RESEARCH - Vitamin B6 and homocysteine changes seen in women with RA

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Vitamin B6 and Homocysteine Changes Seen in Women With Rheumatoid Arthritis

NEW YORK (Reuters Health) Mar 25 - Compared with healthy women, those

with rheumatoid arthritis are deficient in vitamin B6 and have

elevated levels of homocysteine, which may contribute to the increased

risk of cardiovascular events seen with the disease, new research

shows.

The vitamin B6 deficit appears to be the result of altered metabolism,

not reduced dietary intake, according to the report in the Journal of

the American Dietetic Association for March. The results also indicate

that as vitamin B6 levels drop and homocysteine levels rise,

disability status worsens.

Numerous reports have shown that rheumatoid arthritis patients are at

risk for early death from cardiovascular disease, the authors point

out. The reason for the elevated risk, however, is unclear since there

is evidence that traditional cardiovascular risk factors, such as

hypercholesterolemia, are no more prevalent in arthritis patients than

in healthy individuals.

Furthermore, through mechanisms that are unclear, plasma homocysteine

increases the risk of cardiovascular disease. Findings from several

studies have indicated that homocysteine metabolism is altered with

rheumatoid arthritis, which may in turn relate to changes in how

vitamin B6 is processed.

Prior research has shown a poor vitamin B status in rheumatoid

arthritis patients, co-authors Dr. Kathleen Woolf and Dr. Melinda M.

Manore comment, but the studies did not provide adequate information

to determine whether this was simply a result of low dietary intake.

The present findings, from a study of 18 patients and 33 healthy

controls, indicate that dietary intake of B vitamins is not decreased

in rheumatoid arthritis patients, yet they still show a deficit of

vitamin B6. Consistent with this finding, rheumatoid arthritis was

also associated with increased levels of homocysteine. None of the

subjects in the study were using B vitamin supplements.

Red blood cell folate levels were decreased in rheumatoid arthritis

patients relative to controls, whereas no significant differences were

noted in plasma levels of folate, vitamin B12, and transcobalamin II.

In agreement with some earlier research, levels of total cholesterol

and LDL cholesterol were actually lower in patients than in controls

(p < 0.05).

" When registered dietitians are working with individuals with

rheumatoid arthritis, they should assess B-vitamin status and plasma

total homocysteine concentrations, " emphasize Dr. Woolf, from Arizona

State University in Mesa, and Dr. Manore, from Oregon State University

in Corvallis.

" Individuals with rheumatoid arthritis may need to get more B vitamins

through diet, supplements, or fortified foods. Foods that are

especially high in vitamin B6 are meats, fish, poultry, legumes,

noncitrus fruits, fortified cereals, and soy products. "

J Am Diet Assoc 2008;108:443-453.

http://www.medscape.com/viewarticle/571962

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Not an MD