Effects of folic acid supplementation on serum homocysteine and lipoprotein (a) levels during pregnancy

• Main Authors: Zohreh Hekmati Azar Mehrabani, Amir Ghorbanihaghjo, Manizheh Sayyah Melli, Maryam Hamzeh-Mivehroud, Nazila Fathi Maroufi, Nasrin Bargahi, Maryam Bannazadeh Amirkhiz, Nadereh Rashtchizadeh
• Format: Article
• Language: English
• Published: Tabriz University of Medical Sciences 2015-12-01
• Series: BioImpacts
• Subjects: Folic acid; Homocysteine; Lipoprotein (a); Pregnancy; MTHFR polymorphism
• Online Access: http://journals.tbzmed.ac.ir/BI/Manuscript/BI-5-177.pdf
• ISSN: 2228-5652; 2228-5660

Introduction: There are many ideas concerning the etiology and pathogenesis of preeclampsia including endothelial dysfunction, inflammation and angiogenesis. Elevated levels of total homocysteine (Hcy) and lipoprotein (a) [Lp(a)] are risk factors for endothelial dysfunction. This study aimed to evaluate the effect of high dose folic acid (FA) on serum Hcy and Lp(a) concentrations with respect to methylenetetrahydrofolate reductase (MTHFR) polymorphisms 677C→T during pregnancy. Methods: In a prospective uncontrolled intervention, 90 pregnant women received 5 mg FA supplementation before pregnancy till 36th week of pregnancy. The MTHFR polymorphisms 677C→T, serum lactate dehydrogenase activity, urine protein and creatinine concentrations were measured before starting folic acid administration. Serum levels of Hcy and Lp(a) were determined before and after completion of folic acid supplementation period. Results: Supplementation of the patients with FA for 36 week decreased the median (minimum–maximum) levels of serum Hcy from 11.40 µmol/L (4.40-28.70) to 9.70 (1.60-20.80) µmol/L (p=0.001). There was no significant change in serum Lp(a) after FA supplementation (p=0.17). The overall prevalence of genotypes in pregnant women that were under study for MTHFR C677T polymorphism was 53.3% CC, 26.7% CT and 20.0% TT. There was no correlation between decreasing level of serum Hcy in the patients receiving FA and MTHFR polymorphisms. Conclusion: Although FA supplementation decreased serum levels of Hcy in different MTHFR genotypes, serum Lp(a) was not changed by FA supplements. Our data suggests that FA supplementation effects on serum Hcy is MTHFR genotype independent in pregnant women.