ADELAIDE, Australia—Research on B vitamins and children with diabetes type 1 has revealed supplementation can normalize endothelial function, a precursor of vascular disease, which begins early in juvenile diabetes and is associated with folate status. Published in the July issue of Pediatrics (118, 1:242-53, 2006) (http://pediatrics.aappublications.org), the study results showed high-dose folate and vitamin B6 normalized endothelial dysfunction in the children, an effect maintained for eight weeks.
The randomized, double-blind, placebo-controlled study involved administration of folate (5 mg/d) and vitamin B6 (100 mg/d)—alone and in combination—for eight weeks in 124 children with type 1 diabetes. Endothelial function, assessed as flowmediated dilation and glyceryltrinitrate-induced dilation with high-resolution ultrasound of the brachial artery, was measured at baseline, at two and four hours after the first dose (n = 35), and at four and eight weeks of treatment (n = 122). From baseline to eight weeks, flow-mediated dilation improved with folate from 2.6% +/- 4.3% (mean +/- SD) to 9.7% +/- 6.0%, with vitamin B6 from 3.5% +/- 4.0% to 8.3% +/- 4.2%, and with folate/vitamin B6 from 2.8% +/- 3.5% to 10.5% +/- 4.4%.
This improvement in flow-mediated dilation occurred within two hours and was maintained at eight weeks for each treatment. Flow-mediated dilation in the placebo group, and glyceryltrinitrate-induced dilation in all groups, did not change. Increases in serum folate, red cell folate, and serum vitamin B6 levels related to increases in flow-mediated dilation. Improvement in flow-mediated dilation was independent of changes in total plasma homocysteine, glucose, hemoglobin A1c and highsensitivity C-reactive protein levels. Baseline red cell folate levels and baseline diastolic blood pressure were related inversely to improvement in flow-mediated dilation. Serum triglyceride and low-density lipoprotein cholesterol inversely related to baseline flow-mediated dilation.
The researchers concluded high-dose folate and vitamin B6 normalized endothelial dysfunction in children with type 1 diabetes; and this effect was maintained over eight weeks, with no additional benefit from combination treatment.