[Paracelsus] Folate, Vitamin B6 Normalize Endothelial Function in Diabetic Children (fwd)

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Vitamin B6 Normalize Endothelial Function in Diabetic Children

MacKenzie KE, Wiltshire EJ, Gent R, et al. Folate

and vitamin B6 rapidly normalize endothelial

dysfunction in children with type 1 diabetes

mellitus. Pediatrics 2006 Jul;118(1):242-253.

PMID: 16818571

http://pediatrics.aappublications.org/cgi/content/full/118/1/242

http://pediatrics.aappublications.org/cgi/reprint/118/1/242

Pediatrics. 2006 Jul;118(1):242-53.

Folate and vitamin B6 rapidly normalize

endothelial dysfunction in children with type 1

diabetes mellitus.

MacKenzie KE, Wiltshire EJ, Gent R, Hirte C, Piotto L, Couper JJ.

Department of Diabetes and Endocrinology,

Children, Youth, and Women's Health Service,

Adelaide, Australia.

karen.mackenzie@...

BACKGROUND: Endothelial dysfunction, a precursor

of vascular disease, begins early in type 1

diabetes mellitus and is associated with folate

status. METHODS: A randomized, double-blind,

placebo-controlled study of folate (5 mg daily)

and vitamin B6 (100 mg daily) in 124 children

with type 1 diabetes determined the immediate and

8-week effects of these vitamins, alone and in

combination, on endothelial function. Endothelial

function, assessed as flow-mediated dilation and

glyceryltrinitrate-induced dilation with

high-resolution ultrasound of the brachial

artery, was measured at baseline, at 2 and 4

hours after the first dose (n = 35), and at 4 and

8 weeks of treatment (n = 122). RESULTS:

Flow-mediated dilation normalized in all

treatment groups. From baseline to 8 weeks,

flow-mediated dilation improved with folate from

2.6% +/- 4.3% (mean +/- SD) to 9.7% +/- 6.0%,

with vitamin B6 from 3.5% +/- 4.0% to 8.3% +/-

4.2%, and with folate/vitamin B6 from 2.8% +/-

3.5% to 10.5% +/- 4.4%. This improvement in

flow-mediated dilation occurred within 2 hours

and was maintained at 8 weeks for each treatment.

Flow-mediated dilation in the placebo group, and

glyceryltrinitrate-induced dilation in all

groups, did not change. Increases in serum

folate, red cell folate, and serum vitamin B6

levels related to increases in flow-mediated

dilation. Improvement in flow-mediated dilation

was independent of changes in total plasma

homocyst(e)ine, glucose, hemoglobin A1c, and

high-sensitivity C-reactive protein levels.

Baseline red cell folate levels and baseline

diastolic blood pressure were related inversely

to improvement in flow-mediated dilation. Serum

triglyceride and low-density lipoprotein

cholesterol inversely related to baseline

flow-mediated dilation. CONCLUSIONS: High-dose

folate and vitamin B6 normalized endothelial

dysfunction in children with type 1 diabetes.

This effect was maintained over 8 weeks, with no

additional benefit from combination treatment.

PMID: 16818571

Folate, Vitamin B6 Normalize Endothelial Function in Diabetic Children

NEW YORK (Reuters Health) Jul 10 - Recent

findings published in the July issue of

Pediatrics suggest that high-dose folate and

vitamin B6 can normalize endothelial function in

children with type 1 diabetes.

Dr. E. McKenzie, of the University of

Adelaide, Australia, and colleagues examined the

immediate and 8-week effect of folate and vitamin

B6, alone or in combination, in 124 children with

type 1 diabetes. The patients were randomized to

daily treatment with: 5 mg folate plus placebo,

100 mg vitamin B6 plus placebo, 5 mg folate plus

100 mg vitamin B6, or two placebo tablets.

The team used flow-mediated dilation and

glyceryltrinitrate-induced dilation with

high-resolution ultrasound of the brachial artery

to measure endothelial function at baseline, at 2

and 4 hours after the first dose (n = 35) and at

4 and 8 weeks of treatment (n = 122).

The researchers report that flow-mediated

dilation normalized in all treatment groups. The

improvements occurred within 2 hours of treatment

and were maintained at 8 weeks for all treatments.

Flow-mediated dilation did not change in the

placebo group and there was no change in

glyceryltrinitrate-induced dilation in any group.

Over 8 weeks, changes in flow-mediated dilation

correlated with increased red cell folate levels

and serum folate levels, and improvement in

vitamin B6 status, Dr. McKenzie and colleagues

report.

An inverse association was observed between

increases in flow-mediated dilation over 8 weeks

and baseline red cell folate levels and baseline

diastolic blood pressure. Serum triglyceride

levels and low-density lipoprotein cholesterol

were inversely associated with baseline

flow-mediated dilation.

" We have shown for the first time that, among

children with diabetes type 1 and normal folate

status, both high-dose folate and high-dose

vitamin B6 normalized endothelial function within

2 hours, an effect that is maintained over 8

weeks with continued treatment. "

This treatment, which is inexpensive and appears

to be safe, " could have a major impact on

long-term diabetic vascular complications, " they

conclude.

Pediatrics 2006;118:242-253.

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Reuters Health Information 2006. © 2006 Reuters Ltd.

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