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Laxative treatment elevates plasma homocysteine: a study on a population-based Swedish sample of old people

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Objectives

Elevated plasma homocysteine might indicate an increased risk of cancer, and cardiovascular and neurological diseases. The homocysteine level depends on the supply of folate and cobalamine, and constipation and/or laxative treatment might compromise this supply. The present study examined the impact of constipation and laxative treatment on the blood levels of homocysteine, folate and cobalamine in a population-based sample of aged people, including consideration of frailty and impaired renal function, both of which may also influence the homocysteine level.

Methods

The study was based on biochemical tests in 341 females and 183 males aged 82 years or older. The concentrations of homocysteine (plasma), folate, cobalamine and urea (serum) were measured in subjects with and without ongoing treatment with laxative drugs. Values were adjusted for age, gender and frailty, as well as for clinical diagnoses and drug therapies known to affect homocysteine levels.

Results

Homocysteine levels were increased and those of folate reduced in aged subjects on laxatives. Homocysteine remained elevated after adjusting for frailty and various neurological disorders. There was no significant effect on homocysteine and folate in constipated subjects without laxatives.

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Acknowledgements

The OCTO-Twin study is a longitudinal study conducted at the Institute of Gerontology (IFG), at the School of Health Sciences in Jönköping, Sweden, in collaboration with the Center for Developmental and Health Genetics at the Pennsylvania State University (PSU), USA, and the Department of Medical Epidemiology at the Karolinska Institute in Stockholm, Sweden. The study was supported by a grant from the National Institute on Aging (NIA: AG 08861), and by the NEPI Foundation.

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Authors and Affiliations

  1. Institute of Gerontology, School of Health Sciences, Jönköping University, Sweden

    Sven E. Nilsson, Sanna Takkinen & Stig Berg

  2. Department of Psychology, Göteborg University, Göteborg, Sweden

    Boo Johansson

  3. Division of Medical Gastroenterology, Sahlgren’s University Hospital, University of Göteborg, Göteborg, Sweden

    Gerhard Dotevall

  4. The NEPI Foundation, Medical Research Centre, Malmö University Hospital, 205 02 , Malmö, Sweden

    Arne Melander

  5. Department of Community Medicine, Lund University, Sweden

    Arne Melander

  6. Center for Developmental and Health Genetics, The Pennsylvania State University, University Park, PA, USA

    Gerald McClearn

Authors
  1. Sven E. Nilsson
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  2. Sanna Takkinen
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  3. Boo Johansson
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  4. Gerhard Dotevall
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  5. Arne Melander
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  6. Stig Berg
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  7. Gerald McClearn
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Correspondence to Arne Melander.

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Nilsson, S.E., Takkinen, S., Johansson, B. et al. Laxative treatment elevates plasma homocysteine: a study on a population-based Swedish sample of old people. Eur J Clin Pharmacol 60, 45–49 (2004). https://doi.org/10.1007/s00228-003-0721-0

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  • DOI: https://doi.org/10.1007/s00228-003-0721-0

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