| | Summary# 44875
Keywords:
ENDOTHELIAL FUNCTION, CORONARY ARTERY DISEASE - Folic Acid, Homocysteine
Topic:
High-Dose Folic Acid Improves Endothelial Function in Coronary Artery Disease, Independent of Its Homocysteine Lowering Effect
Reference:
"High- but not low-dose folic acid improves endothelial function in coronary artery disease,"
Moat SJ, Madhavan A, et al, Eur J Clin Invest, 2006; 36(12): 850-9. (Address: Department of
Medical Biochemistry, University Hospital of Wales, Cardiff, UK).
Summary:
In a study involving 128 patients with coronary artery disease (CAD), supplementation with high-dose
folic acid (5 mg/d) was found to significantly improve endothelial function, independent of its effect on
lowering plasma Hcy levels. The study involved several separate studies. In one study - the folic acid
study - subjects (n=84) were divided into 3 groups. One group received 400 microg/d folic acid, a
second group received 5 mg/d folic acid, and the third group received a placebo. In a second study - the
betaine study - subjects (n=44) were divided into 2 groups, in which one group received 3 g b.i.d.
betaine and the other group received placebo. All treatments were given for a period of 6 weeks. In the
third study - an in vitro study - the effect of folic acid on endothelial function and endothelial nitric oxide
synthase (eNOS) dimerization in isolated rabbit aortic rings and cultured porcine aortic endothelial cells
(PAEC) was investigated. Results found that subj ects who received supplementation with folate at either
400 microg/d or 5 mg/d had significant increases in plasma folate and significant decreases in plasma
Hcy, while only subjects who received 5 mg/d had significant improvements in flow-mediated dilation - a
change which was independent of the reduction in Hcy. In the subgroup of subjects who received
betaine, a significant impairment in flow-mediated dilation was found, despite a reduction in plasma Hcy.
Results of the in vitro studies found that folic acid reversed endothelial dysfunction and promoted eNOS
dimerization in PAEC. These results suggest that supplementation with high-dose folic acid, which has
been shown to improve endothelial function independent of its effect on plasma Hcy levels, may be of
benefit to patients with CAD.
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