out to investigate the effect of folic acid (5mg) and vitamin B12 (10µg) supplementation on coronary heart disease patients aged 40-70 years with plasma homocysteine levels ranging between 8 and 20µmol, and to find out if there is an association between dietary intake of protein, folic acid, vitamin B12 and plasma
homocysteine level in coronary heart disease patients before and after supplementation.
Saudi patients who were newly diagnosed with coronary heart disease on the basis of ECG tracings, previous angiography and/or past history and existing medications from the Cardiology Out-Patient Department of the Security Forces Hospital, Riyadh were recruited. At baseline, lipid profile, glucose, plasma analysis of homocysteine, folic acid and vitamin B12 were determined and then were supplemented with these 2 vitamins for 3 months after which the same parameters were estimated. Patients were classified as low-risk or high risk groups based on homocysteine levels at baseline. Low-risk was defined as homocysteine < 15 µmol/L while high risk was defined as homocysteine levels ≥ 15 µmol/L. Dietary intakes of protein, folic acid and vitamin B12 were assessed on admission and after 3 months using a semi-quantitative food frequency and 24-recal food record method. The results of this study showed that there was a significant decrease in the homocysteine levels of the high-risk group after supplementation while no effect was noticed among the low risk group. Folic acid levels were significantly higher after supplementation among patients in the low-risk group.
Both vitamin B 12 level and the presence of coronary heart disease had a significantly negative impact on
the levels of homocysteine. Serum potassium levels on the other hand had a significant positive correlation with homocysteine levels. Regression analysis revealed that homocysteine was inversely related to serum levels of vitamin B12.. On the other hand, there was an improvement in the folic acid levels of both groups after supplementation.
Based on the results of the present study it can be concluded that, folic acid and vitamin B12 supplementation to hyperhomocysteinemic patients with established CHD is proven to be beneficial as a homocysteine-lowering agents as well as probable effective potassium lowering agents. This study however can only suggest that the supplementation of folic acid and vitamin B12 are an adjuvant therapy for patients with CHD until further clinical trials are done on large number of patients for longer duration.