Summary
Homocysteine may have an effect on risk of cardiovascular disease by stimulating procoagulant
factors and/or impair anti-coagulant mechanisms or fibrinolysis. However, data in
humans of such effects are sparse. In this intervention study, we examined the effect
of homocysteine lowering by B-vitamin supplementation on prothrombin fragments 1 and
2 (F1+2), thrombin-antithrombin complex (TAT), and fibrin degradation products (D-dimer).
The study comprised 118 healthy volunteers, 50 with homocysteine > 16 µmol/L and 68
with homocysteine ≤ 16 µmol/L, who were randomized to placebo or highdose B-vitamin
supplements (5 mg folic acid, 0.4 mg hydroxycobalamin, and 50 mg pyridoxine) daily
for 8 weeks. Although homocysteine concentrations were 27.7% (p < 0.0001) reduced
in the Bvitamin group compared to the placebo group, no effect on F1+2 and TAT concentrations was observed. A 10.4% reduction was observed for D-dimer (p
= 0.08).
In conclusion, it appears that in healthy subjects homocysteine reduction by B-vitamin
supplementation has a modest beneficial effect on clotting activation.
Keywords
Homocysteine - B-vitamins - clotting activation - intervention - healthy volunteers