Introduction and Purpose.The purpose of the research was explore the plasma homocysteine levels in patients with nonalcoholic fatty liver disease, possibility of its correction of vitamin B12 and folic acid dependent on C677T polymorphism gene methylentetrahydrofolate reductase. Nonalcoholic fatty liver disease combined with diabetes mellitus 2 type, hypertension, dyslipidemia and obesity, they are the main components of the metabolic syndrome. That is predictive of cardiovascular diseases that impact and duration and quality of life.
Materials and Methods. In a study of 53 patients participated with nonalcoholic fatty liver disease and 47 patients in the combination of diabetes mellitus 2 type. The control group included 40 healthy individuals. Patients administered vitamin B12 and folic acid under the scheme during the month and of plasma homocysteine levels were determined before and after the treatment.
Results. The results of the study show that patient with minor allele T (C/T and T/T) before treatment of plasma homocysteine level was significantly higher than in major allele homozygous for (C/C) in patients in both groups. In patients with comorbid pathology of this index was higher compared to isolated nonalcoholic fatty liver disease. After treatment received plasma homocysteine decrease in all studied groups of patients. In patients of both groups, homozygotes for the minor allele T (Т/Т) after treatment homocysteine is not decreased significantly as compared with the other genotypes (С/С and C/T). Consistent to earlier research the study supported the hypothesis that low MTHFR enzyme activity in these patients is not compensated by receiving folic acid and vitamin B12 in sufficient quantity. Therefore, patients with genotype T/T for C677T polymorphism of the gene MTHFR for correction hyperhomocysteinemia need additional doses drugs.
Conclusion. Involving to treat vitamin B12 and folic acid significantly reduced plasma homocysteine levels in patients with non alcoholic fatty liver disease. However, in patients minor allele T carriers effect of this treatment on the hyperhomocysteinemia was not significant, which prevented reach target levels of homocysteine in these patients.
Keywords: methylenetetrahydrofolate reductase (MTHFR), allelic polymorphism, homocysteine, nonalcoholic fatty liver disease, treatment of hyperhomocysteinemia.
- Chalasani N,Younossi Z, Lavine JE, Diehl AM, Brunt E, Cusi K, Charlton M, Sanyal AJ. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol. 2012;107:811 – 826.Retrieved from: http://gi.org/wp-content/uploads/2013/12/ACG-AASLD AGA_Guideline_NAFLD_June_2012.pdf
- Leach NV, Dronca E, Vesa SC, Sampelea DP, Craciun EC. Serum homocysteine levels, oxidative stress and cardiovascular risk in non-alcoholic. European Journal of internal medicine. 2014;25(8):762–767.
- Fetisova IN, Lipin MA, Polyakov AV. [Folate metabolism gene polymorphism and human disease]. Herald of new medical technologies. 2007;10(1):7–12.
- Van der Gaag MS, Ubbink JB, Sillanaukee P, Nikkari S, Hendriks HF. Effect of consumption of red wine, spirits and beer on serum homocysteine. Lancet. 2000;29:355–522.
- Franco Brochado MJ, Domenici FA, Martinelli C, Zucoloto S, Carvalho SF, Vannucchi H. Methylenetetrahydrofolate Reductase gene polymorphism and serum homocysteine levels in nonalcoholic fatty liver disease. Nutrition and metabolism. 2013;63(3):193 – 199.
- Zappacosta B, Mastroiacovo P,Persichilli S,Pouni G, Ruggeri S,Minucci A,Carnovale E, Andria G. Homocysteine lowering by folate-rich diet or pharmacological supplementations in subjects with moderate hyperhomocysteinemi. Nutrients. 2013;5:1531–
- Ciaccio M, Bellia С. Hyperhomocysteinemia and cardiovascular risk: effect of vitamin supplementation in risk reduction. Curr Clin Pharmacol. 2010;5(1):30 – 36.
- Smulders YM, den Heijer M, Blom HJ.Homocysteine levels: measure or not? Ned Tijdschr Geneeskd. 2013;157(44):62 – 65.
- Yi X, Zhou Y, Jiang D, Li X, Guo Y, Jiang X. Efficacy of folic acid supplementation on endothelial function and plasma homocysteine concentration in coronary artery disease: A meta-analysis of randomized controlled trials. Exp Ther Med – 2014;7(5):1100 – 1110.
- Kasapoglu B, Turkay C, Yalcin KS, Kosar A, Bozkurt A. MTHFR 677C/T and 1298A/C mutations and non-alcoholic fatty liver disease. Clinical Medicine. 2015;15:243 – 251.
- Garbuzova VYu, Sukhareva VA, Ataman AV. [The frequency of methylenetetrahydrofolatereductase gene C677T single nucleotide poymorphism in individuals of different sex]. J. Clin. Eex. Med. Res. 2013;1(4):385 – 389.Retrieved from:http://www.clinmed.rcpjournal.org/content/15/3/248.full.pdf+html
- Description for drug Neyrobion (p-r d / etc. amp. 3 ml, number 3). Compendium. Retrieved from:http://compendium.com.ua/info/172249/takeda/nejrobion-rastvor-dlja-in_ektsij
- Milovanova GO, Czudzevych BO, Slyvchuk YuI. [The level of homocysteine and changes in lipid metabolism in diabetes mellitus type 2, is associated with coronary heart disease]. Animal biology. 2010;12(2):297–230.
- Vertkin AL, Topolyanskiy AV. [The problem of hyperhomocysteinemia in cardiac patients].Farmateka. 2007;15:10 – 14.
- Robinson DJ, O'Luanaigh C, Tehee E, O'Connell H, Hamilton F, Chin AV, Coen R, Molloy A M, Scott J, Lawlor BA, Cunningham CJ.Vitamin B12 status, homocysteine and mortality amongst community-dwelling Irish elders.Ir J Med Sci. 2011;180(2):451 –455.
- Partearroyo T, Ubeda N, Alonso-Aperte E, Varela-Moreiras G. Moderate or supranormal folic acid supplementation does not exert a protective effect for homocysteinemia and methylation markers in growing rats. Ann Nutr Metab. 2010;56(2):143 – 151.