J Korean Rheum Assoc.  1999 Sep;6(3):238-246.

Study on the Plasma Homocysteine and Serum Vitamin B12, Folate Levels in Patients with Rheumatoid Arthritis

• Cha HS
• Jeon CH
• Koh JH
• Lee CK
• Kim JS
• Kim JW
• Kang SW
• Song YW
• Koh EM

Abstract

OBJECTIVE
Cardiovascular disease is the most frequent cause of death in rheumatoid arthritis(RA) patients and hyperhomocysteinemia is an independent risk factor for cardiovascular disease. We evaluated the status of homocysteine, vitamin B12 and folate in RA patients and the influence of the drugs used in RA on homocysteine and vitamin levels.
METHODS
Fifty-six RA patients and 22 controls were studied. Plasma total homocysteine was measured by HPLC method and serum folate and vitamin B12 were measured by chemiluminescence immunoassay. In RA patients, age, sex, disease duration, medications and laboratory findings were analyzed.
RESULTS
Serum vitamin B12 level was significantly lower in RA patients compared to controls(p=0.033). No significant difference in serum folate level was found between RA patients and controls but plasma total homocysteine level was significantly higher in RA patients. There was no difference in plasma total homocysteine level between patients taking MTX with folate and controls, but plasma total homocysteine level was significantly higher in patients not taking MTX compared with controls(p=0.028). In RA patients taking only hydroxychloroquine(HCQ) as a DMARD, there was significantly lower serum folate level(p=0.033) and higher plasma total homocysteine level(p=0.043) compared with controls. There was a significant negative correlation between plasma total homocysteine level and serum folate level in RA patients(r=-0.319, p=0.017).
CONCLUSION
Plasma total homocysteine level was increased in RA patients but not in patients taking MTX and folate. These findings suggested that folate supplementation may be effective to prevent hyperhomocysteinemia in RA patients.

Keyword

Rheumatoid arthritis; Cardiovascular disease; Homocysteine; Vitamin B12; Folate

MeSH Terms

Antirheumatic Agents
Arthritis, Rheumatoid*
Cardiovascular Diseases
Cause of Death
Chromatography, High Pressure Liquid
Folic Acid*
Homocysteine*
Humans
Hyperhomocysteinemia
Immunoassay
Luminescence
Plasma*
Risk Factors
Vitamin B 12*
Vitamins*
Antirheumatic Agents
Folic Acid
Homocysteine
Vitamin B 12
Vitamins