Effect of Methylprednisolone and Interferon Treatment on Blood Vitamin B12, Folic Acid and Homocysteine Levels in Patients with Multiple Sclerosis

Yıl 2019, Cilt: 4 Sayı: 3, 325 - 338, 30.09.2019

Mesrure Köseoğlu , İpek Midi Tülay Çevlik Serkan Özben , Goncagül Haklar Dilek Günal

https://doi.org/10.26453/otjhs.472020

Öz

Changes in blood homocysteine, vitamin B12 and
folic acid levels have been reported during multiple sclerosis (MS) and
treatment period; however, the exact mechanism has not been enlightened. We investigated the changes of serum
B12, folic acid, and plasma homocysteine levels before and after high-dose IV
methylprednisolone treatment and after interferon-β treatment in patients
admitted with an acute attack of MS.31 patients followed for clinically
definite MS (8 male, 23 female) and 10 control individuals were included in the
study. 20 patients were admitted with an acute attack and were administered 1000 mg/day methylprednisolone for 7 days. 27
patients started interferon-β treatment. Serum B12, folic acid, and plasma
Homocysteine levels measured before and after the 1 month after high dose
steroid treatment and after 3-month interferon-β treatment were compared with
pre-treatment levels and healthy controls. Baseline B12 levels were lower in patients with MS than in healthy
controls, which is consistent with previous findings. Both methylprednisolone and interferon-β treatments increased
serum B12 and folic acid levels compared with baseline; however, only the
increase following methylprednisolone treatment was statistically significant.In
our study, elevated B12 and folic acid levels and decreasing of homocysteine
levels without reaching statistical significance following methylprednisolone
have caused different debates.

Anahtar Kelimeler

multiple sclerosis, methylprednisolone, interferon-beta, vitamin B12, folic acid, homocysteine

Multipl Skleroz Hastalarında Metilprednizolon ve İnterferon Tedavisinin Kan Vitamin B12, Folik Asid ve Homosistein Düzeyleri Üzerine Etkisi

Öz

Multipl Skleroz (MS) hastalığının
seyrinde ve tedavi sürecinde homosistein, vitamin B12 ve folik asit
düzeylerindeki değişiklikler bildirilmiş ancak tam mekanizması
aydınlatılamamıştır. Çalışmamızda, akut atak ile başvuran
hastalarda yüksek doz metilprednizolon tedavisi öncesinde, sonrasında ve interferon-β tedavisi sonrasında
serum B12, folik asit ve homosisitein düzeylerindeki değişiklikler
incelenmiştir. Çalışmaya 1 yıl içinde akut atak ile başvuran,
klinik kesin MS tanısı konarak takip edilen 31 hasta (8 erkek, 23 kadın) ve 10 kontrol olgusu dahil edildi. 20 hasta
akut atak ile başvurdu 7 gün süreyle 1000 mg/gün metilprednizolon uygulandı. 27
hastaya interferon-β tedavisi
başlandı. Yüksek doz steroid tedavi sonrası 1. ay düzeyleri ve interferon-β tedavisi alan hastaların 3. ay sonundaki serum vitamin B12, folik asit ve plazma homosistein düzeyleri ölçülerek kontrol grubu ve tedavisi
öncesi düzeyleri ile karşılaştırıldı. Kontrol grubuna göre MS hastalarının
bazal B12 değerleri daha önceki bulgularla tutarlı olarak daha düşüktü. Hem
metilprednizolon, hem de interferon-β tedavisi sonrası B12 ve folik asid değerlerinde
yükselme saptandı ancak sadece metilprednizolon tedavisi sonrasındaki artış istatiksel
olarak anlamlıydı. Çalışmamızda saptanan metilprednizolon sonrası yükselen B12 ve folik asid düzeyleri
ve istatistiksel anlamlılığa ulaşmayan homosistein düzeylerindeki düşme eğilimi farklı
tartışmalar yaratmaktadır.

Anahtar Kelimeler

multipl skleroz, metilprednizolon, interferon-β, vitamin B12, folik asit, homosistein

Kaynakça

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