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PubMed1988

Folate nutriture in pregnancy.

Folacin intakes from diet and supplements consumed during pregnancy were determined by interview in 566 women. Eight percent of this population (48 women) obtained folacin from diet only. Thirteen percent (76 women) received less than two-thirds of the RDA for folacin for pregnant women. Serum and erythrocyte folate levels in maternal and cord blood were correlated with dietary folacin intakes in subsamples of the group. Women who received their folate from diet alone showed marginal or deficient maternal serum folate levels. Of the group of women whose folacin intake was equal to or greater than the RDA for pregnant women, some had intakes as high as eight times the RDA from supplements. When, in a subsample, total folacin intake was correlated with maternal and cord folate levels, significant correlations were obtained. The high serum and erythrocyte folate levels resulting from self-medication with folate supplements are of concern because of possible deleterious interaction with other nutrients.

Adult↗
PubMed1990

Folate status of adolescents: effects of folic acid supplementation.

This study was designed to determine the folate status of an adolescent population and to demonstrate the effect of folic acid supplementation on subjects with low folate status. In phase one, folate status was evaluated in a biracial sample of 164 adolescents 12 to 15 years old. Socioeconomic, demographic, anthropometric, and 7-day food record data were collected, and serum and erythrocyte folate levels were determined. Thirty-five adolescents considered to have had low folate status 6 months earlier participated in phase two, a 2-month supplementation period and reevaluation. No racial differences were observed in folate status, as indicated by amount of folate in the blood and diet. Boys had significantly (p less than .05) higher folate levels in serum and erythrocytes than did girls. Thirteen percent of the boys and 40% of the girls were folate deficient as judged by amount of erythrocyte folate less than 317 nmol/L (140 ng/mL). The folate-deficient subjects had significantly (p less than .05) lower values of hemoglobin than did the normal subjects. Seventeen percent of the boys and 42% of the girls had folate intakes below the recommended dietary allowance for folate. Supplementation of 400 micrograms folic acid daily for 2 months resulted in significant (P less than .05) increases in serum folate, erythrocyte folate, and hemoglobin values and a decrease in mean corpuscular volume. Evidence of high prevalence of low folate status, positive relationship between erythrocyte folate and hemoglobin, and responses of hemoglobin and mean corpuscular volume to the supplement indicated that folate consumption may not be optimal in some groups of adolescents, especially in girls.

Adolescent↗
PubMed1991

A community study of vitamin B12 and folate levels in the elderly.

OBJECTIVE: To measure the prevalence of low serum vitamin B12, folate, and red cell folate levels and their relationship with other nutritional indices. DESIGN: Prospective survey of elderly subjects using radioisotope dilution assays. SETTING: Primary care medical center, Christchurch, New Zealand. PATIENTS: 257 elderly subjects (age 65 years and over), residing in their own homes or in residential homes, were randomly selected. Of these, 204 (79%) participated. The study population was comparable to the elderly population of New Zealand. MAIN OUTCOME MEASURES: Vitamin B12, serum, and red cell folate levels. RESULTS: The prevalence rates for low levels of serum vitamin B12, folate, and red cell folate were 7.3%, 1%, and 3.3%, respectively. The elderly cohort had lower vitamin B12 (P less than 0.001) but higher serum and red cell folate levels (P less than 0.001) than our normal reference range (age 18-65 years). Red blood cell folate levels showed positive correlations with nutritional indices and mental test scores. No correlations were found between vitamin B12 levels and diet or other nutritional indices. CONCLUSIONS: Low folate levels in older people living at home are infrequent findings. In contrast low vitamin B12 levels are more common. Poor diet and undernutrition may contribute to low folate levels, but these factors are less important for the low B12 levels found.

Aged↗
PubMed1978

Elevated serum levels of unsaturated folate binding protein: clinical correlates in a general hospital population.

We measured the capactiy of unsaturated folate binding protein to bind 3H-pteroylglutamic acid (UFBC) in serums from 489 general hospital patients. Of the patients 20% had mild-to-moderate elevations in UFBC (250 to 500 pg/ml), but only 6% had marked elevations (greater than 650 pg/ml), which correlated with metastatic cancer, active granulomatous disease, and especially with liver disease. The poor correlation of serum UFBC with folate status of the patient suggests that in many instances the elevated serum UFBC is neither the consequence nor the cause of folate deficiency. Although the role of folate binding protein remains unknown, it may be primarily an intracellular protein that is released into the serum as an index of activity of liver cells, granulocytes, and perhaps certain cancer cells.

Adult↗
PubMed1975

The effect of oral contraceptives on folate metabolism. III. Plasma clearance and urinary folate excretion.

The plasma clearance of folic acid (PGA) and urinary excretion of folates were determined in women on oral contraceptives and in control subjects. The initial phase of plasma clearance of PGA (first 5 minutes) was much faster in oral contraceptive users than in the controls, but the subsequent rate of clearance was the same in the two groups. There was a good correlation between the 12-hour urinary folate excretion and serum or red cell folate in both groups. The women on oral contraceptives excreted more folate in their urine for any given level of serum or red cell folate. The increased urinary folate excretion may partly explain the lower serum and red cell folate in oral contraceptive users.

Contraceptives, Oral↗
PubMed2005

Serum folate and homocysteine levels in obese females with non-alcoholic fatty liver.

OBJECTIVE: Folate depletion and hyperhomocysteinemia increase the risk for hepatic alcoholic damage and promote oxidative stress in animals. In addition, some investigators have reported an inverse association between serum folate and body mass index and a positive correlation between total homocysteine and fat mass. We investigated whether there is an association between serum folate and total homocysteine concentrations with the presence of non-alcoholic fatty liver disease (NAFLD) in obese subjects. METHODS: Forty-three obese (body mass index > or =35 kg/m2) patients who underwent bariatric surgery and hepatic biopsy were included. Serum total homocyteine, folate and vitamin B12 concentrations and hepatic enzymes were measured. Liver biopsies were graded for the presence of fat, inflammation, and fibrosis on a scale from 0 to 3. A total histologic score was calculated based on the sum of partial scores. Severe NAFLD was defined as a total score of at least 4 or severe steatosis (partial score for fat = 3). RESULTS: Severe NAFLD was present in 17 patients. Serum folate concentration was significantly lower in obese patients with NAFLD than in those with normal liver or minimal alterations (9.3 +/- 3.5 versus 12.2 +/- 3.1 ng/mL, P = 0.005). Serum total homocysteine and vitamin B12 concentrations were similar in both groups. An inverse correlation between serum folate concentration and body mass index was observed (r = -0.31, P = 0.046). CONCLUSIONS: In this study, severe NAFLD in obese subjects was associated with lower serum folate concentrations and serum homocysteine and vitamin B12 concentrations were not associated with liver damage in obese subjects.

Adult↗
PubMed1997

Folate and vitamin B12 status in a group of preschool children.

UNLABELLED: An adequate intake of folates and vitamin B12 is essential for the rapid growth rates characteristic of infancy. However, little information exists on the prevalence of deficiencies of these nutrients in preschool children. The status of these vitamins was therefore evaluated in a group of 79 children between 2 and 6 years of age. A 5 day dietary record (including a Sunday) was kept for all subjects. All food taken at day care centres was monitored using "Precise individual weighing" and recorded by trained personnel. Measurements were made of serum and erythrocyte folate levels, vitamin B12 levels, number of red blood cells, haemoglobin and haematocrit levels, and mean corpuscular volume. Though the mean intake of folic acid surpassed recommended levels for this age group 31.4% of the subjects showed intakes below those recommended. 7.7% of the subjects showed serum folate levels between 3 and 6 ng/mL, values which indicate a moderate deficiency of this vitamin. A correlation was found between folate intake and serum folate levels r = 0.3654 (P < 0.01). Vitamin B12 intake was 438% that recommended. Only 2.9% of the subjects showed vitamin B12 intake below recommended and none showed serum values below 150 pg/ml, the lower normal limit below which deficiency is considered to exist. CONCLUSION: Amongst preschool children, folate deficiency is probably much more common than vitamin B12 deficiency. However, its incidence is low, and much lower than that observed in other age groups.

Anthropometry↗
PubMed2005

The relationship between serum folate, vitamin B12, and homocysteine levels in major depressive disorder and the timing of improvement with fluoxetine.

The objective of the present study was to examine the relationship between serum folate, vitamin B12, and homocysteine levels and the timing of clinical improvement to fluoxetine in major depressive disorder (MDD) patients. A total of 110 outpatients with MDD who responded to an 8-wk trial of fluoxetine had serum folate, B12, and homocysteine measurements at baseline (prior to fluoxetine initiation). Onset of clinical improvement was defined as a 30% decrease in Hamilton Depression Scale scores that led to a 50% decrease by week 8. Patients with low folate levels ( 0.05). In conclusion, low serum folate levels were found to be associated with a delayed onset of clinical improvement during treatment with fluoxetine in MDD by, on average, 1.5 wk.

Adolescent↗
PubMed2002

Blood folate levels on the Texas-Mexico border.

The Texas-Mexico border population has a high prevalence of neural tube defects (NTDs). In 1998, in an effort to reduce the risk of NTD-affected pregnancies, the US Food and Drug Administration mandated folic acid fortification of enriched grain products. Since then, the median serum folate and red blood cell (RBC) folate levels of US women aged 15 through 44 years has risen. During 1995 through 2000, serum and RBC folate levels of 170 Mexican American women residing on the Texas-Mexico border who had delivered live, normal infants within the previous 3 months were tested. The median serum folate levels rose 46%, and RBC folate levels rose 44%. The increase suggests that food fortification may be affecting folate levels among populations with economic and cultural barriers to consuming fortified foods. However, more data are needed before we can assess the impact of food fortification on NTD rates on the border.

Adolescent↗
PubMed1993

Absorption of pteroylpolyglutamates in mothers of infants with neural tube defects.

The ability to hydrolyse and absorb pteroylpolyglutamates (PteGlun) included in a standard meal in mothers who had given birth to an infant with a neural tube defect was tested by comparing them with mothers who had not had any infants with this defect. When compared with control mothers working in the research unit in which the study was performed, case mothers had significantly lower baseline serum and erythrocyte folate levels, and smaller increases in serum folate following the meal containing PteGlun. However, all estimates of folate were similar when case mothers were compared with a group of mothers who were friends of the case mothers. The results show that the higher the baseline levels of serum and erythrocyte folate the greater the increase in serum folate after the test meal. Fitting a model for the serum folate response curve resulted in coefficients which differed significantly between case mothers and all control mothers. We conclude that intestinal hydrolysis of PteGlun taken orally is not impaired in mothers who have had infants with neural tube defects when compared with control mothers with similar baseline folate levels, although the curves describing the response to the meal for the two groups do differ significantly. Further investigation is required to determine the mechanism underlying this difference.

Adult↗
PubMed1982

Oral contraceptives: effect of folate and vitamin B12 metabolism.

Women who use oral contraceptives have impaired folate metabolism as shown by slightly but significantly lower levels of folate in the serum and the erythrocytes and an increased urinary excretion of formiminoglutamic acid. The vitamin B12 level in their serum is also significantly lower than that of control groups. However, there is no evidence of tissue depletion of vitamin B12 associated with the use of oral contraceptives. The causes and clinical significance of the impairment of folate and vitamin B12 metabolism in these women is discussed in this review of the literature. Clinicians are advised to ensure that women who shop taking "the pill" because they wish to conceive have adequate folate stores before becoming pregnant.

Anemia, Megaloblastic↗
PubMedDate not supplied

Relationship of normal serum vitamin B12 and folate levels to cognitive test performance in subtypes of geriatric major depression.

This retrospective study evaluated the relationships between normal serum vitamin B12 and folate levels and neuropsychologic measures in a sample of 60 geriatric inpatients with psychotic depression, nonpsychotic depression, bipolar disorder, and dementia--all consecutively referred for cognitive testing. The psychotic depression subgroup demonstrated numerous significant positive correlations between B12 and cognitive subtests not seen in other diagnostic subgroups, especially those of IQ, and verbal and visual memory. Metabolic factors including vitamin B12 may play specific roles in the cognitive dysfunctions of different geropsychiatric disorders.

Aged↗
PubMed2002

Folate levels in pregnant women who smoke: an important gene/environment interaction.

OBJECTIVE: The objective of this study was to determine whether serum and red blood cell folate levels were decreased in pregnant women who smoke and whether total plasma homocysteine levels were elevated. STUDY DESIGN: In this cross-sectional study, serum folate, red blood cell folate, and homocysteine were measured in pregnant first- and early second-trimester pregnant women who smoked (case subjects) and pregnant women who did not smoke (control subjects). In addition, vitamin B(12), albumin, creatinine, cotinine, and hematocrit levels and methylenetetrahydrofolate reductase status were determined and compared between groups. RESULTS: Pregnant women who smoked had significantly lower concentrations of serum folate (22.7 vs 29.4 nmol/L; P =.001) and lower concentrations of red blood cell folate (766 vs 900 nmol/L; P =.038 [not significant]) than pregnant women who did not smoke. Dietary folate intake was not significantly different between pregnant women who smoked and pregnant women who did not smoke. Homocysteine levels were also not significantly different between the groups. For each genotype of methylenetetrahydrofolate reductase, lower levels of serum folate were observed in pregnant women who smoked, with the lowest folate levels seen in homozygous mutant methylenetetrahydrofolate reductase 677TT (18.6 nmol/L in pregnant women who smoked vs 24.2 nmol/L in pregnant women who did not smoke). CONCLUSION: Both serum folate and red blood cell folate are lower in pregnant women who smoked than in pregnant women who did not smoke, although homocysteine levels are not significantly different. There is an important gene environment interaction between methylenetetrahydrofolate reductase gene activity and tobacco exposure on serum folate levels. Lower levels of serum folate may account for the higher rate of miscarriage, stillbirth, abruptio placentae, and fetal anomalies that are observed in pregnant women who smoke. Pregnant women who smoke may benefit from higher doses of folic acid periconceptionally.

Adult↗
PubMed1987

Serum ferritin, folate and cobalamin levels and their correlation with anemia in normal full-term pregnant women.

Serum ferritin, folate, cobalamin and hemoglobin concentrations were determined by radioimmunoassay, radioisotopic assay, radioassay and an automated hematology analyser respectively, and then analysed in 221 normal full-term pregnant women in order to evaluate the incidence and the prevalence of nutritional anemia in pregnancy. None of them had received any hematonic during their pregnancy. Their mean age was 27.68 years and the mean duration of pregnancy was 39.51 weeks. Twenty-three (10.41%) of these previously non-anemic pregnant women had clinical anemia after full-term pregnancy. Of the 23 women, 11 (47.83%) had iron-deficiency anemia, with serum ferritin less than 12 micrograms/l; another 11 women had some degree of iron depletion, with serum ferritin less than 20 micrograms/l. So in 22 of the 23 anemic women (95.65%) the cause of anemia may correlate to iron depletion. The remaining one had folate-deficiency anemia. No pure cobalamin deficiency anemia was found in this study. Among the 198 non-anemic normal full-term pregnant women, 92 (46.46%) had iron depletion (serum ferritin less than 20 micrograms/l), of whom 35 (17.68%) had severe iron deficiency, with serum ferritin less than 12 micrograms/l. Another 3 had folate deficiency and 3 had cobalamin deficiency. By including all the anemic and non-anemic pregnant women, 114 (51.58%) of them had some degree of iron depletion. In other words, pregnancy can produce a considerable degree of iron depletion in more than half of the previously non-anemic women.

Adult↗
PubMed2006

[A case-control study on the association between folate and cervical cancer].

OBJECTIVE: To evaluate the possible effects of folate on cervical carcinogenesis and the interaction of folate and human papillomaviruses 16 (HPV16). METHODS: A hospital-based case-control study was conducted. 111 hospitalized cases who were pathologically diagnosed of having cervical cancer and 111 controls identified with hysteromyoma that frequency-matched to cases on age, birth place and residential area. A 60-item food-frequency questionnaire (FFQ) were administered to estimate the consumption of dietary folate. HPV16 DNA in exfoliated cervical cell and serum folate were detected by special PCR and radioimmunoassay respectively. RESULTS: HPV16 infection rate in cases (61.26%) was significantly higher than that in controls (28.83%), with adjusted OR of 4.95(95% CI:2.49-9.83).The levels of dietary folate in cases (5.00 microg/kcal +/- 0.41 microg/kcal) were significantly lower than that in controls (5.14 microg/kcal +/- 0.35 microg/kcal), but the adjusted OR showing no statistical significance. However, serum folate in cases (1.79 ng/ml +/- 1.42 ng/ml) was significantly lower than that in controls(2.59 ng/ml +/- 2.81 ng/ml),and there were significantly increasing trend in the risk of cervical cancer with reducing level of serum folate (chi-squared trend test of P = 0.000). Meanwhile, low-level of serum folate and HPV16-infection showed significant interaction in the development of cervical cancer, with likelihood ratio test of G = 5.56, P = 0.02. CONCLUSION: Results indicated that low levels of folate might increase the risk of cervical cancer, and potential synergistic action might exist between low level of serum folate and HPV16 in the development of cervical cancer.

Case-Control Studies↗
PubMed1975

Serum and erythrocyte folates in combined iron and folate deficiency.

A high incidence of iron and folate deficiency was found in 80 female subjects living in a private institution. Iron therapy in individuals with low serum iron values resulted in a significant increase in hemoglobin levels. An improvement in serum and RBC folate levels was also found following iron therapy but this could not be attributed to treatment since a similar increase was observed in untreated control subjects, probably due to an increased dietary intake of folates during the study period. In subsequent studies small amounts of pteroylglutamic acid were given to all patients and their response to therapy was related to initial serum and RBC folate values. No correlation between serum folate levels and response to folate therapy could be demonstrated. Red cell folate levels on the other hand correlated well with response to therapy. A significant increase in hemoglobin was found following folate therapy in patients with low RBC folates, but not increase in subjects with normal RBC folates. Conversely, the increase in hemoglobin following iron therapy in subjects with normal RBC folates was three times as much as in patients with low RBC folates. Thus, unlike serum folate determinations, RBC folate measurements are a reliable index of tissue folate stores, and useful in the prediction of response to folate therapy in both the iron-deficient and iron-replete states.

Adult↗