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P499. Folate regimen may reduce high homocysteine levels in a Greek cohort of patients with inflammatory bowel disease

E. Tsiaousi1, S. Michael1, S. Polyzos1, C. Stergiopoulos1, K. Anastasiadou1, G. Tsarouchas1, I. Romiopoulos1, C. Zavos1, N. Tantsi1, S. Trygonis1, J. Kountouras1, 1Aristotle University of Thessaloniki, 2nd Medical Clinic, Thessaloniki, Greece

Background

The degree of association between homocysteine metabolism and inflammatory bowel diseases (IBD) remains unknown and the association between hyperhomocysteinemia and thrombosis and oncogenesis remains controversial in IBD. The aim of this study was to investigate the serum homocysteine levels in patients with Crohn's disease (CD) and ulcerative colitis (UC) and the potential folate therapeutic regimen against hyperhomocysteinemia.

Methods

Serum levels of homocysteine were measured in 55 patients with (IBD) (28/55 CD and 31/55 UC patients). Patients with hyperhomocysteinemia received 15 mg folate/day for 2–12 months. Levels of serum homocysteine were measured during folate treatment.

Results

Hyperomocysteinemia was prevalent in 28/55 (50.90%) of patients studied (13 CD and 15 UC patients). Mean homocysteine levels among the patients with hyperhomocysteinemia were 17.72 µmol/L with range 14.23–29.88 µmol/L (normal values 3.7–13.9 µmol/L) (Table 1). Folate was administered in 24/28 patients and serum levels of homocysteine were re-measured in 17 patients. In 14/17 patients lower levels of homocysteine were observed with a mean reduction of 5.25 µmol/L by folate treatment. The baseline levels of homocysteine in these patients were 17.01 µmol/L and post-treatment 11.75 µmol/L.

Table 1. Baseline homocysteine levels among IBD patients
 TotalFemalesMalesCD patientsUC patients
Normal homocysteine levels27 (49.10%)15 (62.5%)12 (38.70%)15 (53.57%)12 (44.44%)
High homocysteine levels28 (50.90%)9 (37.5%)19 (61.29%)13 (46.42%)15 (55.55%)
Total55 (100%)24 (100%)31 (100%)28 (100%)27 (100%)

Conclusion

Hyperhomocysteinemia was prevalent in 50.90% of IBD patients in the study. Administration of folate for at least two months leads to reduction in serum homocysteine in the majority (82%) of patients administered. Prophylactic administration of folate may be a therapeutic alternative against homocysteinemia's adverse sequelae in IBD.