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DOI: 10.1055/s-2004-819995
Karl F. Haug Verlag, in: MVS Medizinverlage Stuttgart GmbH & Co. KG
Risikofaktor Homocystein
Publication History
Publication Date:
16 February 2004 (online)
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Zusammenfassung
Homocystein ist ein Intermediärprodukt im Stoffwechsel der essentiellen schwefelhaltigen Aminosäure Methionin. Die B-Vitamine Vitamin B6, Vitamin B12 und Folsäure spielen eine zentrale Rolle im Stoffwechsel des Homocysteins und Defizite bezüglich dieser Vitamine können zu erhöhten Homocysteinkonzentrationen führen ebenso wie Mutationen verschiedener Enzyme des Homocysteinstoffwechsels. Homocystein ist ein unabhängiger Risikofaktor für kardiovaskuläre Erkrankungen und ab einer Homocysteinkonzentration von etwa 10 μmol/l erhöht sich das Risiko in einer linearen Dosis-Wirkungsbeziehung. Bei erhöhten Homocysteinkonzentrationen kommt es zu Veränderungen der Gefäßmorphologie, zu einem Verlust an antithrombotischer Endothelfunktion und zu einer Homocystein-vermittelten oxidativen Stressbelastung. Darüber hinaus sind erhöhte Homocysteinkonzentrationen assoziiert mit einem Verlust an kognitiver Funktion und stellen einen Risikofaktor für Demenz und Morbus Alzheimer dar. Erhöhte Homocysteinkonzentrationen lassen sich in der Regel effektiv und kostengünstig durch eine Supplementierung mit den Vitaminen B6, B12 und vor allem mit Folsäure absenken. Eine Reduktion der Homocysteinkonzentration auf Werte unter 10 μmol/l ist anzustreben. Dies gilt insbesondere für Patienten mit manifesten Gefäßerkrankungen sowie bei Risikogruppen.
Abstract
Homocysteine is an intermediate product of the metabolism of the essential, sulfur-containing amino acid methionin. The B-vitamins vitamin B6, vitamin B12 and folic acid play an important role in the homocysteine metabolism and deficiencies of these vitamins as well as reduced activities of enzymes of the homocysteine/methionin metabolism can result in high homocysteine concentrations. Hyperhomocysteinemia is an independent risk factor for cardio-vascular diseases and starting at plasma homocysteine concentration of 10 μmol/l the risk increases in a linear dose-response relationship. High homocysteine levels are associated with alterations in vascular morphology, loss of endothelial antithrombotic function and homocysteine-related oxidative stress. Furthermore, high homocysteine is interrelated with cognitive decline and a risk factor for dementia and Alzheimer disease. Supplementation of the vitamins B6, B12 and especially folic acid is inexpensive and effective in the treatment of high homocysteine levels and a reduction of serum/plasma homocysteine below 10 μmol/l is recommended. This is especially true for patients with manifest vascular diseases and high-risk individuals.
Schlüsselwörter
Homocystein - Vitamin B6 - Vitamin B12 - Folsäure - Hyperhomocysteinämie - kardiovaskuläre Erkrankungen
Keywords
Homocysteine, vitamin B6, vitamin B12, folic acid, hyperhomocysteinemia, cardio-vascular diseases
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Korrespondenzadresse
Dr. rer. nat. Wolfgang Bayer
Prof. Dr. Dr. med. Karlheinz Schmidt
Laboratorium für spektralanalytische und biologische Untersuchungen Dr. Bayer GmbH
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70184 Stuttgart
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