Homocysteine, vitamin B12 and folate levels in Iranian patients with ischemic stroke

Objectives: Homocysteine, folate, and some group B vitamins have been proposed as a cause of Cerebro-Vascular Accidents (CVA). We conducted a case-control study to compare the plasma levels of folate, vitamin B12 and homocysteine in Iranian subjects with and without cerebro-vascular accident. Methods: We recruited 82 patients with ischemic stroke as cases and 60 subjects as controls (using simple nonrandom sampling). Homocysteine was measured by fluorimetric high-performance liquid chromatography. Plasma folate and vitamin B12 levels were measured by an ion-capture method. Results: Mean plasma level of vitamin B12 in cases and controls were 358.4 +/- 290.3 Pg/ml and 369.8 +/- 110.4 Pg/ml, respectively which did not show any significant difference. Mean plasma level of folate in cases was significantly lower than the controls (6.8 +/- 4.5 ng/ml vs. 12.2 +/- 3.0 ng/ml, p=0.001). It was also shown that mean plasma level of total homocysteine in cases was significantly higher than the controls (21.1 +/- 9.8 mu M/L vs. 13.5 +/- 3.2 mu M/L, P=0.001). Homocysteine and folate but not plasma B12 had linear relation with age. Male cases had significantly lower Folate and B12 in contrast to women. In addition, male cases had significantly higher Homocysteine level in contrast to women. Conclusions: Our data shows that the level of homocysteine was higher and the level of folate was significantly lower in patients with ischemic stroke in contrast to controls. Effectiveness of supplementary folate and B 12 in such patients needs further well-structured prospective placebo controlled studies.