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The effect of cholestyramine on intestinal absorption.

Cholestyramine in a mean dosage of 0-6 g/kg/day has been given to 18 children with familial hypercholesterolaemia for between one and two and a half years. With prolonged treatment folate deficiency occurred, as evidenced by a fall in the mean serum folate concentration from 7-7 ng/ml before treatment to 4-4 ng/ml for patients on treatment for over one year; a corresponding lowering of red cell folate was also seen. Oral folic acid 5 mg daily overcame this depletion, and should be given to all patients on long-term anion exchange resins. Prothrombin time has remained normal in all patients; there has been a significant decrease in the mean serum concentrations of vitamins A and E and of inorganic phosphorus over the first two years of treatment, although values remain within the normal range. The routine administration of fat-soluble vitamins appears unnecessary but it is prudent to measure prothrombin time and serum vitamins A and E at intervals. In children who were having a normal intake of dietary fat five out of seven tested had faecal fat of over 5 g/day while on cholestyramine. No chold has developed diarrhoea, and growth has been normal. The concentrations of serum iron, vitamin B12, plasma calcium, and protein did not change significantly in any patient.

Animals↗

[Folate- and iron-deficiency in pregnancy (author's transl)].

In an open study the influence of a pure iron-therapy (Aktiferrin) and a combined iron-folic-therapy (Aktiferrin F) on the blood and the folate levels in the serum of 60 anaemic pregnant women was compared. The prophylactic administration and the therapy of iron and folate acid in pregnancy is demanded because of the results of this examination.

Anemia, Hypochromic↗

The effect of methionine on the metabolism of serine and glycine in vitamin B-12-deficient rats.

The effect of methionine supplementation on glycine and serine metabolism was studied in vitamin B-12-deficient rats which received only 0.2% methionine in the diet. In the perfused liver, incorporation of the C-2 of glycine to the C-3 of serine was increased by addition of methionine to the perfusate. The oxidation of [1-14C]glycine to 14CO2 was however depressed. Unlike methionine, glycine did not have any significant effect on the liver folate coenzyme distribution. Oxidation of [3-14C]serine to 14CO2 both in vivo and in perfused liver was increased by methionine. A major portion of the C-3 radioactivity however was recovered in glucose. Data presented indicate that the rate of oxidation of [2-14C]histidine to 14CO2 is a more sensitive indicator of folate deficiency than the rate of oxidation of [3-14C]serine to 14CO2 although both are presumably tetrahydrofolate dependent.

Animals↗

Folate status worsens in recently institutionalized elderly people without evidence of functional deterioration.

OBJECTIVE: To follow folate status, hematological and cognitive changes during the first year of institutionalization among elderly subjects. DESIGN: Prospective study. SETTING: Long-stay unit of the Dijon University Geriatric Hospital. SUBJECTS: Twenty women and four men older than 65 years admitted consecutively. MAIN OUTCOME MEASURES: Folate and vitamin B-6 dietary intake was evaluated by a five-day record on admission (day 1 or d 1), at day 45 (d 45), day 90 (d 90), day 135 (d 135), day 180 (d 180), day 360 (d 360). Circulating levels of folate, vitamin B-6, total homocysteine (tHcy), blood counts and cognitive performance were determined in parallel. RESULTS: From d 1 to d 360, mean folate and vitamin B-6 intakes remained below the French RDA and mean folate intakes decreased significantly (delta = 10.2%, p < 0.05). Mean plasma or erythrocyte folate decreased significantly (delta = 33.7%, p <0.05 and delta = -30.2%, p < 0.001, respectively) from d 1 to d 360; no significant change was observed for the other blood parameters. The incidence of folate deficiency increased (8% vs. 37% for plasma folate <6.8 nmol/L and 8% vs. 17% for erythrocyte folate <340 nmol/L) from d I to d 360. Mean plasma pyridoxal 5'-phosphate (PLP) remained <20 nmol/L during the one-year follow-up. There was no difference between genders for plasma tHcy. Although mean plasma tHcy was <14 micromol/L. plasma tHcy was >14 micromol/L in about one-third of the subjects. At each period, 50% or more subjects were anemic (Hct <35% in women and Hct <40% in men), but the anemia was normocytic (MCV <100 fL). Subjects had a moderate dementia at admission, and no change was observed during the study. CONCLUSIONS: Subjects were already vitamin B-6 deficient at admission. Folate status was impaired during the study. Low vitamin intakes were the main cause of vitamin B-6 deficiency and folate status deterioration. Hematology and mental status capacity were not aggravated by folate status deterioration. Plasma tHcy didn't appear to be an earlier predictor of folate deficiency.

Aged↗

Nutritional survey in an iron- and folate-deficient population.

A high prevalence of folate and iron-deficiency anemia was found in women and children of Kiryat Shmoneh, an Upper Galilee community. Malnutrition was assumed to be partially responsible for these deficiencies. To verify this assumption, a detailed nutrition survey was carried out in 30 families, comprising 232 individuals in this community. A low overall caloric intake was found in 30% of the population studied. The dietary folates consumed were much below the recommended dietary allowance in all subjects. In over 60% of the subjects investigated, the daily iron intake was also below the recommended allowance. These data support the role of malnutrition in the development of folate and iron deficiencies in the community studied.

Adolescent↗

Iron, vitamin B-12 and folate status in Mexico: associated factors in men and women and during pregnancy and lactation.

To determine the prevalence and causes of anemia in rural Mexico, blood samples and longitudinal dietary data were collected from 187 women, some pregnant and then lactating, and from 72 men. Blood was used to measure anemia, mean cell volume, and plasma ferritin, folate and vitamin B-12. Anemia was found in 33% of the men, 54% of nonpregnant, nonlactating women, 35% of pregnant women and 41% of lactating women, and varied by season. Low iron stores (ferritin) accompanied anemia in only 8% of men compared with 38-67% of women. Low meat intake and poor dietary iron bioavailability were associated with anemia in women. There were no cases of low plasma folate. Low plasma vitamin B-12 was common in all groups, and the incidence increased from 15% at 7 mo of pregnancy to 30% at 7 mo of lactation. Vitamin B-12 was lower in the plasma and milk of anemic lactating women than in plasma and milk of non-anemic lactating women and was classified as deficient in 62% of breast milk samples.

Adult↗

Folate deficiency does not alter the usefulness of the serum transferrin receptor concentration as an index for the detection of iron deficiency in mexican women during early lactation.

The purpose of this study was to investigate the usefulness of soluble serum transferrin receptor (TfR) concentration, TfR index and log TfR:ferritin ratio (TfR outcomes) in detecting tissue Fe deficiency among breast-feeding Otomi women residing in Capulhuac, Mexico (2800 m above sea level) and to determine whether folate deficiency modifies the interpretation of these data. Lactating women (n = 68) provided blood samples at 22 +/- 13 d (mean +/- SD) postpartum. Using the 3-index Fe assessment model with and without Hb, 2 women (3%) had Fe-deficient erythropoiesis, 24 (36%) Fe deficiency anemia, and 19 (29%) indeterminate Fe status; 29 (43%) and 5 (7.5%) women had plasma and erythrocyte folate concentrations below normative cutoff values, respectively. Mean values for TfR outcomes were higher among women classified as Fe deficient than those who were Fe sufficient, but did not differ with low or normal blood folate concentrations. Similarly, TfR outcomes did not differ among women with normocytic or macrocytic erythrocytes. Receiver-operating characteristic (ROC) curves generated for TfR outcomes yielded areas under the curve from 0.62 to 0.68, indicating that each of these measures, on its own, is a poor predictor of tissue Fe deficiency in lactating women. In conclusion, low blood folate concentrations or the presence of macrocytosis in Otomi women from Capulhuac, Mexico (moderate altitude) did not influence the utility of TfR outcomes for the detection of Fe deficiency during early lactation. Further, on their own, TfR, TfR index, and TfR:ferritin ratio were poor predictors of tissue Fe deficiency for any given individual.

Blood Specimen Collection↗

Effect of some anticonvulsant drugs on depletion of folate in rats on a vitamin B12-deficient diet.

Rats fed on vitamin B12-deficient or vitamin B12-supplemented diets and treated with phenobarbitone by intraperitoneal injection for 5 d showed significant increases in the activity of glutamate formiminotransferase in liver. The only significant depletion in liver folate activity was in vitamin B12-supplemented rats that were starved for 48 h. When rats were given the same diets, with phenobarbitone and diphenylhydantoin added, for 12 weeks or more in two separate experiments, significant increases in transferase activity were found only in the livers of animals fed on the deficient diet. However, there was significant depletion of liver folate in animals taking the supplemented diet.

Animals↗

Haematological and haemopoietic studies in an air-breathing fish on cyanocobalamin and folacin deficient diet.

Experimental deficiencies of cyanocobalamin and folacin separately and in combination were induced in an air-breathing teleost fish Channa punctatus with the help of a complete vitamin test diet. Cyanocobalamin deficiency produced normocytic hypochromic anaemia while the folacin deficiency as well as the combined deficiency of both vitamins produced macrocytic hypochromic anaemia. Leucocytosis was observed in the individual and combined deficiencies of these vitamins with significant increase in thrombocytes and decrease in neutrophil population. The relative population of different developing stages in erythropoiesis showed significant change. Thus small lymphoid haemoblast decreased in number while young and mature reticulocyte populations increased. Recovery to normal condition could be obtained by restoring deficient groups of fishes to complete vitamin test diet fortified with an initial i.m. administration of 0.01 mg/g and 0.02 mg/g body wt. of cyanocobalamin and folacin respectively. A comparison of deficiency effects on C. punctatus with Labeo rohita shows that the former, a carnivorous species with higher Hb content in peripheral blood is more susceptible to deficiency than the latter, a herbivorous species of fish with lower Hb values.

Anemia, Hypochromic↗

Folate-deficient human lymphoblasts: changes in deoxynucleotide metabolism and thymidylate cycle activities.

Peripheral blood lymphocytes of healthy volunteers cultured with phytohaemagglutinin in folate-deficient medium exhibit megaloblastic maturation with reduced intracellular folate content. We have employed this in vitro model for megaloblastic maturation to determine accompanying changes in cellular thymidylate cycle activities and deoxynucleotide levels. Folate-deficient cells exhibit a two-fold increase in thymidine kinase and thymidylate synthase activities. These increased activities were reduced to those of folate-replete cells by co-culture of folate-deficient cells with thymidine. Folate deficiency was accompanied by reduced cellular levels of thymidine triphosphate (TTP) and deoxyguanosine triphosphate (dGTP). Exogenous deoxyuridine produced no increase in the reduced levels of TTP of folate-deficient cells but effected a two-fold increase in cellular deoxycytidine triphosphate. Exogenous thymidine increased the reduced TTP levels of folate-deficient cells and corrected the reduced dGTP level; the increase in cellular TTP accompanying exogenous thymidine was more pronounced in folate-deficient cells. These in vitro findings are compatible with a block in de novo thymidylate synthesis and explain in part the reported in vivo changes for the deoxynucleotide pool in megaloblastic marrow cells due to folate or vitamin B12 deficiency.

Deoxyadenine Nucleotides↗

Oral ulceration in HIV infection: investigation and pathogenesis.

Oral ulcerations associated with HIV infection include recurrent aphthous ulcers (RAU). Whereas RAU prevalence is not increased, lesion severity is: among a group of HIV+ patients, 66% had the more severe herpetiform or major RAU. This increased severity suggests that HIV disease-related changes in the immune system may exacerbate RAU. In the peripheral blood of healthy subjects with RAU, CD4:CD8 cell ratios may be reversed and the proportion of T cell receptor-gamma delta + cells increased. HIV disease-related immune system changes are characterized by reversed CD4:CD8, lowered CD4 cell counts and an inverse correlation between CD4 cell counts and per cent activated gamma delta lymphocytes. Adhesion molecules and cytokines involved in lymphocyte homing may be important in RAU pathogenesis: ICAM-I and ELAM are strongly expressed, and TNF alpha production is increased in peripheral blood lymphocytes of healthy patients with RAU. In patients with active HIV disease/AIDS, serum TNF alpha levels are increased. Thalidomide, which inhibits TNF alpha production, is effective treatment for RAU. Some RAU patients have vitamin B12 or folate deficiencies, levels of which are commonly low in HIV+/AIDS patients. However, in a case control study of HIV+ patients, vitamin B12- or folate-deficiencies were not found to be significant risk factors for RAU.

Adult↗