SERUM CONCENTRATIONS OF PYRIDOXINE, FOLIC ACID, COBALAMIN, AND HOMOCYSTEIN IN CHILDREN WITH SYNCOPE DUE TO ORTHOSTATIC HYPOTENSION
DOI:
https://doi.org/10.11603/24116-4944.2022.2.13225Keywords:
pyridoxine, folates, cobalamin, homocysteine, syncope due to orthostatic hypotension, childrenAbstract
The aim of the study – to study pyridoxine, folic acid, cobalamin, and homocysteine concentrations in children with syncope due to OH, as well as to investigate the relationships between them and the main clinical and laboratory indicators of syncope.
Materials and Methods. 46 children aged 8–17 years were examined: 23 patients with the diagnosis of syncope due to OH and 23 relatively healthy children. Diagnostic criteria of the European Society of Cardiology (2018) were used for the diagnosis of syncope due to OH. Serum levels of pyridoxine, folic acid, cobalamin, and homocysteine were measured by quantitative enzyme-linked immunosorbent assay. ECG Holter monitoring and 24-hour ambulatory blood pressure monitoring were performed for both groups of children.
Results and Discussion. Analysis of the vitamin blood composition in the group of syncope due to OH revealed low levels of pyridoxine (11.3±1.3; 16.1±1.2 μg/l; p=0.04) and cobalamin (293.0±19.4; 447,3±22.7 ng/l; p=0.000001), high levels of homocysteine (4.2±0.9; 7.8±0.4 μmol/l; p=0.000001) compared to healthy respondents. Also, in children with syncope due to OH was more frequently (p<0.05) registered suboptimal pyridoxine status (26.1 %), pyridoxine deficiency (17.4 %), folate deficiency (39.1 %), suboptimal cobalamin status (52.2 %), and hyperhomocysteinemia (59.1 %). A decrease in the serum cobalamin concentration was accompanied by a decrease in the pulse rate during almost the entire time of the active orthostatic test. Moreover, an increase in serum homocysteine levels was characterized by an increase night systolic blood pressure (BP), BP variability, hypertensive time index, and area under the curve for the systolic and diastolic BP (p<0.05) based on 24-hour BP readings.
Conclusions. Reduced levels of pyridoxine and cobalamin, and increased levels of homocysteine are observed in the serum of children with syncope due to OH. Although the level of folates in syncope and healthy children did not differ, folic acid deficiency was significantly more frequent in the group of syncope due to OH. Prospects for further research consist in a more detailed study of the vitamin blood composition in children with various types of syncope in order to better understand the pathogenesis of fainting and to optimize treatment and prevention measures.
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