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Low plasma vitamin B-6 status affects metabolism through the kynurenine pathway in cardiovascular patients with systemic inflammation.

Abstract
It is unclear whether reduced plasma pyridoxal 5'-phosphate (PLP) during inflammation reflects an altered distribution or increased requirement of vitamin B-6 that may impair overall vitamin B-6 status in tissues. In plasma from 3035 patients undergoing coronary angiography for suspected coronary heart disease, we investigated if plasma concentrations of any metabolites in the kynurenine pathway, which depend on PLP as cofactor, may serve as metabolic marker(s) of vitamin B-6 status. We also examined the association of vitamin B-6 status with serum or plasma concentrations of several inflammatory markers. Among the kynurenines, only 3-hydroxykynurenine (HK) was inversely related to PLP and showed a positive relation to 4 investigated inflammatory markers. A segmented relationship was observed between PLP and HK, with a steep slope at PLP concentrations < 18.4 nmol/L, corresponding to the 5th percentile, and an almost zero slope at higher PLP concentrations. Low PLP and the steep PLP-HK slope were essentially confined to participants with 1 or more inflammatory markers in the upper tertile. Oral supplementation with pyridoxine hydrochloride (40 mg/d) for 1 mo increased plasma PLP 8-fold, reduced the geometric mean (95% CI) of HK from 29.5 to 20.2 nmol/L (P < 0.001), and abolished the steep segment of the PLP-HK curve. The steep inverse relationship of plasma PLP with HK at low plasma PLP and the lowering of HK by pyridoxine suggest plasma HK as a metabolic marker of vitamin B-6 status. Thus, low plasma PLP during inflammation may reflect impaired cellular vitamin B-6 status, as indicated by the concurrent increase in plasma HK.
AuthorsOivind Midttun, Arve Ulvik, Eva Ringdal Pedersen, Marta Ebbing, Oyvind Bleie, Hall Schartum-Hansen, Roy Miodini Nilsen, Ottar Nygård, Per M Ueland
JournalThe Journal of nutrition (J Nutr) Vol. 141 Issue 4 Pg. 611-7 (Apr 01 2011) ISSN: 1541-6100 [Electronic] United States
PMID21310866 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • 3-hydroxykynurenine
  • Kynurenine
  • Pyridoxal Phosphate
  • Vitamin B 6
  • C-Reactive Protein
Topics
  • Adult
  • Aged
  • C-Reactive Protein (analysis)
  • Coronary Disease (metabolism)
  • Female
  • Humans
  • Inflammation (metabolism)
  • Kynurenine (analogs & derivatives, blood, metabolism)
  • Male
  • Middle Aged
  • Pyridoxal Phosphate (blood)
  • Vitamin B 6 (administration & dosage, blood)

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