Ethnicity Does Not Affect the Homocysteine-Lowering Effect of B-Vitamin Therapy in Singaporean Stroke Patients Journal Articles uri icon

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  • Background and Purpose— Increased total homocysteine (tHcy) is a risk factor for stroke. This study examines whether the efficacy of B-vitamins in reducing tHcy is modified by ethnicity in a Singaporean ischemic stroke population. Methods— 505 patients (419 Chinese, 41 Malays and 45 Indians) with ischemic stroke were randomized to receive placebo or B-vitamins. Fasting blood samples collected at baseline and 1 year were assayed for tHcy. MTHFR polymorphisms were genotyped. Results— Ethnicity did not independently determine tHcy at baseline. The magnitude of tHcy reduction by B-vitamin treatment was consistent across ethnic groups (Chinese −3.8±4.5, Malay −4.9±4.2, and Indian −3.3±3.6μmol/L) despite ethnic differences in MTHFR genotype and baseline folic acid (FA) and vitamin B 12 (vitB 12 ) concentrations. Conclusions— Ethnicity does not appear to affect the tHcy-lowering effect of B-vitamins, despite differences in dietary intake and prevalence of MTHFR polymorphisms. This suggests that the effect of B-vitamins in lowering tHcy is generalizable across Asian populations. However, due to relatively small numbers of non-Chinese studied, confirmation in other populations is required.


  • Kasiman, Katherine
  • Eikelboom, John
  • Hankey, Graeme J
  • Lee, Samantha P-K
  • Lim, Joanna P-Z
  • Lee, Jasinda H-Q
  • Chang, Hui-Meng
  • Wong, Meng-Cheong
  • Chen, Christopher PL-H

publication date

  • June 2009

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