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Tomita LY, da Costa AC, Andreoni S, Oyafuso LK, D’Almeida V, Fonseca FL, Rocha AC, Kobata C. Folate Nutritional Status among Psoriasis Patients not Exposed to Antifolate Drug. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401314666180702100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Folic acid fortification program has been established to prevent tube defects.
However, concern has been raised among patients using anti-folate drug, i.e. psoriatic patients, a
common, chronic, autoimmune inflammatory skin disease associated with obesity and smoking.
Objective:
To investigate dietary and circulating folate, vitamin B12 (B12) and homocysteine (hcy) in
psoriatic subjects exposed to the national mandatory folic acid fortification program.
Methods:
Cross-sectional study using the Food Frequency Questionnaire, plasma folate, B12, hcy and
psoriasis severity using the Psoriasis Area and Severity Index score. Median, interquartile ranges
(IQRs) and linear regression models were conducted to investigate factors associated with plasma folate,
B12 and hcy.
Results:
82 (73%) mild psoriasis, 18 (16%) moderate and 12 (11%) severe psoriasis. 58% female,
61% non-white, 31% former smokers, and 20% current smokers. Median (IQRs) were 51 (40, 60)
years. Only 32% reached the Estimated Average Requirement of folate intake. Folate and B12 deficiencies
were observed in 9% and 6% of the blood sample respectively, but hyperhomocysteinaemia
in 21%. Severity of psoriasis was negatively correlated with folate and B12 concentrations. In a multiple
linear regression model, folate intake contributed positively to 14% of serum folate, and negative
predictors were psoriasis severity, smoking habits and saturated fatty acid explaining 29% of circulating
folate.
Conclusion:
Only one third reached dietary intake of folate, but deficiencies of folate and B12 were
low. Psoriasis severity was negatively correlated with circulating folate and B12. Stopping smoking
and a folate rich diet may be important targets for managing psoriasis.
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Affiliation(s)
- Luciana Y. Tomita
- Departamento de Medicina Preventiva, Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | | | - Solange Andreoni
- Departamento de Medicina Preventiva, Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | | | - Vânia D’Almeida
- Departamento de Psicobiologia, EPM, UNIFESP, Sao Paulo, Brazil
| | | | - Ana C.L. Rocha
- Departamento de Medicina Preventiva, Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
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Chung-Filho AA, Brisson GD, Vieira TMF, Chagas-Neto P, Soares-Lima SC, Pombo-de-Oliveira MS. MTHFR rs1801133 polymorphism is associated with increased risk of B-cell precursor lymphoblastic leukaemia with recurrent genetic aberrations of fetal origin. Cancer Epidemiol 2020; 65:101693. [PMID: 32135505 DOI: 10.1016/j.canep.2020.101693] [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: 10/13/2019] [Revised: 01/31/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Childhood acute lymphoblastic leukaemia (ALL) is a heterogeneous disease associated with multiple risk factors including genetic susceptibility. Polymorphisms in folate genes have been associated with a protective effect against ALL, although some studies contradict these findings. We aimed to test whether there is an association between the MTHFR rs1801133 variant and the occurrence of B-cell precursor ALL (BCP-ALL) taking in account molecularly distinct subtypes of fetal origin. METHODS We performed a case-control genotyping study with 2067 samples, 1309 ALL and 758 controls, from children aged ≤ 15 years for MTHFR rs1801133 polymorphism. Risk associations were calculated by odds ratios estimated with unconditional logistic regression, adjusted for frequency-matched ethnic groups. RESULTS Overall, MTHFR rs1801133 does not impact ALL risk in children with more than 6 years of age. A significant positive association for MTHFR rs1801133 variant was found for ALL with KMT2A-r in the dominant model (adj. OR, 1.48, 95 % CI, 1.01-2.17), while ETV6-RUNX1 and Hyperdiploid subgroups have shown a borderline effect (adj. OR, 1.33, 95 % CI, 0.99-1.78). CONCLUSIONS The polymorphism MTHFR rs1801133 increased the risk of infant ALL in Brazilian population.
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Affiliation(s)
- Alython Araujo Chung-Filho
- Pediatric Hematology-Oncology Research Program, Coordenação de Pesquisa, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Gisele Dallapicola Brisson
- Pediatric Hematology-Oncology Research Program, Coordenação de Pesquisa, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Tállita Mecianny Farias Vieira
- Pediatric Hematology-Oncology Research Program, Coordenação de Pesquisa, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Paulo Chagas-Neto
- Pediatric Hematology-Oncology Research Program, Coordenação de Pesquisa, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Sheila Coelho Soares-Lima
- Molecular Carcinogenesis Research Program, Coordenação de Pesquisa, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
| | - Maria S Pombo-de-Oliveira
- Pediatric Hematology-Oncology Research Program, Coordenação de Pesquisa, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
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Godoy A, Tabares AH. Prevalence of low folate deficiency after wheat flour supplementation - should we still measure serum folate? Hematol Transfus Cell Ther 2018; 40:305-309. [PMID: 30370407 PMCID: PMC6200696 DOI: 10.1016/j.htct.2018.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 03/28/2018] [Indexed: 11/17/2022] Open
Abstract
Objectives To determine the frequency of folic acid deficiency in consecutive serum folate determinations and to determine whether there was a significant decrease in serum folate deficiency after folate was added to wheat flour. Methods A retrospective descriptive observational study was performed of consecutive folate measurements at the Hospital Privado Universitario, Cordoba, Argentina. Results Two cohorts were analyzed: 1197 folate measurements between 2001 and 2008 (before supplementation) and 3335 folate measurements from 2009 to 2014 (after supplementation). Folate deficiency was found in 84/1197 (7%) subjects in the pre-supplementation group and in 58/3335 (1.73%) after supplementation. The prevalence of folate deficiency was 12% between 2001 and 2003 when folate was not added to flour compared to 4% in 2004-2007 (p-value < 0.0001) when folate was added to the flour but no widespread use was documented. Conclusions In the studied population, the prevalence of serum folic acid deficiency after folate supplementation was low at 1.73%. There was a significant decrease in folate deficiency after folate was added to wheat flour. Given the low prevalence of folic acid deficiency observed in this and similar studies, and the observed change with supplementation, we conclude that routine measurement of serum folate is of limited clinical use.
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Affiliation(s)
| | - Aldo Hugo Tabares
- Hospital Privado Universitario Córdoba, Córdoba, Argentina.,Instituto Universitario de Ciencias Biomédicas Córdoba (IUCBC), Córdoba, Argentina
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Noor RA, Abioye AI, Ulenga N, Msham S, Kaishozi G, Gunaratna NS, Mwiru R, Smith E, Dhillon CN, Spiegelman D, Fawzi W. Large -scale wheat flour folic acid fortification program increases plasma folate levels among women of reproductive age in urban Tanzania. PLoS One 2017; 12:e0182099. [PMID: 28797054 PMCID: PMC5552223 DOI: 10.1371/journal.pone.0182099] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/12/2017] [Indexed: 12/26/2022] Open
Abstract
There is widespread vitamin and mineral deficiency problem in Tanzania with known deficiencies of at least vitamin A, iron, folate and zinc, resulting in lasting negative consequences especially on maternal health, cognitive development and thus the nation's economic potential. Folate deficiency is associated with significant adverse health effects among women of reproductive age, including a higher risk of neural tube defects. Several countries, including Tanzania, have implemented mandatory fortification of wheat and maize flour but evidence on the effectiveness of these programs in developing countries remains limited. We evaluated the effectiveness of Tanzania's food fortification program by examining folate levels for women of reproductive age, 18-49 years. A prospective cohort study with 600 non-pregnant women enrolled concurrent with the initiation of food fortification and followed up for 1 year thereafter. Blood samples, dietary intake and fortified foods consumption data were collected at baseline, and at 6 and 12 months. Plasma folate levels were determined using a competitive assay with folate binding protein. Using univariate and multivariate linear regression, we compared the change in plasma folate levels at six and twelve months of the program from baseline. We also assessed the relative risk of folate deficiency during follow-up using log-binomial regression. The mean (±SE) pre-fortification plasma folate level for the women was 5.44-ng/ml (±2.30) at baseline. These levels improved significantly at six months [difference: 4.57ng/ml (±2.89)] and 12 months [difference: 4.27ng/ml (±4.18)]. Based on plasma folate cut-off level of 4 ng/ml, the prevalence of folate deficiency was 26.9% at baseline, and 5% at twelve months. One ng/ml increase in plasma folate from baseline was associated with a 25% decreased risk of folate deficiency at 12 months [(RR = 0.75; 95% CI = 0.67-0.85, P<0.001]. In a setting where folate deficiency is high, food fortification program with folic acid resulted in significant improvements in folate status among women of reproductive age.
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Affiliation(s)
- Ramadhani A. Noor
- Africa Academy for Public Health (AAPH), Dar es Salaam, Tanzania
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ajibola I. Abioye
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Nzovu Ulenga
- Africa Academy for Public Health (AAPH), Dar es Salaam, Tanzania
- Management Development for Health (MDH), Dar es Salaam, Tanzania
| | - Salum Msham
- Africa Academy for Public Health (AAPH), Dar es Salaam, Tanzania
| | | | - Nilupa S Gunaratna
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ramadhani Mwiru
- Africa Academy for Public Health (AAPH), Dar es Salaam, Tanzania
| | - Erin Smith
- Helen Keller International, Dar es Salaam, Tanzania
| | | | - Donna Spiegelman
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
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McStay CL, Prescott SL, Bower C, Palmer DJ. Maternal Folic Acid Supplementation during Pregnancy and Childhood Allergic Disease Outcomes: A Question of Timing? Nutrients 2017; 9:nu9020123. [PMID: 28208798 PMCID: PMC5331554 DOI: 10.3390/nu9020123] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/03/2017] [Indexed: 12/17/2022] Open
Abstract
Since the early 1990s, maternal folic acid supplementation has been recommended prior to and during the first trimester of pregnancy, to reduce the risk of infant neural tube defects. In addition, many countries have also implemented the folic acid fortification of staple foods, in order to promote sufficient intakes amongst women of a childbearing age, based on concerns surrounding variable dietary and supplementation practices. As many women continue to take folic acid supplements beyond the recommended first trimester, there has been an overall increase in folate intakes, particularly in countries with mandatory fortification. This has raised questions on the consequences for the developing fetus, given that folic acid, a methyl donor, has the potential to epigenetically modify gene expression. In animal studies, folic acid has been shown to promote an allergic phenotype in the offspring, through changes in DNA methylation. Human population studies have also described associations between folate status in pregnancy and the risk of subsequent childhood allergic disease. In this review, we address the question of whether ongoing maternal folic acid supplementation after neural tube closure, could be contributing to the rise in early life allergic diseases.
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Affiliation(s)
- Catrina L McStay
- Department of Health Western Australia, Perth 6004, Western Australia, Australia.
| | - Susan L Prescott
- School of Paediatrics and Child Health, The University of Western Australia, Subiaco 6008, Western Australia, Australia.
- Telethon Kids Institute, The University of Western Australia, Subiaco 6008, Western Australia, Australia.
- Members of the in-FLAME International Inflammation Network, Perth 6000, Western Australia, Australia.
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Subiaco 6008, Western Australia, Australia.
| | - Debra J Palmer
- School of Paediatrics and Child Health, The University of Western Australia, Subiaco 6008, Western Australia, Australia.
- Telethon Kids Institute, The University of Western Australia, Subiaco 6008, Western Australia, Australia.
- Members of the in-FLAME International Inflammation Network, Perth 6000, Western Australia, Australia.
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