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1.
Biomarkers ; 24(7): 684-691, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31382779

RESUMO

Background: Australia implemented mandatory folic acid fortification of bread-making flour in 2009. Objective: To assess the impact of folic acid fortification in remote vs. regional urban areas and Indigenous vs. non-Indigenous populations in northern Queensland. Methods: Routinely collected data on folic acid measurements in remote areas and two regional urban centres in northern Queensland between 2004 and 2015 were analysed (n = 13,929) dichotomously (folic deficient vs. non-deficient). Results: Overall prevalence of folic acid deficiency was 3.2% (235/7282) in urban centres compared with 7.2% (480/6647) in remote areas (p < 0.001), and 9.3% (393/4240) in the Indigenous population compared with 3.2% (273/8451) in the non-Indigenous population (p < 0.001). Prevalence of folic acid deficiency dropped from 12.2% (n = 481) in 2004-2008 to 1.5% (n = 126) in 2010-2015 (p < 0.001). This translates into a relative risk reduction (RRR) of 88%. RRR was 79% (7.2% vs. 1.5%) in urban centres, 91% (17.3% vs. 1.5%) in remote areas, 92% (20.5% vs. 1.6%) in the Indigenous population and 80% (7.4% vs. 1.5%) in the non-Indigenous population (p < 0.001 for all). Conclusions: Substantial declines of folic acid deficiency to low and comparable proportions in former high-risk populations indicate that mandatory folic acid fortification of flour has had a population-wide benefit in northern Queensland.


Assuntos
Deficiência de Ácido Fólico/epidemiologia , Ácido Fólico/uso terapêutico , Nível de Saúde , Estado Nutricional , Austrália , Análise de Dados , Farinha , Deficiência de Ácido Fólico/tratamento farmacológico , Humanos , Programas Obrigatórios , Prevalência , Queensland/epidemiologia , Saúde da População Rural/normas , Saúde da População Urbana/normas
2.
J Clin Neurosci ; 65: 11-16, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31076249

RESUMO

Schizophrenia (SCH) and drug addiction are chronic disorders that are frequently accompanied by physical diseases, poor nutrition and reduced self-care, all of which are likely to result in vitamin deficiencies. The objective of this study was to compare vitamin levels in SCH patients, substance use disorder (SUD) patients and healthy controls (HCs). The study included 189 SCH patients, 119 SUD patients and 109 HCs. Information on vitamin B12, folic acid and vitamin D levels were retrieved from the hospital's database, and mean values and deficiency/insufficiency were evaluated. Vitamin D deficiency (<30 ng/ml) was more common in the SCH group than in the SUD and HC groups (88.4%, 74.8% and 86.4%, respectively). Although there were no significant differences in folic acid deficiency (<3.0 ng/ml) in the SUD and SCH groups (15.1% and 8.5%, respectively), the incidence of folic acid deficiency was significantly higher in both groups as compared with that in the HC group (5.8%). Significantly higher numbers of patients in the SCH group than in the SUD group had vitamin B12 deficiency (45.5% vs. 28.3%). The prevalence of vitamin B12 deficiency in the SUD group was significantly higher than that the HC group (28.3% vs.11.5%). As compared with the HC group, vitamin D and B12 levels were significantly lower in SCH group, and folic acid and B12 levels were significantly lower in the SUD group. Several vitamin deficiencies appear to be common in both SCH and SUD. Possible reasons should be investigated.


Assuntos
Deficiência de Ácido Fólico/epidemiologia , Esquizofrenia/sangue , Transtornos Relacionados ao Uso de Substâncias/sangue , Deficiência de Vitamina B 12/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Feminino , Ácido Fólico/sangue , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Vitamina B 12/sangue , Vitamina D/sangue
3.
Early Hum Dev ; 132: 45-51, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30974313

RESUMO

BACKGROUND: Poor maternal health, disadvantageous exposures during pregnancy and unfavourable perinatal events are associated with adverse trajectories in offspring cognitive development. AIM: To examine longitudinal associations between antenatal maternal, perinatal and maternal health characteristics and children's early cognitive development across executive control, motor ability and receptive language domains. STUDY DESIGN, SUBJECTS AND OUTCOME MEASURES: Analyses comprised interview and observational data from 4587 children and their mothers enrolled in the longitudinal Growing Up in New Zealand cohort study. Children's executive control (Luria hand clap task), motor skills (mothers' report) and receptive language ability (Peabody Picture Vocabulary Test) were assessed at age 4.5 years. Multivariate logistic regression analyses were conducted, controlling for sociodemographic factors. RESULTS: Smoking pre- and during pregnancy, no folate intake during first trimester and low birth weight were risk factors for poorer executive control. Perceived stress during pregnancy, no folate intake during first trimester and low birth weight were all risk factors for poorer motor ability. Smoking pre-pregnancy, antenatal anxiety and no folate intake during first trimester were risk factors for poorer receptive language ability. CONCLUSION: Adverse ante- and perinatal environments are associated with poorer executive control, motor and receptive language abilities in early childhood. Improving maternal education and support especially for more disadvantaged mothers during pregnancy may reduce the potential deleterious impact of adverse ante- and perinatal conditions on children's early cognition.


Assuntos
Desenvolvimento Infantil , Cognição , Deficiência de Ácido Fólico/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Estresse Psicológico/epidemiologia , Fumar Tabaco/epidemiologia , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Idioma , Masculino , Destreza Motora , Nova Zelândia , Gravidez
4.
Ital J Pediatr ; 45(1): 37, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30867013

RESUMO

BACKGROUND: Neural tube defects (NTDs) are birth defects of the brain, spine, or spinal cord invoked by the insufficient intake of folic acid in the early stages of pregnancy and have a complex etiology involving both genetic and environmental factors. So the study aimed to explore the association between alterations in maternal one-carbon metabolism and NTDs in the offspring. METHODS: We conducted a case-control study to get a deeper insight into this association, as well as into the role of genetic polymorphisms. Plasma concentrations of folate, homocysteine (Hcy), S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH) and genotypes and alleles distributions of 52 SNPs in 8 genes were compared for 61 women with NTDs-affected offspring and 61 women with healthy ones. RESULTS: There were significant differences between groups with regard to plasma folate, SAM, SAH and SAM/SAH levels. Logistic regression results revealed a significant association between maternal plasma folate level and risk of NTDs in the offspring. For MTHFD1 rs2236225 polymorphism, mothers having GA genotype and A allele exhibited an increased risk of NTDs in the offspring (OR = 2.600, 95%CI: 1.227-5.529; OR = 1.847, 95%CI: 1.047-3.259). For MTHFR rs1801133 polymorphism, mothers having TT and CT genotypes were more likely to affect NTDs in the offspring (OR = 4.105, 95%CI: 1.271-13.258; OR = 3.333, 95%CI: 1.068-10.400). Moreover, mothers carrying T allele had a higher risk of NTDs in the offspring (OR = 1.798, 95%CI: 1.070-3.021). For MTRR rs1801394 polymorphism, the frequency of G allele was significantly higher in cases than in controls (OR = 1.763, 95%CI: 1.023-3.036). Mothers with NTDs-affected children had higher AG genotype in RFC1 rs1051226 polymorphism than controls, manifesting an increased risk for NTDs (OR = 3.923, 95%CI: 1.361-11.308). CONCLUSION: Folic acid deficiency, MTHFD1 rs2236225, MTHFR rs1801133, MTRR rs1801349 and RFC1 rs1051226 polymorphisms may be maternal risk factors of NTDs.


Assuntos
Deficiência de Ácido Fólico/genética , Predisposição Genética para Doença/epidemiologia , Defeitos do Tubo Neural/genética , Polimorfismo de Nucleotídeo Único/genética , Adulto , Carbono/metabolismo , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , China , Feminino , Ferredoxina-NADP Redutase/genética , Deficiência de Ácido Fólico/diagnóstico , Deficiência de Ácido Fólico/epidemiologia , Marcadores Genéticos/genética , Genótipo , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Metilenotetra-Hidrofolato Desidrogenase (NADP)/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Antígenos de Histocompatibilidade Menor/genética , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/fisiopatologia , Razão de Chances , Gravidez , Valores de Referência
5.
Brain Dev ; 41(5): 406-412, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30651190

RESUMO

BACKGROUND: Nutritional deficiency in pregnant women is a confirmed cause of neural tube defects (NTDs). Alongside to this background, We sought to determine the nutritional status and level of awareness on the issue of the NTDs as well as folic acid (FA) utilization among women who born infants with NTDs in Tigray region of Ethiopia. METHOD: A standard interviewer and a food frequency questionnaire was used to obtain information from mothers of cases with neural tube defects (n = 205) and their controls (n = 412). Demographic information, weekly food frequency consumption, information on awareness on the issue of the NTDs as well as folic acid (FA) use was collected. RESULT: The mean age of the mothers of the cases and controls was 26.5 years (range 17-43 years) and 26.05 years (range 18-40 years), respectively. Approximately 92.2% (189/205) of the cases and 90.5% (373/412) control mothers do not know the term folic acid (FA). Notably, all participant mothers (100%) did not understand that NTDs are a serious health problem associated with inadequate intake of FA and none of them used FA prior to conception. Food frequency analysis revealed that except for cereals (p = 0.12) and milk products (p = 0.8), the proportion of the consumed food type within seven days recalls period showed a statistically significant difference (p < 0.05) as compared with controls. The dietary diversity score assessment showed those attained low and high dietary diversity score were a statistically significant difference (p = 0.0003) and (p = 0.0002) respectively) as compared with controls, but the medium dietary diversity score no significant variation was found (p = 0.35). CONCLUSION: This study has shown none of the study participants do understand that NTDs are a serious health problem associated with inadequate intake of FA. Dietary diversity score was significantly associated with incidence of NTDs. This Ethiopian study also highlighted the need of considering the basic food in future programs of food fortification with folic acid, preconceptional folic acid supplementation and adequate dietary intake counseling. Advance research is required to find out the gene-nutrient and gene environment interactions, as well as particular causative factors associated with NTDs in Ethiopia.


Assuntos
Deficiência de Ácido Fólico/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Defeitos do Tubo Neural/epidemiologia , Estado Nutricional , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Etiópia/epidemiologia , Feminino , Deficiência de Ácido Fólico/complicações , Humanos , Defeitos do Tubo Neural/etiologia , Gravidez , Complicações na Gravidez/etiologia , Adulto Jovem
6.
Int Health ; 11(6): 487-495, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-30689884

RESUMO

BACKGROUND: Although folate deficiency is linked to adverse health effects, limited data exist characterizing the problem in rural settings. This study determined the prevalence of folate deficiency and anemia in rural adults in the Haitian Central Plateau using combined laboratory methods. METHODS: Dried blood spots (DBSs) and hemoglobin measurements were collected from adult men and women selected by cluster random sampling in Haiti's Central Plateau. DBSs were analyzed for folate using a microbiological assay. Hemoglobin levels were determined using both a HemoCue photometer and the sodium lauryl sulfate microplate method. Red cell folate (RCF) levels were determined by normalizing DBS folate to hemoglobin. RESULTS: Of the 197 subjects assessed for hemoglobin, 11.4% of males and 21.0% of females were anemic (male: hemoglobin<12 g/dL; female: hemoglobin<11 g/dL). Of the 173 subjects assessed for RCF, 27.9% of men and 14.9% of women were folate deficient (RCF<340 nmol/L). Among reproductive-age women, 83.6% had RCF levels associated with a risk of neural tube defects of >14 per 10 000 live births (RCF≤699 nmol/L). CONCLUSIONS: Adults in the Haitian Central Plateau suffer from high rates of anemia and folate deficiency, putting the population at elevated risk for disease. DBSs and microbiological assay make folate evaluation feasible, even in low-resource regions.


Assuntos
Deficiência de Ácido Fólico/epidemiologia , Saúde da População Rural/estatística & dados numéricos , Adolescente , Adulto , Anemia/epidemiologia , Bioensaio , Teste em Amostras de Sangue Seco , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
8.
J Photochem Photobiol B ; 190: 66-71, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30502586

RESUMO

UV radiation has been consistently reported to cause folate photodegradation in vitro and in human skin. Seasonal variations in UV radiation might explain seasonal changes in folate levels in blood. Yet, few studies have addressed this phenomenon. The main objective of this study was to investigate whether a relationship exists between seasonal variations in serum folate levels in a population of Spain (Latitude: 36° 41' 6.88″; Longitude: 4° 30' 0.64″) and the annual variations of solar ultraviolet reached in the localization. From a sample of 118,831 serum folate determinations, two studies were performed. The first one, which included all subjects, showed a decreased in mean folate concentrations in all seasons with respect to winter with lower values in summer. The risk of folate deficiency was 1.37 times greater in summer than in winter (95%CI: 1.29-1.46). In the second study, subjects with a first folate determination in winter and a second one in summer were 3.32 more likely to develop folate deficiency than those with a first folate determination in summer and a second one in winter (95%CI: 1.55 to 7.11). Folate levels showed a seasonal variation inversely related to solar total UV radiation reached in our location, with maximum daily doses of 5000 J m-2 reached in June. A gradual increase in percentage of folate deficiency is observed since spring. So, patients with folate levels close to deficiency are at a higher risk of having folate deficiency in summer.


Assuntos
Ácido Fólico/efeitos da radiação , Estações do Ano , Raios Ultravioleta/efeitos adversos , Adulto , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/epidemiologia , Deficiência de Ácido Fólico/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fotólise , Espanha
9.
Dig Liver Dis ; 51(4): 505-509, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30236765

RESUMO

BACKGROUND: Chronic atrophic autoimmune gastritis (CAAG) leads to vitamin B12 deficiency, but other micronutrient deficiencies are largely understudied. AIMS: To investigate the prevalence of micronutrient deficiencies in CAAG patients and their potential relationship with the grading of gastric atrophy or entero-chromaffin-like cells hyperplasia or body mass index (BMI). METHODS: From 2005 to 2016 a number of CAAG patients underwent regular follow-up with annual blood testing and upper gastrointestinal tract endoscopy every years. RESULTS: Out of the 122 CAAG patients checked (100 F; median age 65 years), 76 presented nutritional deficiencies, single in 24 and multiple in 52 cases: a deficiency of B12 and iron showed in 42 patients, 25-OH vitamin D lacked in 76 and folic acid in 6 cases. 25-OH vitamin D levels directly correlated with B12 levels and were significantly lower in patients with macronodular than in those with linear or micronodular hyperplasia. No significant correlation was observed between B12, folic acid or ferritin levels and BMI, blood gastrin levels, the grading of gastric atrophy or ECL cells hyperplasia. CONCLUSIONS: 25-OH vitamin D deficiency was the main one in CAAG patients: its correlation with B12 deficiency may indicate underlying shared pathogenic mechanisms, although further studies are needed to confirm this hypothesis.


Assuntos
Doenças Autoimunes/sangue , Gastrite Atrófica/sangue , Micronutrientes/deficiência , Deficiência de Vitamina B 12/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Autoimunes/complicações , Doença Crônica , Endoscopia Gastrointestinal , Feminino , Deficiência de Ácido Fólico/complicações , Deficiência de Ácido Fólico/epidemiologia , Gastrite Atrófica/complicações , Gastrite Atrófica/patologia , Humanos , Distúrbios do Metabolismo do Ferro/complicações , Distúrbios do Metabolismo do Ferro/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina D/complicações
10.
Int J Food Sci Nutr ; 70(3): 367-376, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30189767

RESUMO

Low folate status is a risk factor for birth defects. We studied concentrations of red blood cell (RBC)- and serum folate in 198 German women in relation to information on dietary folate intake, demographic and lifestyle factors. Median serum- and RBC-folate levels were; (14.7 and 589 nmol/L, respectively. Serum < 7.0 nmol/L or RBC-folate < 405 nmol/L were observed in 3.5% and 18.7% of the women, respectively. Three per cent of the women had both lowered serum and RBC-folate. Whereas RBC-folate > 952 nmol/L (optimal levels around conception) were observed in 9.6%. Serum- and RBC-folate were positively associated; they showed the expected correlations with homocysteine, but only weak correlations with folate intake. Younger age, lower fibre and higher carbohydrate intakes were associated with lower blood folate. Thus, folate intake of approximately 278 µg/d was not sufficient to achieve optimal folate status in young women. In conclusion, in the absence of fortification with folic acid, the majority of the women did not achieve folate status that is optimal for prevention of birth defects.


Assuntos
Dieta , Suplementos Nutricionais , Deficiência de Ácido Fólico/epidemiologia , Ácido Fólico/administração & dosagem , Estilo de Vida , Adulto , Biomarcadores/sangue , Feminino , Ácido Fólico/sangue , Alemanha , Homocisteína/sangue , Humanos
11.
Nutr Metab Cardiovasc Dis ; 29(1): 9-14, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30459075

RESUMO

BACKGROUND AND AIMS: High concentrations of homocysteine are considered a risk factor for atherosclerosis and coronary artery disease. The aim of this study was to assess whether or not there are gender differences in the plasma concentrations of homocysteine. METHODS AND RESULTS: Data were collected from medical records of individuals examined at a screening center in Israel between the years 2000-2014. Cross sectional analysis was carried out on 9237 men and 4353 women. Mean (SD) age of the study sample was 48.4 (9.7) and 47.7 (9.7) years for men and women respectively. Average homocysteine concentrations were 12.6 (5.9) and 9.6 (3.2) µmol/L in men and women respectively (p < 0.001). Prevalence of homocysteine concentrations above 15 µmol/L was found to be significantly higher in men than in women; 15.5% vs 3.9% respectively (p < 0.001). Low concentrations of vitamin (B12 < 200 pmol/L) and low concentrations of folate (<12 nmol/L) were found to be significantly higher in men than in women 20.4% vs. 16.0% and 18.5% vs. 10.8% respectively. Compared to women, men had a significantly higher odds ratio (95% CI) of having homocysteine concentrations above 15 µmol/L: non adjusted model, 4.47 (3.80-5.26); adjusted model for age, smoking status, body mass index, diabetes mellitus, kidney function and low serum concentrations of vitamin B12 and folate, 3.44 (2.89-4.09). CONCLUSION: Plasma homocysteine concentrations are higher in men than in women. This may be a contributing factor to gender differences for developing atherosclerosis and coronary artery disease.


Assuntos
Homocisteína/sangue , Hiper-Homocisteinemia/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/sangue , Aterosclerose/epidemiologia , Biomarcadores/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/epidemiologia , Estudos Transversais , Feminino , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/epidemiologia , Humanos , Hiper-Homocisteinemia/diagnóstico , Hiper-Homocisteinemia/epidemiologia , Israel , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Fatores de Risco , Fatores Sexuais , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/epidemiologia , Adulto Jovem
12.
Int Urol Nephrol ; 51(2): 223-229, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30547361

RESUMO

PURPOSE: The purpose of the study was to compare serum level of folic acid (FA) in patients with erectile dysfunction (ED) versus healthy controls and to assess its correlation with other well-known confounders for ED. METHODS: Our prospective study compared FA in 60 patients with ED versus 30 healthy controls. Patients were excluded if they had any hormonal disorders, Peyronie's disease, or decompensated systemic illnesses. ED was evaluated by the validated Arabic version of the abbreviated five-item form of the International Index Of Erectile Function and confirmed by penile duplex. Serum FA level was assayed using ELIZA. Mann-Whitney, Kruskal-Wallis, and Chi-square tests and Spearman correlation were used as appropriate and confirmed by logistic regression model. RESULTS: Our study revealed that the median FA of the cases and the controls were 7.1 ng/mL and 13.4 ng/mL, respectively, and this difference was of high statistical significance (p < 0.001). Moreover, our study demonstrated significant relations between serum FA with DM, HTN, smoking, age, and cholesterol (p 0.01, 0.03, 0.014, 0.001, and 0.015, respectively). Our study showed that the best cut-off point of serum FA to detect patients with ED was found to be ≤ 9.42 with sensitivity of 80.00%, specificity of 93.33% and area under curve (AUC) of 91.3%. CONCLUSION: Serum FA level decreased as the severity of ED increased even after adjustment of age, serum testosterone, DM, HTN, and smoking. FA deficiency might be an independent risk factor of ED.


Assuntos
Diabetes Mellitus/epidemiologia , Disfunção Erétil , Deficiência de Ácido Fólico , Hipertensão/epidemiologia , Fumar/epidemiologia , Testosterona/sangue , Adulto , Fatores Etários , Colesterol/sangue , Correlação de Dados , Egito/epidemiologia , Disfunção Erétil/sangue , Disfunção Erétil/diagnóstico , Disfunção Erétil/epidemiologia , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Ultrassonografia Doppler Dupla/métodos
13.
Eur J Nutr ; 58(1): 399-408, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29322314

RESUMO

PURPOSE: The aim of this study was to examine the associations between the risk of cognitive impairment and the serum levels of folate, vitamin B12, and homocysteine (Hcy). METHODS: Subjects were persons aged 60-79 years who participated in the Yangpyeong Cohort study between 2011 and 2012. Cognitive impairment and normal subjects consisted of 100 pairs of old adults matched by age, sex, and education levels. Cognitive function was evaluated with the Korean version of the Mini-Mental State Examination for Dementia Screening (MMSE-DS). Pearson's partial correlation coefficients and conditional multiple logistic regression analysis were applied to determine the associations between cognitive function and the serum levels of folate, vitamin B12, and Hcy. RESULTS: Compared with the matched normal group, the cognitive impairment group had higher proportions of folate deficiency (< 3 ng/mL) and hyperhomocysteinemia (≥ 15 µmol/L). Serum Hcy concentrations were inversely associated with serum folate (r = - 0.234, p = 0.001) and MMSE-DS score (r = - 0.150, p = 0.037) after adjusting for age, sex, and education. The high Hcy group showed a higher prevalence of cognitive impairment (4th vs. 1st quartile, OR 3.30, 95% CI 1.12-9.72, p for trend = 0.014) after adjusting for exercise. CONCLUSIONS: The present findings suggest a putative protective role of high serum folate and normal Hcy against cognitive impairment among older adults.


Assuntos
Disfunção Cognitiva/sangue , Disfunção Cognitiva/epidemiologia , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/epidemiologia , Homocisteína/sangue , Idoso , Causalidade , Estudos de Coortes , Comorbidade , Feminino , Ácido Fólico/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prevalência , República da Coreia/epidemiologia , Vitamina B 12/sangue
14.
Nutr Health ; 25(1): 29-36, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30590987

RESUMO

BACKGROUND:: Folate and vitamin B12 are essential micronutrients, the deficiency of which can be associated with public health problems worldwide. AIM:: The aims of this study were to assess the folate and vitamin B12 status of healthy adults and the effect of gender differences on their deficiency using serum folate, vitamin B12 and red blood cell (RBC) folate as biomarkers and their relation to hematological indices. METHODS:: This study was a part of the Azar cohort study, which is designed as a noncommunicable disease survey in the population of Shabestar, East Azerbaijan, Iran. A total of 95 healthy adults (35 men, 60 women) were chosen according to exclusion criteria and assessed using demographic characteristics and blood sampling. RESULTS:: Low concentrations of serum folate, vitamin B12 and RBC folate were detected in 16.8%, 61.1% and 40% of all subjects, respectively. Prevalence of low serum folate and vitamin B12 was higher in men than women (25.7% versus 11.7% for serum folate, 77.1% versus 51.7% for serum vitamin B12).A significant positive correlation was found between hemoglobin and serum folate, vitamin B12 and RBC folate concentrations ( r = 0.279, 0.335, 0.228, respectively). No statistically significant correlation between mean corpuscular volume and serum folate, vitamin B12 and RBC folate was seen ( r = -0.049, -0.030, -0.016, respectively). CONCLUSIONS:: There was a high prevalence of low folate and vitamin B12 concentrations in our community. Regarding the impact of these two vitamins deficiency on overall health, we suggest further investigations with more participants. In addition, monitoring hematological indices could be useful in people with folate and vitamin B12 deficiency.


Assuntos
Deficiência de Ácido Fólico/epidemiologia , Ácido Fólico/sangue , Hemoglobinas/metabolismo , Estado Nutricional , Deficiência de Vitamina B 12/epidemiologia , Vitamina B 12/sangue , Complexo Vitamínico B/sangue , Adulto , Fatores Etários , Estudos de Coortes , Índices de Eritrócitos , Eritrócitos/metabolismo , Feminino , Deficiência de Ácido Fólico/sangue , Hematologia , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Deficiência de Vitamina B 12/sangue
15.
Nutrients ; 10(10)2018 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-30314363

RESUMO

Data on the nutritional situation and prevalence of micronutrient deficiencies in Azerbaijan are scarce, and knowledge about anemia risk factors is needed for national and regional policymakers. A nationally representative cross-sectional survey was conducted to assess the prevalence of micronutrient deficiencies, over- and undernutrition, and to disentangle determinants of anemia in children and women in Azerbaijan. The survey generated estimates of micronutrient deficiency and growth indicators for children aged 0⁻59 months of age (6⁻59 months for blood biomarkers) and non-pregnant women 15⁻49 years of age. Questionnaire data, anthropometric measurements, and blood samples were collected to assess the prevalence of under- and over-nutrition, anemia, iron deficiency, and iron deficiency anemia, in both groups. In children only, vitamin A deficiency and zinc deficiency were also assessed. In women only, folate and vitamin B12 deficiencies and vitamin A insufficiency were assessed. In total, 3926 household interviews were successfully completed with a response rate of 80.6%. In the 1455 children, infant and young child feeding practices were relatively poor overall; the prevalence of wasting and stunting were 3.1% and 18.0%, respectively; and 14.1% of children were overweight or obese. The prevalence of anemia was 24.2% in 6⁻59 months old children, the prevalence of iron deficiency was 15.0% in this age group, and the prevalence of iron deficiency anemia was 6.5%. Vitamin A deficiency was found in 8.0% of children, and zinc deficiency was found in 10.7%. Data from 3089 non-pregnant women 15⁻49 years of age showed that while undernutrition was scarce, 53% were overweight or obese, with increasing prevalence with increasing age. Anemia affected 38.2% of the women, iron deficiency 34.1% and iron deficiency anemia 23.8%. Vitamin A insufficiency was found in 10.5% of women. Folate and vitamin B12 deficiency were somewhat more common, with prevalence rates of 35.0% and 19.7%, respectively. The main risk factors for anemia in children were recent lower respiratory infection, inflammation and iron deficiency. In women, the main risk factors for anemia were iron deficiency and vitamin A insufficiency. Anemia is a public health problem in Azerbaijani children and women, and additional efforts are needed to reduce anemia in both groups.


Assuntos
Anemia/epidemiologia , Desnutrição/epidemiologia , Micronutrientes/deficiência , Estado Nutricional , Hipernutrição/epidemiologia , Adolescente , Adulto , Anemia/sangue , Anemia/etiologia , Anemia Ferropriva/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etiologia , Azerbaijão/epidemiologia , Pré-Escolar , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/complicações , Deficiência de Ácido Fólico/epidemiologia , Humanos , Lactente , Recém-Nascido , Ferro/sangue , Masculino , Desnutrição/sangue , Desnutrição/complicações , Micronutrientes/sangue , Pessoa de Meia-Idade , Hipernutrição/sangue , Hipernutrição/complicações , Prevalência , Fatores de Risco , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/complicações , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/epidemiologia , Adulto Jovem , Zinco/sangue , Zinco/deficiência
16.
Scand J Gastroenterol ; 53(8): 917-922, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30231804

RESUMO

OBJECTIVES: Patients are at risk of anemia post Roux-en-Y gastric bypass (RYGB). We sought to determine the prevalence of anemia and related nutritional deficiencies 5 years after RYGB and to evaluate adherence to nutritional supplements with iron, vitamin B12, and folate. MATERIAL AND METHODS: Patients operated with RYGB 2004-2006 were eligible for evaluation. Blood samples were collected and use of nutritional supplements was recorded preoperatively, and at outpatients' consultations 1, 2, and 5 years postoperatively. Of 203 patients operated, 184 (91%) completed the 5 year follow-up and were included in the study. Of these, 97% had valid measurements of hemoglobin both at baseline and after 5 years. RESULTS: During the 5 years after RYGB, the prevalence of anemia increased from 4% preoperatively to 24% in females, and from 0% to 7% in males. Ferritin levels decreased gradually in both genders. Iron deficiency increased from 6% preoperatively to 42% at 5 years in females, and from 0% to 9% in males. Vitamin B12 deficiency was not altered while folate deficiency decreased from 10% preoperatively to 1% at 5 years. Five years after surgery 25% reported the use of supplements with iron, while 83% used vitamin B12 and 65% used multivitamins with folate. CONCLUSIONS: We observed a long-term increase in anemia and iron deficiency after RYGB in both genders, but most pronounced in women. Our postoperative protocol for prevention of vitamin B12 and folate deficiencies appear acceptable. Iron status and iron supplementation seems to need stronger emphasis during follow-up after RYGB.


Assuntos
Anemia Ferropriva/epidemiologia , Deficiência de Ácido Fólico/epidemiologia , Derivação Gástrica/efeitos adversos , Obesidade Mórbida/cirurgia , Deficiência de Vitamina B 12/epidemiologia , Adulto , Anemia Ferropriva/etiologia , Anemia Ferropriva/prevenção & controle , Suplementos Nutricionais , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/etiologia , Deficiência de Ácido Fólico/prevenção & controle , Seguimentos , Humanos , Ferro/sangue , Modelos Lineares , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Noruega/epidemiologia , Período Pós-Operatório , Distribuição por Sexo , Vitamina B 12/sangue , Deficiência de Vitamina B 12/etiologia , Deficiência de Vitamina B 12/prevenção & controle
17.
Ann N Y Acad Sci ; 1431(1): 35-57, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30239016

RESUMO

Inadequate folate status in women of reproductive age (WRA) can lead to adverse health consequences of public health significance, such as megaloblastic anemia (folate deficiency) and an increased risk of neural tube defect (NTD)-affected pregnancies (folate insufficiency). Our review aims to evaluate current data on folate status of WRA. We queried eight databases and the World Health Organization Micronutrients Database, identifying 45 relevant surveys conducted between 2000 and 2014 in 39 countries. Several types of folate assays were used in the analysis of blood folate, and many surveys used folate cutoffs not matched to the assay. To allow better comparisons across surveys, we attempted to account for these differences. The prevalence of folate deficiency was >20% in many countries with lower income economies but was typically <5% in countries with higher income economies. Only 11 surveys reported the prevalence of folate insufficiency, which was >40% in most countries. Overall, folate status data for WRA globally are limited and must be carefully interpreted due to methodological issues. Future surveys would benefit from using the microbiologic assay to assess folate status, along with assay-matched cutoffs to improve monitoring and evaluation of folic acid interventions, thus informing global efforts to prevent NTDs.


Assuntos
Deficiência de Ácido Fólico/epidemiologia , Ácido Fólico/sangue , Reprodução/fisiologia , Coleta de Amostras Sanguíneas , Feminino , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/complicações , Humanos , Defeitos do Tubo Neural/etiologia , Prevalência
18.
Birth Defects Res ; 110(14): 1139-1147, 2018 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-30070772

RESUMO

BACKGROUND: Spina bifida and anencephaly are largely preventable birth defects through mandatory folic acid fortification. Our objective was to estimate the proportion of folic acid-preventable spina bifida and anencephaly (FAP SBA) prevented worldwide through mandatory fortification of wheat and/or maize flour with folic acid during the year 2017. METHODS: Using existing data, we identified countries with mandatory fortification policies that added at least 1.0 ppm folic acid to wheat and/or maize flour and had information on percentage of industrially milled flour that is fortified. We assumed mandatory folic acid fortification at 200 µg/day of folic acid fully protects against FAP SBA, reducing the prevalence of spina bifida and anencephaly to 0.5 per 1,000 live births. RESULTS: Overall, 59 countries met our criteria for implementing mandatory folic acid fortification of wheat and/or maize flour in 2017. These countries prevented about 50,270 out of 280,500 FAP SBA births in 2017. Thus, we have only achieved 18% prevention of FAP SBA worldwide. Several countries in Africa and Asia with a high number of FAP SBA-affected births do not have mandatory fortification. CONCLUSION: About 230,000 children unnecessarily developed FAP SBA globally in 2017. There is an urgent need for all countries to implement mandatory folic acid fortification, a proven, safe public health intervention that saves money and prevents infant mortality and disability. Prevention of FAP SBA can play an important role in helping countries to achieve their Sustainable Development Goals for health.


Assuntos
Anencefalia/epidemiologia , Alimentos Fortificados/provisão & distribução , Disrafismo Espinal/epidemiologia , Anencefalia/prevenção & controle , Feminino , Ácido Fólico/metabolismo , Ácido Fólico/uso terapêutico , Deficiência de Ácido Fólico/epidemiologia , Deficiência de Ácido Fólico/metabolismo , Deficiência de Ácido Fólico/terapia , Humanos , Lactente , Mortalidade Infantil , Gravidez , Prevalência , Disrafismo Espinal/prevenção & controle , Triticum , Zea mays
19.
Birth Defects Res ; 110(14): 1148-1152, 2018 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-30114345

RESUMO

PURPOSE: The present study attempts to understand the complex contribution of biochemical (plasma homocysteine) and nutritional parameters (dietary pattern and folate supplementation) to the neural tube defects (NTDs) affected pregnancies and controls in North Indian population. METHODS: Case-control study design was adopted to assess the role of folic acid, dietary habits, and homocysteine in relation to NTD births. The subjects comprised of 130 mothers of affected children (cases) and 233 mothers of healthy children (controls), who were either carrying NTD fetus or gave birth to NTD child. RESULTS: The mean homocysteine levels were elevated in cases (15.71 ± 8.35 µmol/L) as compared to controls (12.87 ± 5.95 µmol/L) but were lower among the non-vergetarians (13.55 ± 6.64 µmol/L) than the vegetarians (14.78 ± 7.93 µmol/L). Vegetarian dietary habit increased the NTD risk by 1.6 fold (95% CI = 1.0-2.7) while folic acid supplementation demonstrated a protective effect for conceptions (OR = 0.59; 95% CI = 0.3-0.9). Consumption of folic acid with non-vegetarian diet witnessed lowering of homocysteine in cases (12.88 ± 6.81 µmol/L) and in controls (11.85 ± 5.54 µmol/L), with an odds ratio depicting a 3.1 fold risk for consuming vegetarian diet without folic acid supplementation during the peri-conceptional period. CONCLUSION: It is suggested that plasma hyperhomocysteinemia bears negative impact on child-bearing women group, of north Indian ancestry, in modulating the risk of NTDs. Efforts should be made to enhance awareness regarding folic acid and vitamin B12 (non-vegetarian diet) supplementations alongwith proper nutritional intake among women, especially those consuming vegetarian diet to control homocysteine levels in order to reduce the risk of NTDs.


Assuntos
Ácido Fólico/uso terapêutico , Homocisteína/análise , Defeitos do Tubo Neural/epidemiologia , Adulto , Estudos de Casos e Controles , Dieta , Dieta Vegetariana , Suplementos Nutricionais , Comportamento Alimentar , Feminino , Ácido Fólico/sangue , Ácido Fólico/metabolismo , Deficiência de Ácido Fólico/epidemiologia , Deficiência de Ácido Fólico/metabolismo , Deficiência de Ácido Fólico/terapia , Homocisteína/sangue , Humanos , Índia/epidemiologia , Lactente , Mortalidade Infantil , Pessoa de Meia-Idade , Razão de Chances , Prevalência
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