Tohoku J. Exp. Med., 2004, 204(2)

Serum Vitamin B₁₂ and Folic Acid Levels in Acute Cerebral Atherothrombotic Infarction

ABDULKADIR KOCER, NURHAN INCE,¹ E. CUNEYT CANBULAT² and MEHMET SARGIN³

Department of Neurology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, ¹Department of Public Health, Istanbul Medical Faculty, University of Istanbul, ²Department of Clinical Biochemistry, PTT Education and Research Hospital, and ³Department of Family Medicine, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey

Hyperhomocysteinemia is an independent risk factor for atherothrombotic cerebral stroke. Vitamin B₁₂ and folic acid are important determinants of homocysteine metabolism. We aimed to evaluate the relationship, if present, between vitamin B₁₂ and folic acid levels and acute cerebral stroke in this study. Blood aliquots drawn within 24 hours after the stroke from hospitalized patients (n=66) with the diagnosis of acute ischemic cerebrovascular episode and also blood samples from 38 healthy controls without any vascular risk factor were analyzed. With a competitive, chemoluminescence assay, serum levels of vitamin B₁₂ and folic acid were measured in blood samples taken within 24 hours after the stroke. The differences and correlations were tested using frequency test, student-t test and multivariate analysis. Mean serum vitamin B₁₂ levels were significantly lower in the patients than in the control subjects, 245.40 (S.D.: 72.9) and 343.2 (S.D.: 113.0) pg/ml respectively (p=0.0001). This difference was independent from other risk factors. Likewise, mean serum folic acid levels were lower in the patients than in the control subjects, 4.62 (S.D.: 1.94) and 5.97 (S.D.: 1.19) ng/ml, respectively (p=0.003). Mean serum levels of vitamin B₁₂ and folate at the convalescence phase were 253.05 (S.D.: 68.78) pg/ml and 4.48 (S.D.: 2.08) ng/ml, respectively; the values obtained at the acute phase were not significantly different from the values obtained at the convalescence phase. We conclude that low vitamin B₁₂ and folic acid concentrations are associated with an increased risk of stroke, and the relationship for vitamin B₁₂ is independent from the other known modifiable stroke risk factors. For understanding the effects of B₁₂ and folate in stroke patients, more detailed follow-up studies with long period are needed.

keywords —— hyperhomocysteinemia; B₁₂; folate; atherotrombosis; stroke

© 2004 Tohoku University Medical Press

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Address for reprints: Kocer Abdulkadir, M.D., Chief Assistant, Department of Neurology, Dr. Lutfi Kirdar Teaching and Research Hospital, Istanbul, Turkey.

e-mail: abdulkadirkocer@yahoo.com
This article was partially presented as poster (Poster Number 3 at 18 May 2004) at International Congress Of Neuromediterranee VI, 17-21 May 2004, Istanbul, Turkey.