The Journal of the Korean Rheumatism Association  1999;6(3):238-246

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

Hoon Suk CHA 1 ; Chan Hong JEON ; Jay Hyun KOH ; Chang Keun LEE ; Jin Seok KIM ; Jong Won KIM ; Seong Wook KANG ; Yeong Wook SONG ; Eun Mi KOH

Affiliations

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Keywords

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

Country

Republic of Korea

Language

Korean

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.