Pengaruh Penambahan Asam Folat, Vitamin B12 dan B6 pada Pil Besi terhadap Kadar Homocystein Plasma Ibu Hamil Anemia

Rustan, Effendi (2001) Pengaruh Penambahan Asam Folat, Vitamin B12 dan B6 pada Pil Besi terhadap Kadar Homocystein Plasma Ibu Hamil Anemia. Project Report. Center for Research and Development of Nutrition and Food, NIHRD.

Abstract

Background: In the last decade, it has been known that a metabolic effect of folate deficiency is an elevation of total plasma homocysteine. Elevated plasma homocysteine (tHcy) concentrations are associated with the neural tube defects in the foetus in pregnant women. Recent studies have shown that the plasma homocysteine can be lowered by supplementation of folic acid in amount 1-2 times the recommended dietary allowance. Preliminary evidence indicated that vitamin B12 and vitamin B6 may be beneficial when included folic acid supplementation. Objective: To compare the homocysteine lowering potential of folic acid supplementation containing different doses of folic acid, vitamin B12 and B6. Method: Randomised clinical trial with double blinded placebo controlled study. The study was conducted at six villages in the area of four Public Health Centre in Bogor district. Anaemic pregnant women in their 12-20th week of pregnancy (n=74) divided into two groups and received a treatment for 14 week. The control group (n = 36) received capsulated iron pill containing 200 mg ferrous sulfate + 250 ug folic acid, which is equivalent with iron pill's using in anaemia control program. While the treatment group (n = 38) received 200 mg ferrous sulfate + 500 ug folic acid + 250 ug vitamin B12 + 5 mg vitamin B6. Before and after intervention data on haemoglobin, haematocrite, and plasma homocysteine were obtained from all subjects. Results: At the beginning of the study 98,65 % of the pregnant women had mild anaemia (Hb 9.0-10.9 g %) and 1.35 % with moderate anaemia (Hb 7.0-8.9 g%). Plasma homocysteine were normohomocysteinemic with concentrations ranging from 3.0 to 10.9 u mol/L; median value of the two groups was 6.65 umol/L. There was no significant reductions or significant differences (p > 0.05) in plasma homocysteine were observed in the two groups receiving vitamin supplementation. Conclusions: These results suggested that there was no different effect due to the different dosage of folic acid supplement's to plasma homocysteine concentrations, suggesting that 250 ug folic acid a day may be an optimal homocysteine lowering dose, and the addition of vitamin B12 and vitamin B6 supplementation were not necessary.

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