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Plattel CHM, Lever S, Simons CPM, Haitsma V. Vitamin B12 Deficiency in Children and Adolescents: A Case for Revised Diagnostic Parameters. Food Nutr Bull 2024; 45:S23-S27. [PMID: 38987874 DOI: 10.1177/03795721241252850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND Vitamin B12 deficiency is commonly diagnosed using thresholds developed for adults, yet emerging evidence indicates these levels may not be appropriate for children and adolescents. This misalignment can lead to underdiagnosis in younger populations, with potential long-term health implications. CASE SUMMARY Chief Complaint: The 17-year-old female patient experienced severe fatigue, menstrual irregularities, psychological distress, and neurological symptoms over several years. The 13-year-old male patient had behavioral changes, gastrointestinal complaints, and sensory disturbances from an early age.Diagnosis: Both adolescents displayed B12 levels that were considered low-normal based on adult thresholds, complicating their diagnostic processes. Their diverse and atypical symptomatology required a comprehensive review of their medical and family histories, clinical symptoms, and risk factors.Intervention: Treatment included administration of hydroxocobalamin injections, complemented by dietary adjustments.Outcome: Both patients responded well to the treatment, showing significant improvements in their symptoms and overall quality of life. CONCLUSION The main takeaway from these cases is the importance of tailoring diagnostic adequate thresholds and treatment plans to the pediatric population to address and manage B12 deficiency effectively. This approach can significantly enhance patient outcomes and prevent the progression of potentially severe complications in later life.
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Affiliation(s)
- Clara H M Plattel
- B12 institute, Rotterdam, the Netherlands
- B12 Institute Foundation, Rotterdam, the Netherlands
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Zhang R, Wu X, Lu L, Hu R, Teng Y, Pan L, Zeng X, Jiang W, Li W, Dong L, Zhu W. Assessment of blood one-carbon metabolism indexes during mid-to-late pregnancy in 397 Chinese pregnant women. Front Nutr 2024; 11:1348930. [PMID: 38389796 PMCID: PMC10881806 DOI: 10.3389/fnut.2024.1348930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Objectives One-carbon metabolism (OCM) significantly influences fetal growth and neurodevelopment through transferring methyl group to biomolecules, during which folate, methionine, choline and betaine function as methyl donor nutrients, while vitamin B2, B6, B12 function as enzyme cofactors, and homocysteine (Hcy) and S-adenosyl methionine (SAM) are functional metabolites. This study aimed to assess blood OCM index levels and explore their relationships among Chinese pregnant women. Methods Data were obtained from the baseline of the Mother-Child Nutrition and Health Cohort Study. Pregnant women, voluntarily recruited from September 2020 to June 2022 during antenatal examinations in five Chinese cities at 24-32 gestational weeks, provided fasting venous blood samples. Measurements included RBC and serum folate, serum vitamin B2, B6, B12, choline, betaine, methionine, total Hcy (tHcy), and plasma SAM. Sociodemographic characteristics and pregnancy-related conditions were collected via a self-designed questionnaire. Results Of 397 participants, 82.6% were in mid-pregnancy (24-27 gestational weeks) and 17.4% were in late-pregnancy (28-32 gestational weeks). Serum folate, vitamin B6, and B12 deficiencies were 2.5, 1.3, and 8.3%, respectively. Elevated tHcy (≥10 μmol/L) was observed in 1.8% of pregnant women. Elderly pregnant women (aged 35 and above) exhibited significantly lower serum methionine levels (p < 0.05), while multiparous women had lower RBC folate levels (p < 0.05), and lower serum methionine and vitamin B12 levels (p < 0.10, not statistically significant). Partial correlation analysis revealed positive associations between RBC folate and cofactor vitamin B12 (r = 0.244, p < 0.05) in the folate cycle, as well as significant correlations between two methyl donor paths [serum folate was significantly related to serum choline (r = 0.172) and betaine (r = 0.193)]. As functional biomarkers of OCM, serum tHcy exhibited negative associations with RBC folate (β = -0.330, p < 0.05) and vitamin B6 (β = -0.317, p < 0.05), and plasma SAM displayed a positive association with serum betaine (β = 0.610, p < 0.05), while negatively associated with serum vitamin B6 (β = -0.181, p < 0.05). Conclusion The blood OCM exhibited imbalances during mid-to-late pregnancy, characterized by lower levels of folate, vitamin B6, and B12, alongside elevated tHcy levels. Adequate folate and vitamin B6 emerged as significant predictors of lower tHcy levels. Additionally, serum betaine showed a positive correlation with plasma SAM. This suggests the importance of not only ensuring sufficient folate but also optimizing other OCM-related nutrients throughout pregnancy.
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Affiliation(s)
- Rong Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Health Science Centre, Peking University, Beijing, China
| | - Xiangyi Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Health Science Centre, Peking University, Beijing, China
| | - Lu Lu
- Gaomi City People's Hospital, Weifang, China
| | - Rui Hu
- Beijing Huairou Maternity and Child Health Care Hospital, Beijing, China
| | - Yue Teng
- Haidian Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Lina Pan
- Hunan Ausnutria Institute of Food and Nutrition, Changsha, China
| | - Xiaoling Zeng
- Hunan Ausnutria Institute of Food and Nutrition, Changsha, China
| | - Wei Jiang
- Hunan Ausnutria Institute of Food and Nutrition, Changsha, China
| | - Wei Li
- Hunan Ausnutria Institute of Food and Nutrition, Changsha, China
| | - Ling Dong
- Hunan Ausnutria Institute of Food and Nutrition, Changsha, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Health Science Centre, Peking University, Beijing, China
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McCaddon A, Miller JW. Homocysteine-a retrospective and prospective appraisal. Front Nutr 2023; 10:1179807. [PMID: 37384104 PMCID: PMC10294675 DOI: 10.3389/fnut.2023.1179807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
The biologically important amino acid homocysteine links sulfur, methionine, and one-carbon metabolism. This review describes its initial discovery, the identification of the clinical condition of "homocystinuria" and the recognition of its close relationship to folate and vitamin B12 metabolism. It discusses the history behind its current association with diverse diseases including neural tube defects, cardio- and cerebrovascular disease and, more recently, dementia and Alzheimer's Disease. It also explores current controversies and considers potential future research directions. It is intended to give a general overview of homocysteine in relation to health and disease.
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Affiliation(s)
- Andrew McCaddon
- Faculty of Social and Life Sciences, Wrexham Glyndwr University, Wrexham, United Kingdom
| | - Joshua W. Miller
- Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, United States
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4
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Patti MA, Braun JM, Arbuckle TE, MacFarlane AJ. Associations between folic acid supplement use and folate status biomarkers in the first and third trimesters of pregnancy in the Maternal-Infant Research on Environmental Chemicals (MIREC) Pregnancy Cohort Study. Am J Clin Nutr 2022; 116:1852-1863. [PMID: 36255373 PMCID: PMC9761751 DOI: 10.1093/ajcn/nqac235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/15/2022] [Accepted: 08/19/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Achieving optimal folate status during early gestation reduces the risk of neural tube defects (NTDs). While inadequate folate intake remains a concern, it is becoming increasingly common for individuals to consume higher than recommended doses of folic acid (FA) with minimal additional benefit. OBJECTIVE Here, we sought to investigate the determinants, including FA supplement dose and use, of plasma total and individual folate vitamer concentrations in the first and third trimesters of pregnancy. METHODS Using data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a cohort exposed to mandatory FA fortification, we measured plasma total folate and individual folate vitamer [5-methyltetrahydrofolate (5-methylTHF), unmetabolized FA (UMFA), and non-methyl folates (sum of THF, 5-formylTHF, 5,10-methenyl-THF)] concentrations in the first and third trimesters (n = 1,893). Using linear mixed models, we estimated associations between plasma folate concentrations, total daily supplemental FA intake, plasma vitamin B-12 concentrations, and multiple demographic, maternal, and reproductive factors. RESULTS Almost 95% of MIREC study participants met or exceeded the recommended daily supplemental FA intake from supplements (≥400 μg/d), with approximately 25% consuming more than the Tolerable Upper Intake Level (>1000 μg/d). Over 99% of MIREC participants had a plasma total folate status indicative of maximal NTD risk reduction (25.5 nmol/L) regardless of FA supplement dose. UMFA was detected in almost all participants, with higher concentrations associated with higher FA doses. Determinants of adequate FA supplement intake and folate status associated with reduced NTD risk included indicators of higher socioeconomic position, higher maternal age, nulliparity, and lower prepregnancy BMI. CONCLUSIONS In the context of mandatory FA fortification, our data indicate that higher-than-recommended FA doses are unwarranted, with the exception of individuals at higher risk for NTDs. Ideally, prenatal supplements would contain 400 rather than 1000 µg FA, thereby enabling the consumption of optimal and safe FA doses.
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Affiliation(s)
- Marisa A Patti
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada (retired)
| | - Amanda J MacFarlane
- Nutrition Research Division, Health Canada, Ottawa, Ontario, Canada
- Department of Biology, Carleton University, Ottawa, Ontario, Canada
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5
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He J, Jiang D, Cui X, Ji C. Vitamin B12 status and folic acid/vitamin B12 related to the risk of gestational diabetes mellitus in pregnancy: a systematic review and meta-analysis of observational studies. BMC Pregnancy Childbirth 2022; 22:587. [PMID: 35870897 PMCID: PMC9308279 DOI: 10.1186/s12884-022-04911-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background This review was conducted to investigate the association between serum vitamin B12 levels as well as folic acid/vitamin B12 during pregnancy and the risk of gestational diabetes mellitus (GDM). Methods A comprehensive search of electronic databases (Embase, PubMed, and Web of Science) was performed. The odds ratios (ORs) with 95% confidence intervals (CIs) of GDM risk were summarized using a random effects model. We also performed subgroup analyses to explore the source of heterogeneity. Results A total of 10 studies, including 10,595 pregnant women were assessed. Women with vitamin B12 deficiency were at higher risk for developing GDM when compared with those who were vitamin B12 sufficient (OR, 1.46; 95% CI 1.21–1.79; I2: 59.0%). Subgroup analysis indicated that this association might differ based on sample size and geographical distribution. Elevated vitamin B12 levels may decrease the risk of GDM by 23%. The role of excess folic acid and low vitamin B12 levels in the occurrence of GDM is also controversial. Conclusion In summary, vitamin B12 deficiency is associated with increased risk of GDM, it is necessary to pay more attention to the balance of vitamin B12 and folic acid. However, more in-depth studies across multiple populations are needed to verify these results. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04911-9.
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Reischl-Hajiabadi AT, Garbade SF, Feyh P, Weiss KH, Mütze U, Kölker S, Hoffmann GF, Gramer G. Maternal Vitamin B 12 Deficiency Detected by Newborn Screening-Evaluation of Causes and Characteristics. Nutrients 2022; 14:3767. [PMID: 36145143 PMCID: PMC9505342 DOI: 10.3390/nu14183767] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 12/14/2022] Open
Abstract
Vitamin B12 deficiency, mostly of maternal origin in newborns, is a well-treatable condition but can cause severe neurologic sequelae in infants. Early detection of vitamin B12 deficiency allows the pre-symptomatic treatment of affected children. This evaluation assesses the characteristics of maternal vitamin B12 deficiency detected by newborn screening. In a prospective single-center study, a systematic screening strategy for vitamin B12 deficiency using a combination of two second-tier strategies was applied. In addition to confirmatory diagnostics in children, the systematic work-up of vitamin B12 status was also performed for their mothers. Maternal characteristics were assessed including ethnic origin, diet, and vitamin supplementation during pregnancy. For affected mothers, a work-up by internal medicine was recommended. In total, 121 mother-infant couples were analyzed. 66% of mothers adhered to a balanced diet including meat. The cause of maternal vitamin B12 deficiency was unknown in 56% of cases, followed by dietary causes in 32%, and organic causes in 8%. All mothers following a vegan diet and most mothers with a vegetarian diet took vitamin preparations during pregnancy, whereas only 55.8% of mothers with a balanced diet took folic acid or other vitamins. Maternal vitamin B12, folic acid, and homocysteine levels were significantly correlated with the child's folic acid levels, and with homocysteine, methylmalonic, and methylcitric acid levels in first and second NBS dried blood spots. Most children had normal blood counts and showed normocytosis. Although 36.7% of mothers showed anemia, only one presented with macrocytosis. Adherence to vitamin supplementation in pregnancy is low despite the recommendation for supplementation of folic acid. Ideally, the evaluation of mothers for vitamin B12 levels and appropriate therapy should be initiated in early pregnancy. In infants detected through newborn screening, the multidisciplinary assessment and therapy of both children and mothers should be performed.
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Affiliation(s)
- Anna T. Reischl-Hajiabadi
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Sven F. Garbade
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Patrik Feyh
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Karl Heinz Weiss
- Department of Internal Medicine IV, Gastroenterology and Hepatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Ulrike Mütze
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Stefan Kölker
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Georg F. Hoffmann
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Gwendolyn Gramer
- Division of Neuropediatrics and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
- University Medical Center Hamburg-Eppendorf, University Children’s Hospital, Martinistraße 52, 20246 Hamburg, Germany
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Yuan X, Han X, Zhou W, Long W, Wang H, Yu B, Zhang B. Association of folate and vitamin B12 imbalance with adverse pregnancy outcomes among 11,549 pregnant women: An observational cohort study. Front Nutr 2022; 9:947118. [PMID: 35958250 PMCID: PMC9358651 DOI: 10.3389/fnut.2022.947118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/29/2022] [Indexed: 01/05/2023] Open
Abstract
Objective This study aimed to evaluate maternal serum levels of folate, vitamin B12, and their ratio on admission for labor and determine whether an imbalance between folate and vitamin B12, represented by a higher or lower serum folate to vitamin B12 ratio (SFVB12R), was associated with adverse pregnancy outcomes. Methods A retrospective cohort study of 11,549 pregnant women attending a district specialized hospital and who had serum folate (SF) and serum vitamin B12 (SVB12) levels measured at delivery was performed. The levels of SF, SVB12, and SFVB12R were defined as high (>95th percentile), normal (5–95th percentile), and low (<5th percentile). Information on pregnancy outcomes was retrieved from medical records. Linear regression was performed to examine the association of abnormal SF, SVB12, and SFVB12R levels with fetal growth indicators. Logistic regression was applied to estimate the association between abnormal SF, SVB12, and SFVB12R levels and pregnancy outcomes. Results Lower SF levels were associated with higher risks of intrahepatic cholestasis of pregnancy (ICP, OR 1.58; 95% CI 1.15–2.17), pre-eclampsia (PE, OR 1.89; 95% CI 1.28–2.81), and a lower risk of gestational diabetes mellitus (GDM, OR 0.40; 95% CI 0.23–0.70), whereas higher SVB12 levels were associated with a higher risk of ICP (OR 2.22; 95% CI 1.67–2.96), PE (OR 1.69; 95% CI 1.04-2.74), and GDM (OR 1.62; 95% CI 1.24–2.11). A higher SFVB12R increased birthweight (β 60.99; 95% CI 29.52–92.45) and was associated with a higher risk of large-for-gestational-age (LGA) newborns (OR 3.08; 95% CI 1.63–5.83); a lower SFVB12R decreased birthweight (β −43.81; 95% CI −75.62, −12.00) and was associated with a lower risk of LGA newborns (OR 0.75; 95% CI 0.56–1.00), and with higher risks of ICP (OR 2.03; 95% CI 1.54–2.67) and pregnancy-induced hypertension (PIH, OR 1.81; 95% CI 1.09–3.00). Conclusion An imbalance between folate and vitamin B12, represented by a higher or lower SFVB12R before delivery, was significantly associated with adverse pregnancy outcomes (ICP/PIH/LGA).
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Affiliation(s)
- Xiaosong Yuan
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Xiaoya Han
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Wenbo Zhou
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Wei Long
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Huiyan Wang
- Department of Obstetrics and Gynecology, Changzhou Medical Center, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China
| | - Bin Yu
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Bin Zhang
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
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Quinn MA, Pritchard AE, Visker JR, McPeek AC, Raghuvanshi R, Martin H C, Wellette-Hunsucker AG, Leszczynski EC, McCabe LR, Pfeiffer KA, Quinn RA, Ferguson DP. Longitudinal effects of growth restriction on the murine gut microbiome and metabolome. Am J Physiol Endocrinol Metab 2022; 323:E159-E170. [PMID: 35658543 PMCID: PMC9423779 DOI: 10.1152/ajpendo.00446.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Undernutrition-induced growth restriction in the early stages of life increases the risk of chronic disease in adulthood. Although metabolic impairments have been observed, few studies have characterized the gut microbiome and gut-liver metabolome profiles of growth-restricted animals during early-to-mid-life development. To induce growth restriction, mouse offspring were either born to gestational undernutrition (GUN) or suckled from postnatal undernutrition (PUN) dams fed a protein-restricted diet (8% protein) or control diet (CON; 20% protein) until weaning at postnatal age of 21 days (PN21). At PN21, all mice were fed the CON diet until adulthood (PN80). Livers were collected at PN21 and PN80, and fecal samples were collected weekly starting at PN21 (postweaning week 1) until PN80 (postweaning week 5) for gut microbiome and metabolome analyses. PUN mice exhibited the most alterations in gut microbiome and gut and liver metabolome compared with CON mice. These mice had altered fecal microbial β-diversity (P = 0.001) and exhibited higher proportions of Bifidobacteriales [linear mixed model (LMM) P = 7.1 × 10-6), Clostridiales (P = 1.459 × 10-5), Erysipelotrichales (P = 0.0003), and lower Bacteroidales (P = 4.1 × 10-5)]. PUN liver and fecal metabolome had a reduced total bile acid pool (P < 0.01), as well as lower abundance of riboflavin (P = 0.003), amino acids [i.e., methionine (P = 0.0018), phenylalanine (P = 0.0015), and tyrosine (P = 0.0041)], and higher excreted total peptides (LMM P = 0.0064) compared with CON. Overall, protein restriction during lactation permanently alters the gut microbiome into adulthood. Although the liver bile acids, amino acids, and acyl-carnitines recovered, the fecal peptides and microbiome remained permanently altered into adulthood, indicating that inadequate protein intake in a specific time frame in early life can have an irreversible impact on the microbiome and fecal metabolome.NEW & NOTEWORTHY Undernutrition-induced early-life growth restriction not only leads to increased disease risk but also permanently alters the gut microbiome and gut-liver metabolome during specific windows of early-life development.
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Affiliation(s)
- Melissa A Quinn
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Abby E Pritchard
- Department of Animal Science, Michigan State University, East Lansing, Michigan
| | - Joseph R Visker
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
- Nora Eccles Harrison Cardiovascular Research and Training Institute, The University of Utah, Salt Lake City, Utah
| | - Ashley C McPeek
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Ruma Raghuvanshi
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing Michigan
| | - Christian Martin H
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing Michigan
| | - Austin G Wellette-Hunsucker
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
- Department of Physiology, University of Kentucky, Lexington, Kentucky
| | - Eric C Leszczynski
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Laura R McCabe
- Department of Physiology, Michigan State University, East Lansing Michigan
| | - Karin A Pfeiffer
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Robert A Quinn
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing Michigan
| | - David P Ferguson
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
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Liu Q, Wei S, Lei J, Luo L, Wang F. Periconceptional folate and gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies. J Matern Fetal Neonatal Med 2021; 35:6884-6893. [PMID: 34034602 DOI: 10.1080/14767058.2021.1929158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the relationship between periconceptional folate exposure and risk of gestational diabetes mellitus (GDM). METHODS Several electronic databases, including PubMed, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Cochrane Library, were searched for all relevant cohort studies by January 2021. Studies on relationship between folate exposure (intake or status) and GDM risk were included. Quality of included studies was assessed using Newcastle-Ottawa Scale. Random effects meta-analysis was performed to estimate overall odds ratio (OR) and 95% confidence intervals (CIs) by Stata software (Stata Corp., College Station, TX). RESULTS Ten cohort studies with 40,244 pregnancies were eligible for quantitative meta-analysis. Significant association was observed between folate exposure and risk of GDM (OR = 1.24, p=.036, 95% CI: 1.01-1.52). Subgroup analysis revealed that periconceptional folate exposure of population in China (OR = 1.35, 95% CI: 1.09-1.67) but not in western countries, folate exposure during pregnancy (OR = 1.49, 95% CI: 1.22-1.81) but not before pregnancy, and internal folate exposure (OR = 1.36, 95% CI: 1.10-1.67), were significantly associated with increased GDM risk. CONCLUSIONS Overall, periconceptional folate exposure is positively associated with GDM risk, especially the exposure during pregnancy and exposure in Chinese populations.
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Affiliation(s)
- Qingyun Liu
- Department of Clinical Laboratory, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Shanshan Wei
- Gastrointestinal Endoscopy Center, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jiafan Lei
- Central Laboratory, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Liangping Luo
- Medical Imaging Center,The First Affiliated Hospital of Jinan University, Guangzhou, China.,Engineering Research Center of Medical Imaging Artificial Intelligence for Precision Diagnosis and Treatment, Guangzhou, China
| | - Feng Wang
- Department of Clinical Laboratory, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
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Karaçil Ermumcu MŞ, Mengi Çelik Ö, Acar Tek N. An Evaluation of Awareness, Knowledge, and Use of Folic Acid and Dietary Folate Intake among Non-Pregnant Women of Childbearing Age and Pregnant Women: A Cross-Sectional Study from Turkey. Ecol Food Nutr 2020; 60:101-115. [PMID: 32856479 DOI: 10.1080/03670244.2020.1807344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study was carried out to evaluate awareness, knowledge, and use of folic acid and dietary folate intake among non-pregnant women of childbearing age and pregnant women. A cross-sectional study was completed with 1442 women (1106 non-pregnant and 336 pregnant) in Ankara, Turkey. The individuals' awareness, knowledge, and use of folic acid were questioned and food consumption were taken. More than two-thirds of the non-pregnant and pregnant women had heard of folic acid (77.2% and 89.0%, respectively). The pregnant women (53.9%) knew more that folic acid should be used before conception in order to prevent congenital anomalies than non-pregnant women (41.4%). It was found that 70.2% of the pregnant women and only 15.1% of the non-pregnant women used folic acid supplementation. The pregnant women (1368.4 mcg; 330.4 mcg) significantly had higher folic acid and dietary folate intake than non-pregnant women (29.6 mcg; 289.3 mcg) (p < .01). Despite many public health campaigns, awareness, knowledge, and appropriate use of folic acid are still inadequate and not at the desired level in women of childbearing age.
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Affiliation(s)
| | - Özge Mengi Çelik
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University , Ankara, Turkey
| | - Nilüfer Acar Tek
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University , Ankara, Turkey
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11
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Hayashi I, Takakura K, Yamaguchi K, Sumitomo M, Suzuki M, Sumitomo A, Minato S, Nose Y, Nagai N, Sakane N. Association between socioeconomic status and small-for-gestational-age in Japan: A single center retrospective cohort study. J Obstet Gynaecol Res 2019; 46:110-118. [PMID: 31392834 DOI: 10.1111/jog.14069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/03/2019] [Indexed: 11/29/2022]
Abstract
AIM Small-for-gestational-age (SGA) status has negative health consequences in neonates and later life. Low socioeconomic status (SES) is a reported risk factor for adverse birth outcomes, such as SGA and preterm birth (PTB). The present study investigated whether maternal SES is associated with adverse outcomes in Japanese pregnant women. METHODS Retrospective data were collected for 1970 Japanese women with singleton pregnancies who delivered between January 2007 and December 2011 at a single center: low SES group (n = 197); and controls (n = 1773). Low SES was defined according to the criteria of the Japanese pregnant-childbirth hospitalization support policy system. RESULTS The low SES group included a significantly higher proportion of young women, women with single marital status, greater parity, pre-pregnancy smoking and a lack of regular employment (P < 0.001, respectively). The crude odds ratio (OR) for the association between low maternal SES and SGA was 1.80 (95% confidence interval [CI] 1.15-2.82, P = 0.010). After adjustment for baseline maternal age, parity, body mass index, smoking and gestational weight gain, the adjusted OR for the association between low maternal SES and SGA was 1.92 (95% CI 1.17-3.17, P = 0.010). No significant association was found between maternal SES and PTB. CONCLUSION The present results suggest that low maternal SES is associated with SGA births in the Japanese population. Mitigation of low maternal SES could be urgent public health to prevent disadvantage birth outcome.
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Affiliation(s)
- Ikuyo Hayashi
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan.,Laboratory of Nutritional Physiology, Graduate School of Human and Environmental Science, University of Hyogo, Himegi, Hyogo, Japan
| | - Kenji Takakura
- Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Ken Yamaguchi
- Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Masahiro Sumitomo
- Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Maki Suzuki
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan.,Laboratory of Nutritional Physiology, Graduate School of Human and Environmental Science, University of Hyogo, Himegi, Hyogo, Japan
| | - Aya Sumitomo
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Satomi Minato
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan.,Laboratory of Nutritional Physiology, Graduate School of Human and Environmental Science, University of Hyogo, Himegi, Hyogo, Japan
| | - Yoko Nose
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan.,Laboratory of Nutritional Physiology, Graduate School of Human and Environmental Science, University of Hyogo, Himegi, Hyogo, Japan
| | - Narumi Nagai
- Laboratory of Nutritional Physiology, Graduate School of Human and Environmental Science, University of Hyogo, Himegi, Hyogo, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
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12
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One-Carbon Metabolism Links Nutrition Intake to Embryonic Development via Epigenetic Mechanisms. Stem Cells Int 2019; 2019:3894101. [PMID: 30956668 PMCID: PMC6431457 DOI: 10.1155/2019/3894101] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/06/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
Beyond energy production, nutrient metabolism plays a crucial role in stem cell lineage determination. Changes in metabolism based on nutrient availability and dietary habits impact stem cell identity. Evidence suggests a strong link between metabolism and epigenetic mechanisms occurring during embryonic development and later life of offspring. Metabolism regulates epigenetic mechanisms such as modifications of DNA, histones, and microRNAs. In turn, these epigenetic mechanisms regulate metabolic pathways to modify the metabolome. One-carbon metabolism (OCM) is a crucial metabolic process involving transfer of the methyl groups leading to regulation of multiple cellular activities. OCM cycles and its related micronutrients are ubiquitously present in stem cells and feed into the epigenetic mechanisms. In this review, we briefly introduce the OCM process and involved micronutrients and discuss OCM-associated epigenetic modifications, including DNA methylation, histone modification, and microRNAs. We further consider the underlying OCM-mediated link between nutrition and epigenetic modifications in embryonic development.
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13
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Knight AK, Park HJ, Hausman DB, Fleming JM, Bland VL, Rosa G, Kennedy EM, Caudill MA, Malysheva O, Kauwell GPA, Sokolow A, Fisher S, Smith AK, Bailey LB. Association between one-carbon metabolism indices and DNA methylation status in maternal and cord blood. Sci Rep 2018; 8:16873. [PMID: 30442960 PMCID: PMC6237996 DOI: 10.1038/s41598-018-35111-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/18/2018] [Indexed: 01/02/2023] Open
Abstract
One-carbon metabolism is essential for multiple cellular processes and can be assessed by the concentration of folate metabolites in the blood. One-carbon metabolites serve as methyl donors that are required for epigenetic regulation. Deficiencies in these metabolites are associated with a variety of poor health outcomes, including adverse pregnancy complications. DNA methylation is known to vary with one-carbon metabolite concentration, and therefore may modulate the risk of adverse pregnancy outcomes. This study addresses changes in one-carbon indices over pregnancy and the relationship between maternal and child DNA methylation and metabolite concentrations by leveraging data from 24 mother-infant dyads. Five of the 13 metabolites measured from maternal blood and methylation levels of 993 CpG sites changed over the course of pregnancy. In dyads, maternal and fetal one-carbon concentrations were highly correlated, both early in pregnancy and at delivery. The 993 CpG sites whose methylation levels changed over pregnancy in maternal blood were also investigated for associations with metabolite concentrations in infant blood at delivery, where five CpG sites were associated with the concentration of at least one metabolite. Identification of CpG sites that change over pregnancy may result in better characterization of genes and pathways involved in maintaining a healthy, term pregnancy.
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Affiliation(s)
- Anna K Knight
- Genetics and Molecular Biology Program, Emory University, Atlanta, GA, USA
| | - Hea Jin Park
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Dorothy B Hausman
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Jennifer M Fleming
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Victoria L Bland
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Gisselle Rosa
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Elizabeth M Kennedy
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Olga Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Gail P A Kauwell
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, USA
| | - Andrew Sokolow
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, USA
| | - Susan Fisher
- Piedmont Athens Regional Midwifery, Athens, GA, USA
| | - Alicia K Smith
- Genetics and Molecular Biology Program, Emory University, Atlanta, GA, USA. .,Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Lynn B Bailey
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
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14
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Parisi F, Rousian M, Koning AHJ, Willemsen SP, Cetin I, Steegers-Theunissen RPM. Periconceptional maternal one-carbon biomarkers are associated with embryonic development according to the Carnegie stages. Hum Reprod 2018; 32:523-530. [PMID: 28104698 DOI: 10.1093/humrep/dew349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/14/2016] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Is periconceptional maternal one-carbon (I-C) metabolism associated with embryonic morphological development in non-malformed ongoing pregnancies? SUMMARY ANSWER Serum vitamin B12, red blood cell (RBC) folate and plasma total homocysteine (tHcy) are associated with embryonic development according to the Carnegie stages. WHAT IS KNOWN ALREADY Derangements in maternal I-C metabolism affect reproductive and pregnancy outcomes, as well as future health of the offspring. STUDY DESIGN, SIZE, DURATION Between 2010 and 2014, women with singleton ongoing pregnancies were enrolled in a prospective periconceptional cohort study. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 234 pregnancies, including 138 spontaneous or IUI pregnancies with strict pregnancy dating and 96 pregnancies derived from IVF, ICSI or cryopreserved embryo transfer (IVF/ICSI pregnancies), underwent longitudinal transvaginal three-dimensional ultrasound (3D US) scans from 6+0 up to 10+2 weeks of gestation. Carnegie stages were defined using internal and external morphologic criteria in a virtual reality system. Maternal venous blood samples were collected at enrollment for serum vitamin B12, RBC folate and plasma tHcy assessment. Associations between biomarker concentrations and longitudinal Carnegie stages were investigated using linear mixed models. MAIN RESULTS AND THE ROLE OF CHANCE We performed a median of three 3D US scans per pregnancy (range 1-5) resulting in 600 good quality data sets for the Carnegie stage annotation (80.5%). Vitamin B12 was positively associated with embryonic development in the total study population (β = 0.001 (95% CI: 0.000; 0.002), P < 0.05) and in the subgroup of strictly dated spontaneous pregnancies (β = 0.002 (95% CI: 0.001; 0.003), P < 0.05). Low vitamin B12 concentrations (-2SD, 73.4 pmol/l) were associated with delayed embryonic development by 1.4 days (95% CI: 1.3-1.4) compared with high concentrations (+2SD, 563.1 pmol/l). RBC folate was positively associated with Carnegie stages only in IVF/ICSI pregnancies (β = 0.001 (95% CI: 0.0005; 0.0015), P < 0.05). In this group, low RBC folate concentrations (-2SD, 875.4 nmol/l) were associated with a 1.8-day delay (95% CI: 1.7-1.8) in development compared with high concentrations (+2SD, 2119.9 nmol/l). tHcy was negatively associated with embryonic development in the total study population (β = -0.08 (95% CI: -0.14; -0.02), P < 0.01), as well as in the IVF/ICSI subgroup (β = -0.08 (95% CI: -0.15; -0.01), P < 0.05). High tHcy concentrations (+2SD, 10.4 µmol/l) were associated with a delay of 1.6 days (95% CI: 1.5-1.7) in embryonic development compared with low concentrations (-2SD, 3.0 µmol/l). LIMITATIONS, REASONS FOR CAUTION The study was performed in a tertiary care center, resulting in high rates of folic acid supplement use and comorbidity that may reduce the external validity of our findings. WIDER IMPLICATIONS OF THE FINDINGS In periconceptional care, maternal I-C biomarkers should be taken into account as predictors of embryonic morphological development. Combining embryonic size measurements with morphological assessment could better define normal embryonic development. STUDY FUNDING/COMPETING INTEREST(S) The work was funded by the Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. RPMST is CSO of the startup company Slimmere Zorg and CEO of eHealth Care Solutions. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- F Parisi
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands
| | - M Rousian
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands
| | - A H J Koning
- Department of Bioinformatics, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands
| | - S P Willemsen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands.,Department of Biostatistics, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands
| | - I Cetin
- Centre for Fetal Research Giorgio Pardi, Department of Biomedical and Clinical Sciences, Hospital Luigi Sacco, Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milan, Italy
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Centre, PO Box 2040, 3000CA Rotterdam, The Netherlands
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15
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The effect of oxidative stress induced by tert-butylhydroperoxide under distinct folic acid conditions: An in vitro study using cultured human trophoblast-derived cells. Reprod Toxicol 2018; 77:33-42. [PMID: 29425713 DOI: 10.1016/j.reprotox.2018.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 12/14/2022]
Abstract
Preeclampsia is a pregnancy disorder characterized by high maternal blood pressure, fetal growth restriction and intrauterine hypoxia. Folic acid is a vitamin required during pregnancy. In this work, we investigated the relationship between preeclampsia and the intake of distinct doses of folic acid during pregnancy. Considering that preeclampsia is associated with increased placental oxidative stress levels, we investigated the effect of oxidative stress induced by tert-butylhydroperoxide (TBH) in human trophoblast-derived cells cultured upon deficient/low, physiological and supra-physiological folic acid levels. The negative effect of TBH upon thiobarbituric acid reactive substances (TBARS), total, reduced and oxidized glutathione, cell viability, cell proliferation, culture growth and cell migration was more marked under folic acid excess. This study suggests more attention on the dose administered, and ultimately, on the overall folic acid levels during pregnancy, in the context of preeclampsia risk.
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16
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Hou TY, Davidson LA, Kim E, Fan YY, Fuentes NR, Triff K, Chapkin RS. Nutrient-Gene Interaction in Colon Cancer, from the Membrane to Cellular Physiology. Annu Rev Nutr 2017; 36:543-70. [PMID: 27431370 DOI: 10.1146/annurev-nutr-071715-051039] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The International Agency for Research on Cancer recently released an assessment classifying red and processed meat as "carcinogenic to humans" on the basis of the positive association between increased consumption and risk for colorectal cancer. Diet, however, can also decrease the risk for colorectal cancer and be used as a chemopreventive strategy. Bioactive dietary molecules, such as n-3 polyunsaturated fatty acids, curcumin, and fermentable fiber, have been proposed to exert chemoprotective effects, and their molecular mechanisms have been the focus of research in the dietary/chemoprevention field. Using these bioactives as examples, this review surveys the proposed mechanisms by which they exert their effects, from the nucleus to the cellular membrane. In addition, we discuss emerging technologies involving the culturing of colonic organoids to study the physiological effects of dietary bioactives. Finally, we address future challenges to the field regarding the identification of additional molecular mechanisms and other bioactive dietary molecules that can be utilized in our fight to reduce the incidence of colorectal cancer.
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Affiliation(s)
- Tim Y Hou
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843; .,Department of Biochemistry and Biophysics, Texas A&M University, College Station, Texas 77843
| | - Laurie A Davidson
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843; .,Department of Nutrition and Food Science, Texas A&M University, College Station, Texas 77843.,Center for Translational Environmental Health Research, Texas A&M University, College Station, Texas 77843
| | - Eunjoo Kim
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843; .,Department of Molecular and Cellular Medicine, Texas A&M University, College Station, Texas 77843
| | - Yang-Yi Fan
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843; .,Department of Nutrition and Food Science, Texas A&M University, College Station, Texas 77843
| | - Natividad R Fuentes
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843; .,Faculty of Toxicology, Texas A&M University, College Station, Texas 77843
| | - Karen Triff
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843;
| | - Robert S Chapkin
- Program in Integrative Nutrition and Complex Diseases, Texas A&M University, College Station, Texas 77843; .,Department of Biochemistry and Biophysics, Texas A&M University, College Station, Texas 77843.,Department of Nutrition and Food Science, Texas A&M University, College Station, Texas 77843.,Faculty of Toxicology, Texas A&M University, College Station, Texas 77843.,Center for Translational Environmental Health Research, Texas A&M University, College Station, Texas 77843
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17
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Morales-Hidalgo P, Roigé-Castellví J, Vigil-Colet A, Canals Sans J. The Childhood Autism Spectrum Test (CAST): Spanish adaptation and validation. Autism Res 2017; 10:1491-1498. [PMID: 28383173 DOI: 10.1002/aur.1793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/06/2017] [Accepted: 03/10/2017] [Indexed: 11/09/2022]
Abstract
The Childhood Autism Spectrum Test (CAST; Scott, Baron-Cohen, Bolton & Brayne, 2002) has proved to be a good test for screening autism spectrum disorders (ASD) and social communication problems. This study provides evidence on its psychometric properties, describe its validity for screening and provides data on its discriminative capabilities in a Spanish sample of 4-12 year-old children from community and clinical settings (N = 1460 and 36, respectively). Factorial and convergent validity is also assessed. The full Spanish version with a cut-off score of 15 presented a high sensitivity (83.9%) and specificity (92.5%), a positive predictive value (PPV) of .63 and an internal consistency (α) of .826. Some items showed low discriminating power and these results led us to propose a reduced version with 28 items and a cut-off score of 13, which presented a high sensitivity (85.7%) and specificity (91.16%), a PPV of .61 and an α of .839. Correlations were high between the Spanish full and reduced versions of the CAST, and ADI-R (Autism Diagnostic Interview Revised) and ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition). Like previous adaptation studies, a two-factor structure was found. The data show that the CAST can be a valid and reliable questionnaire for ASD screening in Spanish clinical and community populations. Autism Res 2017, 10: 1491-1498. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Paula Morales-Hidalgo
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Joana Roigé-Castellví
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Andreu Vigil-Colet
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Josefa Canals Sans
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
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18
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Guéant JL. One carbon metabolism, a complex metabolic network involved in pathomechanisms of inherited disorders, birth defects and age-related pathologies. Biochimie 2016; 126:1-2. [DOI: 10.1016/j.biochi.2016.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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