Effect of vitamin B therapy and polymorphism of MS & CBS gene on homocysteine, cardiovascular events in ischemic stroke: A randomized controlled trial

Background: - Cardiovascular disorders is becoming an epidemic among South Asians. The study aim was to detect polymorphism of Methionine synthase & cystathionine beta-synthase genes and effect of vitamin B therapy on homocysteine, and major cardiovascular outcomes. Methods- A randomized controlled trial was conducted upon 90 hyperhomocysteinemic ischemic stroke patients at a tertiary care hospital. Participants were randomly selected into vitamin B therapy (B6, B9 & B12) or the control group (standard hospital treatment) (n=45 in each group) given for four months. Collected data includes genetic polymorphisms, homocysteine levels, vitamin B12, folate levels. Results- Both the genotypic distribution found no significant association with p value 0.3 & 0.7 respectively. The vitamin B therapy group reported significant reduction in homocysteine levels, mRS scores and improvement in vitamin B12, folate levels with p value <0.01. Regression analysis showed that vitamin B 12 levels and green vegetable consumption were significant factors for the homocysteine but polymorphism lacks this association. Conclusion- Polymorphisms were not found to be associated with hyperhomocysteinemia among ischemic stroke. Even though, nutritional deficiencies, consumption of green vegetables proved as independent predictors of the hyperhomocysteinemia. The vitamin B therapy has been proficiently reduced homocysteine and improve nutritional deficiencies in this area.