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Effect of L-methionine supplementation on plasma homocysteine and other free amino acids: a placebo-controlled double-blind cross-over study

Abstract

Objective:

The essential amino acid L-methionine is a potential compound in the prophylaxis of recurrent or relapsing urinary tract infection due to acidification of urine. As an intermediate of L-methionine metabolism, homocysteine is formed. The objective was to study the metabolism of L-methionine and homocysteine, and to assess whether there are differences between patients with chronic urinary tract infection and healthy control subjects.

Design:

A randomized placebo-controlled double-blind intervention study with cross-over design.

Setting:

Department of Nutritional Physiology, Institute of Nutrition in cooperation with the Department of Internal Medicine III, Friedrich Schiller University of Jena, Germany.

Subjects:

Eight female patients with chronic urinary tract infection and 12 healthy women (controls).

Interventions:

After a methionine-loading test, the volunteers received 500 mg L-methionine or a placebo three times daily for 4 weeks.

Main outcome measures:

Serum and urinary concentrations of methionine, homocysteine, cystathionine, cystine, serine, glycine and serum concentrations of vitamin B12, B6 and the state of folate.

Results:

Homocysteine plasma concentrations increased from 9.4±2.7 μmol/l (patients) and 8.9±1.8 μmol/l (controls) in the placebo period to 11.2±4.1 μmol/l (P=0.031) and 11.0±2.3 μmol/l (P=0.000), respectively, during L-methionine supplementation. There were significant increases in serum methionine (53.6±22.0 μmol/l; P=0.003; n=20) and cystathionine (0.62±0.30 μmol/l; P=0.000; n=20) concentrations compared with the placebo period (33.0±12.0 and 0.30±0.10 μmol/l; n=20). Simultaneously, renal excretion of methionine and homocysteine was significantly higher during L-methionine intake.

Conclusions:

Despite an adequate vitamin status, the supplementation of 1500 mg of L-methionine daily significantly increases homocysteine plasma concentrations by an average of 2.0 μmol/l in patients and in control subjects. An optimal vitamin supplementation, especially with folate, might prevent such an increase.

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Correspondence to G Jahreis.

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Guarantor: G Jahreis.

Contributors: BD: conception, design, conduct of the study, analysis, statistics, data interpretation, writing the manuscript; RF: conception, design, medical attendance; MB: analysis, data interpretation; RS: analysis, data interpretation, statistics; JG: medical attendance; GJ: conception, design, data interpretation.

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Ditscheid, B., Fünfstück, R., Busch, M. et al. Effect of L-methionine supplementation on plasma homocysteine and other free amino acids: a placebo-controlled double-blind cross-over study. Eur J Clin Nutr 59, 768–775 (2005). https://doi.org/10.1038/sj.ejcn.1602138

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