British Journal of Nutrition

Review Article

Vitamin B6: a challenging link between nutrition and inflammation in CVD

Valentina Lottoa1, Sang-Woon Choia2 and Simonetta Frisoa1 c1

a1 Department of Medicine, University of Verona School of Medicine, Policlinico “G.B. Rossi”, P.le L.A. Scuro 10, 37134 Verona, Italy

a2 Vitamins and Carcinogenesis Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA


The objective of the present review is to highlight the relationship between low vitamin B6 status and CVD through its link with inflammation. While overt vitamin B6 deficiency is uncommon in clinical practice, increasing evidence suggests that marginal vitamin B6 deficiency is rather frequent in a consistent proportion of the population and is related to an increased risk of inflammation-related diseases. Ample evidence substantiates the theory of atherosclerosis as an inflammatory disease, and low plasma vitamin B6 concentrations have been related to increased CVD risk. Several studies have also shown that low vitamin B6 status is associated with rheumatoid arthritis and chronic inflammatory bowel diseases, both of which hold an underlying chronic inflammatory condition. Furthermore, the inverse association observed between inflammation markers and vitamin B6 supports the notion that inflammation may represent the common link between low vitamin B6 status and CVD risk. In addition to the epidemiological evidence, there are a number of cell culture and animal studies that have suggested several possible mechanisms relating impaired vitamin B6 status with chronic inflammation. A mild vitamin B6 deficiency characterises, in most cases, a subclinical at-risk condition in inflammatory-linked diseases which should be addressed by an appropriate individually tailored nutritional preventive or therapeutic strategy.

(Received May 25 2010)

(Revised January 13 2011)

(Accepted January 14 2011)

(Online publication April 13 2011)


c1 Corresponding author: S. Friso, fax +39 45 8027473, email


Abbreviations: CAD, coronary artery disease; CRP, C-reactive protein; hs-CRP, high-sensitivity C-reactive protein; MI, myocardial infarction; PLP, pyridoxal 5′-phosphate; RA, rheumatoid arthritis