Martin Čaprnda a Katarína Rašlová
Homocysteine is an amino acid which is product of methionine demethylation. Mildly elevated plasmatic level of homocysteine is associated with increased risk of atherosclerosis. Folic acid, vitamin B6 and B12 are cofactors of homocysteine degradation. Several studies found, that administration of those vitamins decreases plasmatic level of homocysteine, but results of randomized clinical trials VISP, NORVIT and HOPE TOO failed to prove decrease of cardiovascular events in spite of lowered homocysteine level. These results don’t necessarily mean that homocysteine theory as risk factor of atherogenesis is incorrect; there are various opinions why supplementation with folic acid, vitamin B6 and B12 failed to prove clinical benefit for patients. We should consider alternative approaches to reducing homocysteine metabolism.