Comparison of Serum Homocysteine, Vitamin B12, Vitamin B6 and Folate Levels in Different Glaucoma Types

Byung Ju Choo; Young Hoon Hwang; Joo Hwa Lee; Tai Jin Kim

doi:10.3341/jkos.2013.54.1.104

Journal List > J Korean Ophthalmol Soc > v.54(1) > 1009418

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Choo, Hwang, Lee, and Kim: Comparison of Serum Homocysteine, Vitamin B12, Vitamin B6 and Folate Levels in Different Glaucoma Types

Original Article

J Korean Ophthalmol Soc 2013;54(1):104-111.

Published online: 25 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.1.104

Comparison of Serum Homocysteine, Vitamin B12, Vitamin B6 and Folate Levels in Different Glaucoma Types

Byung Ju Choo, MD¹, Young Hoon Hwang, MD², Joo Hwa Lee, MD, PhD³, Tai Jin Kim, MD^1,

¹Department of Ophthalmology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

²Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University, Seoul, Korea

³Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

Address reprint requests to Tai Jin Kim, MD Department of Ophthalmology, Seoul Paik Hospital #9 Mareunnae-ro, Jung-gu, Seoul 100-032, Korea Tel: 82-2-2270-0082, Fax: 82-2-2266-6159, E-mail: lasiklove@hanmail.net

Received 10 February 2012 Accepted 10 July 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the levels of serum homocysteine, vitamin B12, vitamin B6 and folate in patients with normal-tension glaucoma, pseudoexfoliation glaucoma and high-tension glaucoma.

Methods

Thirty-two healthy subjects, 35 patients with normal-tension glaucoma, 22 patients with pseudoexfoliation glaucoma and 31 patients with high-tension glaucoma were included in the present study. Fasting venous samples were collected from all the participants. The levels of serum homocysteine, vitamin B12, vitamin B6 and folate were measured. One-way analysis of variance was used for the comparison of homocysteine, vitamin B12, vitamin B6 and folate levels among the 4 groups.

Results

The mean homocysteine levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.91 ± 5.11 and 17.60 ± 3.89 μ mol/l, respectively, which were significantly higher than that of the control group (p = 0.014, p = 0.013, respectively). The mean vitamin B6 levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.67 ± 14.32 and 17.00 ± 10.58 nmol/l, respectively, which were significantly lower than that of the control group (p = 0.026, p = 0.008, respectively).

Conclusions

Hyperhomocysteinemia may play a role as a risk factor in the development or progression of pseudoexfoliation glaucoma and high-tension glaucoma.

Keywords: High-tension glaucoma, Homocysteine, Normal-tension glaucoma, Pseudoexfoliation glaucoma, Vitamin B6

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Figure 1.

Distribution of serum homocysteine (A), vitamin B12 (B), vitamin B6 (C) and folate (D) levels in control, normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PXG) and high-tension glaucoma groups. Black squares indicate the mean values; vertical bars indicate the 95% confidence intervals.

Figure 2.

Pathways of homocysteine metabolism involving vitamin B12, vitamin B6 and folate.

Table 1.

Comparison of demographic and clinical characteristics among study groups

	Control (n = 32)	NTG (n = 35)	PXG (n = 22)	High-tension glaucoma (n = 31)	p-value
Age	60 ± 6 (50, 72)	59 ± 7 (48, 70)	62 ± 6(52, 74)	60 ± 7(48, 73)	0.216^*
Sex (M/F)	18/14	20/15	13/9	17/14	0.992^†
Intraocular pressure (mm Hg)	14.74 ± 2.24(13.94, 15.55)	17.07 ± 1.57(16.53, 17.61)	18.11 ± 2.00(17.22, 19.00)	18.23 ±1.90(17.53, 18.92)	<0.001^*
Spherical equivalent (diopter)	–0.62 ± 2.01(−1.35, 0.10)	–0.70 ± 1.95(−1.37, −0.03)	0.35 ± 1.37(−0.25, 0.96)	–0.28 ± 1.73(−0.91, 0.37)	0.210^*
Central corneal thickness (μ m)	552.75 ± 32.65(540.98, 564.52)	546.84 ± 37.29(534.03, 559.65)	520.89 ± 112.53(471.00, 570.78)	549.77 ± 38.51(535.65, 563.90)	0.155^*
Cup-to-disc ratio	0.33 ± 0.06(0.31, 0.35)	0.67 ± 0.07(0.65, 0.70)	0.71 ± 0.11(0.66, 0.76)	0.70 ± 0.08(0.67, 0.73)	<0.001^*

Values are presented as mean ± standard deviation (95% confidence interval).

NTG = normal-tension glaucoma; PXG = pseudoexfoliation glaucoma.

^* One-way analysis of variance

^† Chi-squared test.

Table 2.

Mean ± standard deviation (95% confidence interval) of serum homocysteine, vitamin B12, vitamin B6 and folate in study groups

	Control (n = 32)	NTG (n = 35)	PXG (n = 22)	High-tension glaucoma (n = 31)	p-value^*
Homocysteine (μ mol/l)	14.15 ± 4.57(12.51, 15.80)	15.17 ± 4.19(13.73, 16.60)	17.91 ± 5.11(15.64, 20.17)	17.60 ± 3.89(16.17, 19.02)	0.003^†
Vitamin B12 (pg/ml)	479.03 ± 216.83(400.86, 557.21)	490.28 ± 198.33(422.15, 558.41)	491.56 ± 241.69(384.40, 598.71)	495.48 ± 225.83(412.64, 578.31)	0.992
Vitamin B6 (nmol/l)	32.42 ± 30.56(21.40, 43.44)	24.05 ± 10.78(20.35, 27.76)	17.67 ± 14.32(11.32, 24.02)	17.00 ± 10.58(13.12, 20.88)	0.006^‡
Folate (ng/ml)	9.83 ± 5.36(7.90, 11.76)	9.34 ± 2.10(8.62, 10.06)	10.36 ± 2.99(9.04, 11.69)	11.34 ± 2.93(10.27, 12.42)	0.141

Values are presented as mean ± standard deviation (95% confidence interval).

NTG = normal-tension glaucoma; PXG: pseudoexfoliation glaucoma.

^* One-way analysis of variance with post hoc analysis

^† Control > PXG/high-tension glaucoma with high IOP by post hoc analysis

^‡ Control > PXG/ high-tension glaucoma with high IOP by post hoc analysis.

Table 3.

Correlation between intraocular pressure and serum homocysteine in study groups

	Correlation coefficient	p-value^*
Control	–0.197	0.280
NTG	0.132	0.449
PXG	0.099	0.663
High-tension glaucoma	0.086	0.646

NTG = normal-tension glaucoma; PXG = pseudoexfoliation glaucoma.

^* Spearman's correlation.

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