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  • Original Article
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The folic acid metabolite L-5-methyltetrahydrofolate effectively reduces total serum homocysteine level in orthotopic liver transplant recipients: a double-blind placebo-controlled study

European Journal of Clinical Nutrition volume 62, pages 796–801 (2008)Cite this article

Abstract

Objective:

Hyperhomocysteinemia is a described risk factor of cardiovascular diseases. The aim of this study was the treatment of hyperhomocysteinemia in liver transplant recipients with L-5-methyltetrahydrofolate (L-5-MTHF; 1 mg) vs folic acid (1 mg) vs placebo in a double-blind placebo-controlled study and to compare the relative responsiveness of these patients to L-5-MTHF and folic acid.

Subjects/Methods:

Patients were recruited from Hepatology-Transplantation-Unit at Johann Wolfgang Goethe-University, Frankfurt. Sixty patients were included in this study and 12 patients dropped out for different reasons. The patients were treated over 8 weeks with supplemental L-5-MTHF or folic acid or placebo. Serum homocysteine (HCY) was analyzed with high-performance liquid chromatography (HPLC) beside routine lab tests.

Results:

We observed only a significant decrease of total serum HCY in the L-5-MTHF group during the study period (at week 0: 15±7.7 μ M; after 8 weeks treatment: 9.41±2.6 μ M, P<0.001). There was no significant decrease of total serum HCY neither in the folic acid group nor in the placebo group.

Conclusion:

The effects of L-5-MTHF are significantly more potent than folic acid itself. Therefore, lowering serum HCY in liver transplant recipients is effective with L-5-MTHF.

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Acknowledgements

The study medication L-5-MTHF was provided from Merck Eprova, Schaffhausen in Switzerland. L-5-MTHF, folic acid and placebo were capsuled at Hirsch Pharmacy, Zeil 111, Frankfurt, Germany.

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Authors and Affiliations

  1. 1st Department of Internal Medicine and Gastroenterology, Johann Wolfgang Goethe-University, Frankfurt, Germany

    B Akoglu, H Bolouri, A Jaffari, E Kutschera, W F Caspary & D Faust

  2. Hirsch Pharmacy, Frankfurt, Germany

    M Schrott

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  1. B Akoglu
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  2. M Schrott
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  3. H Bolouri
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  4. A Jaffari
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  5. E Kutschera
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  6. W F Caspary
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  7. D Faust
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Corresponding author

Correspondence to D Faust.

Additional information

Guarantor: B Akoglu.

Contributors: The study was designed and supervised by BA, DF and WFC. MS produced the study medication in his reputable pharmacy. HB, AJ and EK coordinated the patients and the lab work. BA analyzed the data, interpreted the current findings and wrote the paper.

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Akoglu, B., Schrott, M., Bolouri, H. et al. The folic acid metabolite L-5-methyltetrahydrofolate effectively reduces total serum homocysteine level in orthotopic liver transplant recipients: a double-blind placebo-controlled study. Eur J Clin Nutr 62, 796–801 (2008). https://doi.org/10.1038/sj.ejcn.1602778

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602778

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