Effect of folate supplementation on serum homocysteine and plasma total antioxidant capacity in hypercholesterolemic adults under lovastatin treatment: a double-blind randomized controlled clinical trial

Abstract

Background and aims: Hypercholesterolemia is one of the predisposing factors of cardiovascular diseases. A positive correlation of homocysteine (Hcy) concentration with total cholesterol is described. Lovastatin, one of the most administered agents in hypercholesterolemia, is not effective in lowering the level of serum Hcy and increasing serum total antioxidant capacity (TAC). This study was performed to evaluate the effects of folate supplementation on lowering Hcy level and changes of TAC in asymptomatic hypercholesterolemic adults under lovastatin treatment.

Methods: This was a double-blind randomized controlled clinical trial. Forty asymptomatic newly diagnosed hypercholesterolemic individuals were recruited. Patients were randomized into two groups: group A--20 patients supplemented for 8 weeks with folate (5mg daily) and group B--20 patients receiving placebo. Lovastatin was administered to both groups. Laboratory lipid profiles, serum Hcy and folate concentration, and TAC were measured at the beginning and after the 8(th) week of the study period.

Results: After folate supplementation in group A subjects, serum Hcy was significantly decreased (13.35+/-5.01 micromol/L to 8.43+/-2.52 micromol/L, p=0.001), whereas no significant changes occurred in group B (p>0.05). A significant increase in TAC was only observed in group A (1.54+/-0.24 micromol/L to 1.96+/-0.42 micromol/L, p<0.001).

Conclusions: Folate supplementation decreases the serum level of Hcy and increases TAC. It seems that a pharmacological dose of folate supplementation could potentially decrease the risk of cardiovascular diseases by reducing serum level of Hcy in adults with hypercholesterolemia.