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首页> 外文期刊>Clinical and laboratory haematology >Oral pharmacologic doses of cobalamin may not be as effective as parenteral cobalamin therapy in reversing hyperhomocystinemia and methylmalonic acidemia in apparently normal subjects.
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Oral pharmacologic doses of cobalamin may not be as effective as parenteral cobalamin therapy in reversing hyperhomocystinemia and methylmalonic acidemia in apparently normal subjects.

机译：在明显正常的受试者中，口服钴胺素在逆转高同型胱氨酸血症和甲基丙二酸血症方面，可能不如肠胃外服用钴胺素有效。

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摘要

A postmenopausal female evaluated for thrombophilia because of bone infarcts had mild hyperhomocysteinemia, which increased when hormone replacement was discontinued. Serum folate, cobalamin and methylmalonic acid were normal. Compound heterozygosity for C677T/A1298C methylenetetrahydrofolate reductase polymorphisms was present but oral folic acid failed to lower homocysteine and actually increased methylmalonic acid. Oral cobalamin therapy increased serum cobalamin and partially decreased methylmalonic acid but had no effect on homocysteine. Homocysteine remained unchanged after 11 months of oral cobalamin, folic acid and pyridoxine therapy. However, intramuscular cobalamin promptly decreased both metabolites to normal. Thus, parenteral cobalamin therapy may have greater metabolic effects than oral vitamin therapy even in apparently normal subjects.
机译：绝经后的女性因骨梗塞而进行了血栓形成性评估，并伴有轻度高同型半胱氨酸血症，当激素替代治疗中断时，这种现象会增加。血清叶酸，钴胺素和甲基丙二酸正常。存在用于C677T / A1298C亚甲基四氢叶酸还原酶多态性的化合物杂合性，但口服叶酸未能降低高半胱氨酸，而实际上增加了甲基丙二酸。口服钴胺素治疗可增加血清钴胺素，部分降低甲基丙二酸，但对高半胱氨酸无影响。口服钴胺素，叶酸和吡ido醇治疗11个月后，同型半胱氨酸保持不变。但是，肌内钴胺素会迅速将两种代谢物降低至正常水平。因此，即使在显然正常的受试者中，肠胃外钴胺素治疗也可能比口服维生素治疗具有更大的代谢作用。

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