Association of Folate, Vitamin B6, B12, and Homocysteine Blood Levels with Ischemic Stroke

血液中葉酸、維生素B6、Bl2及半胱胺酸濃度與缺血性腦中風之關聯

張武雄(Wu-Shiung Chang) ； 鄭世呈(Chih-Chung Cheng) ； 魏燕蘭(len-Lan Wei) ； 陳品伶(Ping-Ling Chen) ； 張英明(Ying-Ming Chang) ； 胡朝榮(Chaur-JongHu)

《北市醫學雜誌》 1卷4期 (2004/10) Pp. 412-417

https://doi.org/10.6200/TCMJ.2004.1.4.04

摘要

高血半胱胺酸可能是一粥狀硬化血管疾病，包括缺血性腦中風之危險因子。葉酸、維生素 B6、B12不足，基於生化代謝機轉與高血半胱胺酸相關；然而這些低維生素濃度亦被認為獨立參與粥狀硬化血管疾病之發生。本研究即要探討血液中葉酸、維生素B6、Bl2及半胱胺酸濃度與缺血性腦中風之關聯性。總共有55位缺血性腦中風病人與92位非缺血性腦中風人士（控制組）參與。本研究發現葉酸、維生素B。於缺血性腦中風病人較控制組為低（p值分別為0.003與0.002) ；半胱膿酸於病人組較高但未達統計意義 (p=0.74）。維生素 B 、 2 於兩組則無差別。經年齡調整後葉酸、維生素 B 。於缺血性腦中風病人仍明顯較控制組為低（95％信賴區間0.750-0.903及0.877-0.981）。因此本研究結果支持低葉酸，低維生素B6與缺血性腦中風相關聯；而此現象可能獨立於高血半胱胺酸。

關鍵字

缺血性腦中風 ； 半胱胺酸 ； 維生素 B6 ； 維生素 B12

並列摘要

Objective: Hyperhomocysteinemia might be a risk factor for atherosclerotic vascular diseases, including ischemic stroke. Deficiency of folate, vitamin B6, or vitamin B12 has been linked to hyperhomocysteinemia based on the biochemical metabolism. However, low levels of these vitamins themselves were also attributed to atherosclerosis independently. This study explores the association between the plasma levels of these vitamins, homocysteine and ischmic stroke. Methods: A total of 55 patients with ischemic stroke and 92 control subjects were recruited in this study. Plasma levels of homocysteine, folate, vitamin B12, and vitamin B6 were determined by use of HPLC or radloimmunoassay method. Results: Both vitamin B6 and folate are significantly lower in ischemic stroke patients with a p value of 0.0002 and 0.003 respectively. Homocysteine levels appear to be higher in patient group but it fail to achieve statistical significance (P= 0.074). Vitamin B12 levels are not significanty different in both groups. After age-adjusted analysis, vitamin B6 and folate levels are still inversely related to stroke significantly (95% confidence interval, 0.877-0.981 and 0.750-0.903). Conclusions: Lower serum concentrations of vitamin B6 and folate are associated with ischemic stroke. These effects, however, may be independent of hyperhomocysteinemia.

並列關鍵字

schemic stroke ； homocysteine ； folic acid ； vitamin B12 ； vitamin B6