Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 6;9(1):28.
doi: 10.3390/diagnostics9010028.

4-Pyridoxic Acid/Pyridoxine Ratio in Patients with Type 2 Diabetes is Related to Global Cardiovascular Risk Scores

Rima Obeid  1 , Juergen Geisel  2 , Wilfred A Nix  3
Affiliations
Free PMC article

4-Pyridoxic Acid/Pyridoxine Ratio in Patients with Type 2 Diabetes is Related to Global Cardiovascular Risk Scores

Rima Obeid et al. Diagnostics (Basel). .
Free PMC article

Abstract

Background: Vascular diseases are multifactorial and several risk factors may have synergetic effect on the global vascular risk. Among patients with diabetes, we investigated whether vitamin B6 species differ according to global cardiovascular risk.

Methods: The present observational study included 122 patients with type 2 diabetes (mean (SD) age = 69.9 (9.1) years; 50% men). Concentrations of vitamin B6 vitamers were measured. Classical blood biomarkers and risk factors were used to compute a multivariate risk score.

Results: Plasma concentrations of 4-pyridoxic acid were higher in patients with high risk versus those with low risk scores (48.2 (63.7) vs. 31.9 (15.0) nmol/L; p = 0.031). Plasma pyridoxine was significantly lowered in patients at high risk (2.8 (28.4) vs. 38.1 (127.8) nmol/L; p = 0.003). PAr index (4-pyridoxic acid/pyridoxal + pyridoxal 5'-phosphate) (1.05 (0.07) vs. 0.84 (0.06); p = 0.017) and the ratio of 4-pyridoxic acid/pyridoxine (7.0 (4.8) vs. 3.9 (3.2); p < 0.001) were higher in patients at high risk. After adjustment for cystatin C and C-reactive protein, only pyridoxine and 4-pyridoxic acid/pyridoxine ratio remained significantly different according to vascular risk scores. 4-Pyridoxic acid/pyridoxine ratio was the best marker to discriminate between patients according to their risk scores-area under the curve (AUC) (95% confidence intervals (CI)) = 0.72 (0.62⁻0.81). 4-Pyridoxic acid/pyridoxine ratio was directly related to plasma levels of soluble vascular cell adhesion molecule 1.

Conclusion: Vitamin B6 metabolism was shifted in patients with multiple vascular risk factors. The catabolism to 4-pyridoxic acid was enhanced, whereas the catabolism to pyridoxine was lowered. High 4-Pyridoxic acid/pyridoxine ratio is independently associated with global cardiovascular risk.

Keywords: 4-pyridoxic acid; diabetes; vascular risk; vitamin B6 catabolism; vitamin deficiency.

PubMed Disclaimer

Conflict of interest statement

R.O. received an honorarium from Merck Darmstadt for lectures. The other authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zuo H., Ueland P.M., Midttun O., Vollset S.E., Tell G.S., Theofylaktopoulou D., Travis R.C., Boutron-Ruault M.C., Fournier A., Severi G., et al. Results from the European Prospective Investigation into Cancer and Nutrition Link Vitamin B6 Catabolism and Lung Cancer Risk. Cancer Res. 2018;78:302–308. doi: 10.1158/0008-5472.CAN-17-1923. - DOI - PubMed
    1. Ulvik A., Pedersen E.R., Svingen G.F., McCann A., Midttun O., Nygard O., Ueland P.M. Vitamin B-6 catabolism and long-term mortality risk in patients with coronary artery disease. Am. J. Clin. Nutr. 2016;103:1417–1425. doi: 10.3945/ajcn.115.126342. - DOI - PubMed
    1. Shen J., Lai C.Q., Mattei J., Ordovas J.M., Tucker K.L. Association of vitamin B-6 status with inflammation, oxidative stress, and chronic inflammatory conditions: The Boston Puerto Rican Health Study. Am. J. Clin. Nutr. 2010;91:337–342. - PMC - PubMed
    1. Friso S., Girelli D., Martinelli N., Olivieri O., Lotto V., Bozzini C., Pizzolo F., Faccini G., Beltrame F., Corrocher R. Low plasma vitamin B-6 concentrations and modulation of coronary artery disease risk. Am. J. Clin. Nutr. 2004;79:992–998. doi: 10.1093/ajcn/79.6.992. - DOI - PubMed
    1. Ueland P.M., McCann A., Midttun O., Ulvik A. Inflammation, vitamin B6 and related pathways. Mol. Aspects Med. 2017;53:10–27. - PubMed