期刊
CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION
卷 62, 期 20, 页码 5462-5475出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/10408398.2021.1885341
关键词
B vitamins; folic acid; cobalamin; riboflavin; pyridoxine; nutrients; sources; stroke; homocysteine; hyperhomocysteinemia
This study discusses the complex relationship between Hcy and B vitamins, emphasizing the regulating factors of B vitamins in stroke prevention. Suggestions for further large, well-designed studies targeting specific subgroups are also provided.
Elevated plasma levels of homocysteine (Hcy) are a recognized risk factor for stroke. This relationship represents one aspect of the debated `Hcy hypothesis'. Elevated Hcy may be an independent and treatable cause of atherosclerosis and thrombotic vascular diseases. Further observations indicate that proper dietary supplementation with B-vitamins decreases total plasma Hcy concentrations and may be an effective intervention for stroke prevention. Metabolic vitamin B-12 deficiency is a nutritional determinant of total Hcy and stroke risk. Genetic factors may link B vitamins with stroke severity due to the impact on Hcy metabolism of polymorphism in the genes coding for methylenetetrahydrofolate reductase, methionine-synthase, methionine synthase reductase, and cystathionine beta-synthase. Several meta-analyses of large randomized controlled trials exist. However, they are not completely in agreement about B vitamins' role, particularly folic acid levels, vitamin B-12, and B-6, in lowering the homocysteine concentrations in people at high stroke risk. A very complex relationship exists between Hcy and B vitamins, and several factors appear to modify the preventive effects of B vitamins in stroke. This review highlights the regulating factors of the active role of B vitamins active in stroke prevention. Also, inputs for further large, well-designed studies, for specific, particularly sensitive subgroups are given.
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