Effect of / 生物医学与环境科学（英文）

Objective@#This study aimed to investigate the effects of @*Methods@#In this study, 0.1% DMG was supplemented in 20% casein diets that were either folate-sufficient (20C) or folate-deficient (20CFD). Blood and liver of rats were subjected to assays of Hcy and its metabolites. Hcy and its related metabolite concentrations were determined using a liquid chromatographic system.@*Results@#Folate deprivation significantly increased pHcy concentration in rats fed 20C diet (from 14.19 ± 0.39 μmol/L to 28.49 ± 0.50 μmol/L; @*Conclusion@#DMG supplementation exhibited hypohomocysteinemic effects under folate-sufficient conditions. By contrast, the combination of folate deficiency and DMG supplementation has deleterious effect on pHcy concentration.

Estimation of serum folate and vitamin B12 levels in children with severe acute malnutrition

Background: Severe acute malnutrition is the important health issue children affected in India. It is often associated with Iron, Vitamin B12 and Folic acid and other micronutrient deficiencies. These reports of declining trend of Iron and folic acid deficiency with implementation of national anemia control programme. Estimation of Serum Folate and Vitamin B12 levels in SAM children aged 6-60 months with anemia was the objective of the study.Methods: A hospital based observational study on 80 children admitted to nutritional rehabilitation center were suffering from severe acute malnutrition (SAM) in the age group of 6-60 months enrolled in the study during the period November 2018 to May 2019 .Data was collected using a predesigned and pretested Proforma, containing details of feeding, socio-economic and development history. Blood samples were sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.Results: Out of 80 children, majority were between the age group of 24-60 months and majority were boys (53.8%). Mean Vitamin B12 and folic acid levels being 384.61 and 8.95 respectively. 45% and 3.8% had vitamin B12 and folic acid deficiencies respectively. Majority of neurological changes and developmental delays were noted in B12 deficient group. Of the 36, B12 deficient children, majority had moderate anaemia (40.2%), normal total count (41.7%), 60% had neutropenia, 44.4% had lymphocytosis, majority had normocytic (30.9%) anemia.Conclusions: There was a moderate to high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.B12 and folate deficiency shall be considered in all cases with SAM irrespective of blood indices. Treatment will have impact on prognosis of child.

Prevalence and factors associated with folate deficiency among Filipino women of child-bearing age

@#Introduction: Folate deficiency is associated with many complications of pregnancy. A cross-sectional survey was conducted to determine the prevalence and factors associated with deficiency in red blood cell (RBC) folate among Filipino women of child-bearing age in the Province of Batangas, Philippines. Methods: A total of 184 Filipino women aged 15 to 49 years were interviewed on their socio-economic and demographic profiles. Mean energy and folate intakes were obtained using food recalls over a three-month period. RBC folate was used to measure long-term folate status and analysed through immuno-assay method. Results: About two in ten women were folate deficient based on the normal cut-off points (<400 ng/mL) preventive of neural tube defect-affected pregnancies. Respondents have very low intake of folate at 81 and 239 micrograms dietary folate equivalent (µg DFE) from dietary sources and with folic acid supplementation, respectively. Vegetable gardening and livestock raising (p<0.10) and use of folic-acid containing supplements showed significant correlations with folate status (p<0.05). Further, regression analysis showed that among the significant factors, the non-usage of folic acid-containing supplements showed increased likelihood of RBC folate deficiency by six times compared to users (OR=6.391, p<0.10). Conclusion: The findings of the study suggest a high prevalence of folate deficiency among Filipino women. Folate is an essential nutrient for healthy pregnancy. It is important that women, capable of bearing a child must assure adequate folate intake from foods and folic-acid containing supplements. The study recommends a more aggressive campaign on the importance of folate among women of child-bearing age.

Pruebas bioquímicas para el diagnóstico de anemia megaloblástica / Biochemical tests for diagnosis of megaloblastic anemias / Testes bioquímicos para o diagnóstico de anemia megaloblástica

Es intención de este trabajo hacer un breve repaso sobre el metabolismo de la Vitamina B12 y del Folato o Vitamina B9. Estas dos vitaminas hidrosolubles juegan un papel importante en el metabolismo celular. Son cofactores de reacciones metabólicas de transferencia de grupos monocarbonados, esenciales para el mantenimiento de la vida. Además se describen las nuevas determinaciones de laboratorio, se evalúan cuáles son los estudios necesarios para arribar a un correcto diagnóstico del paciente con Anemia Macrocítica (AM), su etiología y cómo muchas drogas de uso frecuente en medicina producen AM. Se realiza también la evaluación del conjunto de metodologías que se pueden efectuar como rutina en el laboratorio especializado en hematología y se propone un algoritmo para el diagnóstico del paciente con AM.

The aim of this article is to make a little review on Vitamin B12 and Folate or Vitamin B9 metabolism. These hydrosoluble vitamins have a very important role in cell metabolism. They are cofactors in metabolic reactions of methyl group transfer, essential for life maintaining. Furthermore, new laboratory tests are described, and it is evaluated which the necessary studies are to arrive at a correct diagnosis for macrocytic anemia (MA) patients, their etiology, and how many drugs frequently used in medicine originate MA. Also, the set of methodologies that can be carried out routinely in the laboratory specialized in hematology is evaluated. Finally, a diagnosis algorithm to detect MA in patients is proposed.

Este trabalho visa a realizar uma breve revisão sobre o metabolismo da Vitamina B12 e do Folato ou Vitamina B9. Estas duas vitaminas hidrossolúveis têm um papel importante no metabolismo celular. São cofatores de reações metabólicas de transferência de grupos monocarbonados, essenciais para manter a vida. Também são descritas novas determinações de laboratório, avaliam-se quais são os estudos necessários para chegar a um diagnóstico correto do paciente com Anemia Macrocítica (AM), sua etiologia e de qué maneira muitas drogas de uso frequente em medicina produzem AM. Realiza-se também a avaliação do conjunto de metodologias que podem realizar-se como rotina no laboratório especializado em hematologia e se propõe um algoritmo para o diagnóstico do paciente com AM.

Malnutrition and central retinal vein occlusion in a young man.

Can vitamin B12 and folate deficiency cause central retinal vein occlusion? We conducted a literature search to find out whether nutritional deficiency of vitamin B12 and folate can lead to impaired vision. The patient in the article reported in Ophthalmology, department of MMIMSR, Haryana, India, with complain of gradual painless visual loss over six weeks. He was found to have unilateral central retinal vein occlusion with significant anemia and vitamin B12 and folate deficiency. Vitamin B12 and folate deficiency can lead to elevated levels of homocysteine. We found a large amount of published data relating central retinal vein occlusion to elevated homocysteine levels, but there was a lack of conclusive evidence for this association Patients should be asked about their dietary history where a thrombotic event is suspected or confirmed.

Los niveles de ácido fólico en la población venezolana y su impacto en el área de salud pública / Folic acid levels in the venezuelan population and its impact on public health

Los folatos, constituyen cofactores fundamentales para los procesos bioquímicos que conducen a la sintesis y eventual modificación epigénetica de ácidos nucleicos e histonas. Además, su metabolismo está intimamente relacionado al metabolismo de la homocisteina. Se han descrito numerosas causas de mal funcionamiento del ciclo metabólico de folatos, la causa más frecuente y quizas la más relevante desde el punto de vista de salud pública es la deficiencia nutricional. El papel central del folato en la sintesis y posteriores modificaciones epigenéticas del material genético, por una parte, así como su relación con la homeostasis de la homocisteina, lo han asociado a dos tipos de patologías de gran importancia en salud pública: a) Enfermedades cardiovasculares y b) Defectos del desarrollo embrionario. En la actualidad, su papel en el riesgo cardiovascular es sujeto de controversia ya que estudios clínicos poblacionales no lo respaldan, sin embargo, si existe evidencia clara de su papel en la aparición de defectos del desarrollo embrionario, especificamente aquellos centrados en el tubo neural y el sistema cardio-circulatorio. Estas evidencias, llevaron a proponer diversos modelos programáticos en salud pública para prevenir y tratar a nivel poblacional el deficit nutricional de folatos. De los varios modelos ensayados, la fortificación obligatoria de ciertos alimentos de consumo masivo ha demostrado ser el mas exitoso y es actualmente implementado en 54 paises a nivel mundial. En Venezuela, desde la decada del 2000 se ha demostrado experimentalmente una seria deficiencia nutricional de folato, que afecta a más del 70% de la población femenina en edad fertil. A pesar de los múltiples llamados hechos a los responsables de las politicas de salud en el país, Venezuela sigue siendo uno de los pocos paises en la región que no ha implementado un programa de fortificación. Su implementación no requiere de una fuerte inversión oficial, pero si debe ser acompañado de un programa eficiente de seguimiento que permita a) evaluar los beneficios y b) las posibles modificaciones en su implementación(AU)

The folate cofactors are essential for the biochemical processes that lead to the eventual synthesis and epigenetic modification of histones and nucleic acids. In addition, their metabolism is closely related to homocysteine metabolism. While there have been described numerous causes malfunction folate metabolic cycle, the most common and perhaps the most important cause, from the point of view of public health, is nutritional deficiency. The central role of folate in the synthesis and subsequent epigenetic modifications of genetic material, on the one hand, and their relationship with the homeostasis of homocysteine, have been associated with two types of diseases of great public health importance: a) Cardiovascular Diseases b) Defects of embryonic development. Currently, its role in cardiovascular risk is the subject of controversy since this have not received support from population trials , however, there is clear evidence of their role in the onset of embryonic development defects, specifically those focused on the neural tube and the cardio-circulatory system. This evidence, led to propose different program models in public health, at the population level, to attack the nutritional deficit of folates. Of the several models tested, mandatory fortification of certain foods for mass consumption has proved the most successful and is currently implemented in 54 countries worldwide. In Venezuela, since the 2000s it has been shown, experimentally, a serious nutritional folate deficiency, which affects over 70% of the female population of childbearing age. Despite numerous appeals made to those responsible for health policies in the country, Venezuela remains one of the few countries in the region that has not implemented a program of fortification. Its implementation does not requires a strong government investment, but must also be accompanied by an effective monitoring program that allows a) evaluation of the potential benefits and b) support rational implementation of any necessary changes(AU)

Mechanism of intestinal folate transport during folate deficiency in rodent model.

Background & objectives: Folate deficiency is a public health problem and is the most notable for its association with neural tube defect in developing embryo, megaloblastic anaemia, cancers and cardiovascular diseases. The mechanisms of the intestinal folate uptake process have been earlier characterized. However, much less is known about regulation. In this study we evaluated the mechanistic insights of folate absorption in an in vivo model of folate deficiency. Methods: Male Wistar rats were fed folate-containing diet (2 mg/kg folic acid) or a folic acid-free diet over 3 months and folate transport was studied in intestinal brush border membrane vesicles (BBMV). Results: The characterization of the folate transport system in intestinal brush border membrane (BBM) suggested it to be a carrier mediated, acidic pH stimulated, and Na+ independent. Folate deficiency increased the folate transport by altering the Vmax without changing the Km of folate transport process. The increased transport efficiency of the BBM was associated with upregulation of folate transporters at both mRNA and protein level. Interpretation & conclusions: Folate deficiency resulted in significant upregulation of intestinal folate uptake, by increasing number of transporters without any change in specificity of transporters towards its substrate. The observed upregulation was associated with significant increase in reduced folate carrier (RFC) and proton coupled folate transporter (PCFT) expressions, suggesting the transcriptional and translational regulation of folate uptake during folate deficiency.

Prevalence of folate and vitamin B12 deficiency in Mexican children aged 1 to 6 years in a population-based survey / Distribución de la prevalencia de deficiencia de folato y vitamina B12 en niños mexicanos de 1 a 6 años de edad. Encuesta con base poblacional

OBJECTIVE: To describe the magnitude and distribution of folate and vitamin B12 deficiency in Mexican children. MATERIALS AND METHODS: Folate and vitamin B12 serum concentrations were measured in a probabilistic sample of 2 099 children. Adjusted prevalence, mean concentrations and relevant associations were calculated based on series of logistic and linear regression models. RESULTS: The overall prevalence of folate and vitamin B12 deficiency were 3.2% and 7.7%, respectively. The highest prevalence of folate was found in the 2-year-old (7.9%), and of vitamin B12 in the 1 year-old (9.1%) groups. Being a beneficiary of the fortified milk program Liconsa was protectively associated with serum folate (p=0.001) and daily Intake of milk with vitamin B12 (p=0.002) concentrations. CONCLUSIONS: We describe the magnitude of folate and vitamin B12 deficiencies in Mexican children. The deficiency of both vitamins in children under 2 years old is a moderate public health problem in Mexico.

OBJETIVO: Describir la magnitud de la deficiencia de folato y vitamina B12 en niños mexicanos. MATERIAL Y MÉTODOS: Se midieron las concentraciones séricas de folatos y vitamina B12 en una muestra probabilística de 2 099 niños. Se calcularon prevalencias ajustadas, medias de las concentraciones y las asociaciones relevantes mediante una serie de modelos de regresiones logísticas y lineales. RESULTADOS: La prevalencia global de deficiencia de folatos y vitamina B12 fueron 3.2% y 7.7%, respectivamente. La prevalencia más alta de folatos se encontró en el grupo de 2 años (7.9%) y de la vitamina B12 en los de 1 año de edad (9.1%). Ser beneficiario del programa de leche fortificada Liconsa estuvo asociado de manera protectora con el folato serico (p=0.001) y la ingestión diaria de leche con la de vitamina B12 (p=0.002). CONCLUSIONES: La deficiencia de ambas vitaminas, en los niños menores de dos años, es un problema de salud pública de magnitud moderada en México.

Two Cases Report of Subacute Combined Degeneration in Association with Folate Deficiency

Subacute combined degeneration is the clinical syndrome associated with vitamin B12 deficiency and characterized by usually symmetrical weakness and progressively worsening of, and abnormal sensations of the legs, arms, trunk, or other area, mental abnormalities, and vision difficulties. Subacute combined degeneration primarily affects the spinal cord, but it also includes damage to the brain, the nerves of the eye, and the peripheral (body) nerves. In this study, we report two patients with subacute combined degeneration of the cord in association with folate deficiency. Subacute combined degeneration of the spinal cord and optic atrophy occurred only in the patients with vitamin B12 deficiency. However, diet-induced folic acid deficiency and subacute combined degeneration of the spinal cord which improved significantly after treatment with folic acid has been recorded.

COMPARISON STUDY OF PLASMA FOLATE IN CHINESE ADULTS IN GENDERS AND AGES / 营养学报

Objective: To describe the differences of plasma folate concentration and prevalence of folate deficiency in genders and ages in Chinese adults aged 35 to 64 years. Methods: By cross-sectional analysis, plasma folate concentration was measured in 2 545 adults including men and women by microbiological assay. Results: (1) Men tended to have lower plasma folate concentration and higher prevalence of folate deficiency(9.70 nmol/L, 31.0%) than did women(14.2 nmol/L, 12.5%, P=0.001). (2) Men in South have significantly higher plasma folate concentration and lower prevalence of folate deficiency than in North. The difference of plasma folate concentration was not evident between urban and rural area, but evident in North between in winter and spring. There were no significant differences of prevalence of folate deficiency for men between urban and rural areas in both regions. For women, the differences of plasma folate concentration in areas were significant, which were higher in South and urban, and lower in North and rural areas. (3) Plasma folate concentration increased with age in Southern men. A similar trend for others was not significant. Conclusion: Men have lower plasma folate concentration and higher prevalence of plasma folate deficiency than do women. The distribution of plasma folate concentrations in urban and rural areas seems different between men and women.