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. 2012 Jul;142(7):1280-5.
doi: 10.3945/jn.111.153056. Epub 2012 May 23.

Plasma pyridoxal-5-phosphate Is Inversely Associated With Systemic Markers of Inflammation in a Population of U.S. Adults

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Plasma pyridoxal-5-phosphate Is Inversely Associated With Systemic Markers of Inflammation in a Population of U.S. Adults

Lydia Sakakeeny et al. J Nutr. .
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Low vitamin B-6 status, based on plasma concentrations of pyridoxal-5-phosphate (PLP), has been identified in inflammatory diseases, including cardiovascular disease, rheumatoid arthritis, inflammatory bowel disease, and diabetes. Our objective was to examine the association between plasma PLP and multiple markers of inflammation in a community-based cohort [n = 2229 participants (55% women, mean age 61 ± 9 y)]. We created an overall inflammation score (IS) as the sum of standardized values of 13 individual inflammatory markers. Multivariable-adjusted regression analysis was used to assess the associations between the IS and plasma PLP. Geometric mean plasma PLP concentrations were lower in the highest tertile category of IS relative to the lowest (61 vs. 80 nmol/L; P-trend < 0.0001). Similarly, the prevalence of PLP insufficiency was significantly higher for participants in the highest compared with the lowest tertiles for IS categories. These relationships persisted after accounting for vitamin B-6 intake. Also, there were significant inverse relationships between plasma PLP and 4 IS based on functionally related markers, including acute phase reactants, cytokines, adhesion molecules, and oxidative stress. In addition, secondary analyses revealed that many of the individual inflammatory markers were inversely associated with plasma PLP after adjusting for plasma C-reactive protein concentration. This study, in combination with past findings, further supports our hypothesis that inflammation is associated with a functional deficiency of vitamin B-6. We discuss 2 possible roles for PLP in the inflammatory process, including tryptophan metabolism and serine hydroxymethyltransferase activity.

Conflict of interest statement

Author disclosures: L. Sakakeeny, R. Roubenoff, M. Obin, J. D. Fontes, E. J. Benjamin, Y. Bujanover, P. F. Jacques, and J. Selhub, no conflicts of interest.


Decrease in plasma PLP with higher IS at each level of vitamin B-6 intake in 1863 participants of the seventh examination of the Framingham Offspring Study. The IS is the sum of Z-scores of CRP, fibrinogen, IL-6, TNFα, TNFR-2, osteoprotegerin, P-selectin, CD40L, ICAM-1, MCP-1, myeloperoxidase, LPLP-A2 mass, LPLP-A2 activity, and isoprostanes. Geometric means (95%CI) of plasma PLP (nmol/L) from participants of the seventh examination (n = 1863) adjusted for sex, age, BMI, plasma homocysteine, folate, vitamin B-12, creatinine, total cholesterol, protein intake, energy intake, NSAID use, and cigarette use. P-trend for the relation between plasma PLP and IS stratified by vitamin B-6 intake was derived by entering IS into the model as a continuous rather than categorical variable. n = 631 for vitamin B-6 intake >4.2 mg/d, n = 610 for vitamin B-6 intake between 2.2 and 4.2 mg/d, and n = 622 for vitamin B-6 intake <2.2 mg/d. CD40L, CD40 ligand; ICAM-1, intracellular adhesion molecule-1; IS, inflammation score; LPLP-A2, lipoprotein phospholipase A2; MCP-1, monocyte chemoattractant protein-1; NSAID, nonsteroidal antiinflammatory drug; PLP, pyridoxal-5-phosphate; TNFR-2, TNF receptor-2.

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