Pakistan Journal of Medical Sciences


ISSN 1681-715X





Volume 26

October - December 2010

Number  4


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High prevalence of mild hyperhomocysteinemia and folate,
B12 and B6 deficiencies in an urban population
in Karachi, Pakistan

Mohsin Yakub1, Mohammad Perwaiz Iqbal2, Ghulam Nabi Kakepoto3, Ghazala Rafique4,
Yousuf Memon5, Iqbal Azam6, Naseema Mehboobali7, Siddiqa Parveen8, Ghulam Haider9


Objective: To find out the prevalence of hyperhomocysteinemia, and deficiencies of folate, vitamin B6 and vitamin B12 in an urban population in Karachi, Pakistan.

Methodology: In a pre and post experimental study, eight hundred and seventy-two apparently healthy adults (aged 18-60 years; 355 males and 517 females) were recruited from a low-income urban locality in East of Karachi from February 2006 to March 2007. Fasting venous blood was obtained. Serum was analyzed for folate and vitamin B12. Plasma was analyzed for pyridoxal phosphate (PLP, coenzymic form of B6) and total homocysteine. A group of vitamin-deficient individuals (n=194) was given 3-week supplementation with folic acid (5mg/day), methycobalamin (0.5mg/day) and pyridoxine hydrochloride (vitamin B6, 50 mg/day). After supplementation, serum/plasma levels of folate, vitamin B12, PLP and homocysteine were again determined.

Results: Prevalence of hyperhomocysteinemia (>15Ámol/l) was 32%. Similarly percent values of folate deficiency (<3.5ng/ml), vitamin B6 deficiency (PLP<20 nmol/l) and vitamin B12 deficiency (<200pg/ml) in the study population were 27.5%, 33.7% and 9.74%, respectively. Hyperhomocysteinemia was associated with male sex, folate deficiency, vitamin B12 deficiency [OR (95%CI), 8.3(5.7-12.1); 2.5(1.76-3.58); 2.6(1.5-4.5), respectively]. A 3-week supplementation with folic acid, methycobalamin and pyridoxine hydrochloride in vitamin-deficient subjects decreased plasma homocysteine levels by 37%.

Conclusion: High prevalence estimates of folate, vitamin B12, and vitamin B6 deficiencies appear to be the major determinants of hyperhomocysteinemia in a low income general population in Karachi.

KEY WORDS: Cardiovascular diseases, Folate deficiency, Hyperhomocysteinemia, Vitamin B6 deficiency, Vitamin B12 deficiency.

Pak J Med Sci    October - December 2010    Vol. 26 No. 4    923-929

How to cite this article:

Yakub M, Iqbal MP, Kakepoto GN, Rafique G, Memon Y, Azam I, Mehboobali N, Parveen S, Haider G. High prevalence of mild hyperhomocysteinemia and folate, B12 and B6 deficiencies in an urban population in Karachi, Pakistan. Pak J Med Sci 2010;26(4):923-929

1. Mohsin Yakub,
2. Mohammad Perwaiz Iqbal,
3. Ghulam Nabi Kakepoto,
Department of Pathology & Microbiology.
4. Ghazala Rafique,
5. Yousuf Memon,
6. Iqbal Azam,
7. Naseema Mehboobali,
8. Siddiqa Parveen,
9. Ghulam Haider,
1,2,7-9: Department of Biological and Biomedical Sciences.
4-6: Department of Community Health Sciences.
1-9: Aga Khan University,
Karachi, Pakistan.


Mohammad Perwaiz Iqbal,
Professor of Biochemistry,
Department of Biological & Biomedical Sciences
Aga Khan University, Stadium Road,
P.O. Box-3500, Karachi-74800,

* Received for Publication: May 21, 2010

* Revision Received: May 28, 2010

* Second Revision: July 27, 2010

* Final Revision Accepted: August 19, 2010


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