Published Online
on December 4, 2003

A more recent version of this article appeared on January 1, 2004

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Submitted on August 8, 2003
Accepted on August 26, 2003

Inflammation, Homocysteine, and Vitamin B6 Status After Ischemic Stroke

P. J. Kelly MB, MS, MRCPI^*; J. P. Kistler MD; V. E. Shih MD; R. Mandell BA; N. Atassi MD; M. Barron BS; H. Lee PhD; S. Silveira BA; and K. L. Furie MD, MPH

From the Stroke Service (P.J.K., J.P.K., N.A., M.B., S.S., K.L.F.) and Amino Acid Laboratory (V.E.S., R.M.), Department of Neurology, and Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass.

^* To whom correspondence should be addressed. E-mail: pjkelly{at}partners.org.

Background and Purpose--Epidemiological studies have described an association between low vitamin B6 (measured as pyridoxal 5'-phosphate [PLP]) and ischemic stroke, independent of homocysteine (tHcy). We investigated B6 status, tHcy, and inflammation (measured by C-reactive protein [CRP]) in patients with stroke and controls.

Methods--Consecutive cases with new ischemic stroke were compared with matched controls. Fasting tHcy, PLP, and CRP were measured.

Results--The adjusted odds ratio of low PLP in the highest compared with the lowest CRP quartile was 16.6 (2, 139.9, P=0.01). Age, CRP, supplemental vitamin use, and albumin were independent predictors of PLP (P<0.05 for all). No relationship was observed between CRP and tHcy.

Conclusion--The relationship between inflammation and low B6 status may partially explain the findings of previous epidemiological studies.

Key words: homocyst(e)ine • inflammation • nutrition • pyridoxine • stroke

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