Yafteh

1. M.Sc Student of nutritional sciences, Faculty of Health, Tabriz University of Medical Sciences

2. Associated professor, Department of Nutritional, Faculty of Health, Tabriz University of Medical Sciences

3. Assistant professor, Department of Internal, Faculty of medicine, Tabriz University of Medical Sciences

Abstract

Background: Ischemic is on of the major cause of death and inabilities in the world. Environmental and nutritional risk Factors such as inadequate intake of vitamin B12 and folic acid followed by high serum total homocysteine concentration

increases the risk of cerebrovascular diseases. The aim of this study was to compare serum level of homocysteine, vitamin B12 and folic acid in Ischemic patients and healthy controls.

Materials and methods: In this case-control study, 45 inpatients subjects (30 M,16 F aged 45-75 years)and 45 age sex matched healthy subjects (29 M and 16 F) were selected. 5ml blood was take for each subject and serum level of homocysteine (using ELISA), vitamin B12 and folate (using RIA) were measured.

Results: There were no significant differences in age and BMI between canes and controls. The Serum homocysteine level in controls war higher than in controls (18.68μmol/L±1.53 vs 9.96μmol/L±0.9, P<0.001) while Serum Vitamin B12 and folate concentrations in patients were lower than in controls 394.28 Pmol/L ±19.39 vs 631.60pmol/L ±33.1 vs 1.53ngml ±0.08, P<0.001, respectively). Serum homocysteine was inversely and significantly Correlated with serum folate Changes and Vitamin B12. 8% and 10% Changes in homocysteine level were explained by Changes in Serum folate and Vitamin B12.

Conclusion: As Low intakes of vitamin B12 and folic acid result in high homocysteine concentration and consequently higher risk for Ischemic cerebrovasular events, proper diet including adequate intake of these vitamins is suggested.

Acne vulgaris is one of the most common skin disorders and Isotretinoin has widely been used as a treatment for its severe and resistant cases in recent years. Considering the controversy over the effect of systemic Isotretinoin on reducing the plasma level of folic acid and the negative effect of this reduction on health, this study was conducted to assess the influence of systemic Isotretinoin on the plasma level of folic acid during the years 2008 and 2009 in Khorramabad city. Materials and Methods: 61 patients including 38 women and 23 men with severe or moderate acne (age mean 23.6+6 y/o) who were resistant to conventional treatments were supplemented with 0.5mg/kg/day of oral Isotretinoin for 30 days. They were instructed not to use any other drugs with an effect on folic acid level or change their diet. The serum levels of folic acid were measured at the baseline and at the end of the treatment period. The statistical analyses were carried out using the paired T-test. Results: The mean levels of folic acid were 26.75+9.42 nmol/lit and 23.6+8.42 nmol/lit at the baseline and after 30 days of Isotretinoin supplementation respectively. This showed a significant decrease in plasma folic acid level (p=0.008). Conclusion: This study revealed a significant reduction in plasma level of folic acid following a 30 day use of oral Isotretinoin in acne patients. Concerning the important role of folic acid in metabolic functions, we recommend further studies to assess the effect of longer periods of Isotretinoin treatment as well as other relevant factors on folic acid metabolism. Moreover, folic acid supplementation and simultaneous use of Isotretinoin is recommended in patients with acne.