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Vitamin B6 Effects for Women Taking Birth Control Pills

Vitamin B6 Effects on One-Carbon Metabolism

Status
Completed
Phases
Phase 2Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01128244
Enrollment
13
Registered
2010-05-21
Start date
2010-04-30
Completion date
2014-06-30
Last updated
2017-02-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Vitamin B6 Deficiency

Keywords

oral contraceptives, Vitamin B6, birth control pills, amino acids, Vitamin B6 deficiency, Vitamin B6 deficiency in women on oral contraceptives

Brief summary

Chronically inadequate B6 nutritional status is associated with aberrant one-carbon (1C) metabolism and health. Plasma pyridoxal phosphate (PLP) \>30 nmol/L often has been considered to be the cutoff indicative of nutritional adequacy, with 20-30 nmol/L considered marginal deficiency; however, the current Recommended Dietary Allowance (RDA) value was based on a more conservative cutoff of 20 nmol/L plasma PLP. As shown by in the investigators preliminary data, biochemical perturbations occur when humans have marginal B6 deficiency consistent with plasma PLP of 20-30 nmol/L. A prospective study also showed that plasma PLP \<23.3 nmol/L is associated with 1.8-times higher risk of recurrent venous thromboembolism than those with PLP \>23.3 nmol/L. The mechanism by which low B6 intake is associated with risk of vascular disease is not known. Since B6-deficiency has little tendency to raise fasting plasma total homocysteine (tHcy) but yields an elevated tHcy response following a methionine load, low B6 nutriture may lead to repeated transient mild hyperhomocysteinemia following meal consumption. Several reports of associations between elevated plasma C-reactive protein (CRP) and low B6 status have raised the hypothesis that systemic inflammation is prone to occur during B6 deficiency or contributes to low B6 status. The investigators previously found that healthy humans in low B6 status caused by dietary restriction exhibited normal plasma CRP levels. The investigators also postulate that oxidative stress associated with low B6 status, coupled with impaired glutathione synthesis, contributes to such risk. These questions indicate the need for a more thorough understanding of the metabolic changes occurring in low B6 status from marginal B6 intake and from drug interactions such as in women using oral contraceptives.

Detailed description

Potential subjects will undergo a prescreening visit to meet the inclusion criteria, have a history, physical exam and routine labs drawn. The labs will verify the nutritional eligibility of folate, vitamin B12 and vitamin B6. If the inclusion criteria is met then the following will take place. The subjects will come to the University of Florida (UF) Clinical and Translational Science Institute (CTSI) Clinical Research Center (CRC) for a 9 hour infusion (with stable isotope labeled serine, methionine and leucine) twice during the research study. Once at the start of the study and again at day 29. Blood samples will be taken for metabolite analysis. The infusion of nonradioactive, stable isotope labeled amino acids allows determination of the rate of metabolic reactions in one-carbon metabolism. The results from all subjects' blood analyses will provide us with information about rates of several parts of metabolism and vitamin B6 status. During the 2-days prior to the infusion a controlled diet will be required. The subjects will be fed at the CTSI CRC. Dietary calculations and formulations will be conducted by using Minnesota Nutrition Data Systems software. Subjects will come to the CRC twice per day where they will meet with staff, consume morning and evening meals, and will be provided a sack lunch and snacks (including weekends). Protein intake will be kept constant. After the first infusion, all subjects will consume their self-selected usual diets for 28 days along with a commercial B6 supplement providing 10 mg/day. Weekly measurement of blood will be used to verify compliance. All subjects will then consume a 2-day controlled diet at the UF CRC to normalize protein intake, followed by an infusion procedure identical to the first. During the 4-week supplementation period, all subjects will come to the CRC weekly for weighing, blood samples, and consultation with staff. Careful screening, close monitoring and education of subjects, along with weekly monitoring of blood levels, all contribute to a high degree of compliance.

Interventions

DIETARY_SUPPLEMENTVitamin B6

Subjects will receive vitamin B6 supplementation.

PROCEDUREInfusion of labeled serine, methionine and leucine

Subjects will be given an infusion of the stable isotope labeled amino acids, serine, methionine and leucine prior to vitamin B6 supplementation and after 28 days of B6 treatment. In addition, they will receive a special diet 2 days prior to the infusion and will have weekly weight, blood, and visits to the clinic.

Sponsors

University of Florida
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
Yes

Inclusion criteria

* healthy female subjects * normal screening labs * normal body weight * nonpregnant * Plasma PLP\<30nmol/L

Exclusion criteria

* history of gastrointestinal surgery * chronic disease * vitamin supplementation * high protein diet * progesterone * no smoking * chronic drug use * alcoholism * no vitamin supplementation

Design outcomes

Primary

MeasureTime frameDescription
Total Remethylation of HomocysteineBlood samples will be taken prior to infusion and at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7.5, and 9h. Infusions will be conducted at baseline and after 28 daysData from analysis of serine, methionine and leucine in the timed blood samples of all subjects will provide a measurement of the metabolic rate of total remethylation of homocysteine before and after vitamin B6 supplementation.
Flux of Homocysteine Remethylation From Serine-derived CarbonBlood samples will be taken prior to infusion and at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7.5, and 9h. Infusions will be conducted at baseline and after 28 daysData from analysis of serine, methionine and leucine in the timed blood samples of all subjects will provide a measurement of the metabolic rate of homocysteine remethylation from serine-derived carbon before and after vitamin B6 supplementation. These flux values may be slightly higher than flux of total homocysteine remethylation in Outcome Measure 1 because of the small contribution of methionine salvage to the flux measured in Outcome Measure 2.
Fasting Plasma Pyridoxal Phosphate ConcentrationFasting blood samples will be taken at baseline and after 28 days of vitamin B6 supplementation.For all subjects, the concentration of plasma pyridoxal phosphate in fasting blood samples taken before and after the supplementation period will provide a direct measure of vitamin B6 nutritional status.
Fasting Plasma Cystathionine ConcentrationFasting blood samples will be taken at baseline and after 28 days of vitamin B6 supplementation.For all subjects, the concentration of plasma cystathionine in fasting blood samples taken before and after the supplementation period will provide a functional measure of vitamin B6 nutritional status.

Secondary

MeasureTime frameDescription
Plasma 3-hydroxykynurenine ConcentrationApril, 2010 - June, 2014For all subjects, analysis of blood samples before and after vitamin B6 supplementation will allow evaluation of discriminating biomarkers using targeted metabolite profile analysis of one-carbon metabolism and tryptophan catabolism constituents. Also, we will conduct exploratory evaluation and potential identification of new biomarkers using metabolomics analysis on subjects before and after vitamin B6 supplementation.

Countries

United States

Participant flow

Participants by arm

ArmCount
Vitamin B6 Effects in OC Users
Subjects will be given an infusion of the amino acids, serine, methionine and leucine prior to vitamin B6 supplementation and after 28 days of treatment. In addition, they will receive a special diet 2 days prior to the infusion and will have weekly weight, blood, and visits to the clinic. Vitamin B6: Subjects will receive vitamin B6 supplementation. Infusion of amino acids, serine, methionine and leucine: Subjects will be given an infusion of the amino acids, serine, methionine and leucine prior to vitamin B6 supplementation and after 28 days of B6 treatment. In addition, they will receive a special diet 2 days prior to the infusion and will have weekly weight, blood, and visits to the clinic.
13
Total13

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event1
Overall StudyScheduling conflict2

Baseline characteristics

CharacteristicVitamin B6 Effects in OC Users
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
13 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
9 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Gender
Female
13 Participants
Gender
Male
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
2 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
11 Participants
Region of Enrollment
United States
13 participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
0 / 13
serious
Total, serious adverse events
1 / 13

Outcome results

Primary

Fasting Plasma Cystathionine Concentration

For all subjects, the concentration of plasma cystathionine in fasting blood samples taken before and after the supplementation period will provide a functional measure of vitamin B6 nutritional status.

Time frame: Fasting blood samples will be taken at baseline and after 28 days of vitamin B6 supplementation.

Population: Women using oral contraceptives and exhibiting low vitamin B6 status.

ArmMeasureGroupValue (MEAN)Dispersion
Total Homocysteine Remethylation FluxFasting Plasma Cystathionine ConcentrationBaseline prior to vitamin supplementation0.14 micromol/LStandard Deviation 0.06
Total Homocysteine Remethylation FluxFasting Plasma Cystathionine ConcentrationAfter 28-days of vitamin supplementation0.13 micromol/LStandard Deviation 0.06
p-value: 0.45t-test, 2 sided
Primary

Fasting Plasma Pyridoxal Phosphate Concentration

For all subjects, the concentration of plasma pyridoxal phosphate in fasting blood samples taken before and after the supplementation period will provide a direct measure of vitamin B6 nutritional status.

Time frame: Fasting blood samples will be taken at baseline and after 28 days of vitamin B6 supplementation.

Population: Women using oral contraceptives and exhibiting low vitamin B6 status.

ArmMeasureGroupValue (MEAN)Dispersion
Total Homocysteine Remethylation FluxFasting Plasma Pyridoxal Phosphate ConcentrationBaseline prior to vitamin supplementation25.8 nmol/LStandard Deviation 3.6
Total Homocysteine Remethylation FluxFasting Plasma Pyridoxal Phosphate ConcentrationAfter 28-days of vitamin supplementation143 nmol/LStandard Deviation 58
p-value: <0.001t-test, 2 sided
Primary

Flux of Homocysteine Remethylation From Serine-derived Carbon

Data from analysis of serine, methionine and leucine in the timed blood samples of all subjects will provide a measurement of the metabolic rate of homocysteine remethylation from serine-derived carbon before and after vitamin B6 supplementation. These flux values may be slightly higher than flux of total homocysteine remethylation in Outcome Measure 1 because of the small contribution of methionine salvage to the flux measured in Outcome Measure 2.

Time frame: Blood samples will be taken prior to infusion and at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7.5, and 9h. Infusions will be conducted at baseline and after 28 days

Population: Women using oral contraceptives and exhibiting low vitamin B6 status.

ArmMeasureGroupValue (MEAN)Dispersion
Total Homocysteine Remethylation FluxFlux of Homocysteine Remethylation From Serine-derived CarbonBaseline prior to vitamin supplementation6.60 micromol/(kg x hr)Standard Deviation 1.9
Total Homocysteine Remethylation FluxFlux of Homocysteine Remethylation From Serine-derived CarbonAfter 28-days of vitamin supplementation6.92 micromol/(kg x hr)Standard Deviation 2.2
p-value: 0.62t-test, 2 sided
Primary

Total Remethylation of Homocysteine

Data from analysis of serine, methionine and leucine in the timed blood samples of all subjects will provide a measurement of the metabolic rate of total remethylation of homocysteine before and after vitamin B6 supplementation.

Time frame: Blood samples will be taken prior to infusion and at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7.5, and 9h. Infusions will be conducted at baseline and after 28 days

Population: Women using oral contraceptives exhibiting low vitamin B6 status evaluated at baseline and after vitamin B6 supplementation.

ArmMeasureGroupValue (MEAN)Dispersion
Total Homocysteine Remethylation FluxTotal Remethylation of HomocysteineAfter 28-days of vitamin supplementation5.63 micromol/(kg x hr)Standard Deviation 1.1
Total Homocysteine Remethylation FluxTotal Remethylation of HomocysteineBaseline prior to vitamin supplementation6.07 micromol/(kg x hr)Standard Deviation 1.1
p-value: 0.2t-test, 2 sided
Secondary

Plasma 3-hydroxykynurenine Concentration

For all subjects, analysis of blood samples before and after vitamin B6 supplementation will allow evaluation of discriminating biomarkers using targeted metabolite profile analysis of one-carbon metabolism and tryptophan catabolism constituents. Also, we will conduct exploratory evaluation and potential identification of new biomarkers using metabolomics analysis on subjects before and after vitamin B6 supplementation.

Time frame: April, 2010 - June, 2014

Population: Women using oral contraceptives and exhibiting low vitamin B6 status.

ArmMeasureGroupValue (MEAN)Dispersion
Total Homocysteine Remethylation FluxPlasma 3-hydroxykynurenine ConcentrationBaseline prior to vitamin supplementation25.9 microl/LStandard Deviation 14
Total Homocysteine Remethylation FluxPlasma 3-hydroxykynurenine ConcentrationAfter 28-days of vitamin supplementation27.3 microl/LStandard Deviation 14
Comparison: Data were analyzed by paired t-test adjusted for multiple testing by Sidak methods.p-value: <0.05t-test, 2 sided

Source: ClinicalTrials.gov · Data processed: Mar 19, 2026