Vitamin B6: a challenging link between nutrition and inflammation in CVD

The objective of the present review is to highlight the relationship between low vitamin B-6 status and CVD through its link with inflammation. While overt vitamin B-6 deficiency is uncommon in clinical practice, increasing evidence suggests that marginal vitamin B-6 deficiency is rather frequent in a consistent proportion of the population and is related to an increased risk of inflammation-related diseases. Ample evidence substantiates the theory of atherosclerosis as an inflammatory disease, and low plasma vitamin B-6 concentrations have been related to increased CVD risk. Several studies have also shown that low vitamin B-6 status is associated with rheumatoid arthritis and chronic inflammatory bowel diseases, both of which hold an underlying chronic inflammatory condition. Furthermore, the inverse association observed between inflammation markers and vitamin B-6 supports the notion that inflammation may represent the common link between low vitamin B-6 status and CVD risk. In addition to the epidemiological evidence, there are a number of cell culture and animal studies that have suggested several possible mechanisms relating impaired vitamin B-6 status with chronic inflammation. A mild vitamin B-6 deficiency characterises, in most cases, a subclinical at-risk condition in inflammatory-linked diseases which should be addressed by an appropriate individually tailored nutritional preventive or therapeutic strategy.