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Neuropediatrics 2000; 31(6): 298-302
DOI: 10.1055/s-2000-12953
Original Article

Georg Thieme Verlag Stuttgart · New York

Homocysteine Metabolism and Effects of Folic Acid Supplementation in Patients Affected with Spina Bifida

Ingeborg A. Brouwer1,2 , Marijke van Dusseldorp2,6 , C. M. G. Thomas1,3 , Nathalie M. J. van der Put4 , M. A. Gaytant1 , T. K. A. B. Eskes1 , J. G. A. J. Hautvast2 , Régine P. M. Steegers-Theunissen1,5
  • 1 Department of Obstetrics and Gynaecology, University Hospital St. Radboud, Nijmegen, The Netherlands
  • 2 Division of Human Nutrition and Epidemiology, Wageningen University, Wageningen, The Netherlands
  • 3 Department of Chemical Endocrinology, University Hospital St. Radboud, Nijmegen, The Netherlands
  • 4 Department of Paediatrics and Neurology, University Hospital St. Radboud, Nijmegen, The Netherlands
  • 5 Department of Epidemiology, University Hospital St. Radboud, Nijmegen, The Netherlands
  • 6 Current address: Department of Nutritional Epidemiology, TNO Voeding, Zeist, The Netherlands
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Publikationsdatum:
31. Dezember 2000 (online)

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Folic acid supplementation around conception decreases the risk of having offspring with a neural tube defect. However, the aetiology is often still unknown. This study investigated whether spina bifida patients have lower blood folate and higher fasting and post-methionine-load plasma total homocysteine (tHcy) concentrations than control patients. Moreover, the effects of supplementation with 500 µg folic acid/d on folate and tHcy concentrations were determined. Spina bifida patients (n = 12) and disabled control patients (n = 15) received 4 weeks of placebo treatment followed by 4 weeks of intervention with 500 µg folic acid/d. Blood was collected at the start and after 4 and 8 weeks. A methionine-loading test was performed at the start and the end of the study. At baseline, no significant differences occurred between spina bifida and control patients. Folic acid supplementation significantly increased plasma and red blood cell folate concentrations in both groups. Folic acid decreased fasting tHcy concentrations in control patients by 1.6 ± 0.5 µmol/l (p < 0.01) and in spina bifida patients by 2.2 ± 1.3 µmol/l (p = 0.10). This study does not show a derangement in homocysteine metabolism in spina bifida compared to control patients. Moreover, folic acid supplementation seems at least as effective in spina bifida patients as in controls.

Key words

Spina bifida - Homocysteine - Folate - Folic acid

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Régine Steegers-Theunissen

Department of Obstetrics and Gynaecology University Hospital St. Radboud Nijmegen

P. O. Box 9101

6500 HB Nijmegen

The Netherlands

eMail: r.steegers@MIE.KUN.NL