• 제목/요약/키워드: Folic acid deficiency

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Folate during reproduction: the Canadian experience with folic acid fortification

  • Lindzon, Gillian;O'Connor, Deborah L.
    • Nutrition Research and Practice
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    • 제1권3호
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    • pp.163-174
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    • 2007
  • Folate has received international attention regarding its role in the risk-reduction of birth defects, specifically neural tube defects (NTDs). In 1998 health officials in Canada, like the United States, mandated the addition of folic acid to white flour and select grain product's to increase the folate intake of reproductive-aged women. Subsequent to this initiative there has been an increase in blood folate concentrations in Canada and a 50% reduction in NTDs. Many countries, including Korea, have not mandated folic acid fortification of their food supply. Reasons vary but often include concern over the masking of vitamin $B_{12}$ deficiency, a belief that folate intakes among womenare adequate, low priority relative to other domestic issues, and the philosophy that individuals have the right not to consume supplemental folic acid if they so choose. Prior to folic acid fortification of the food supply in Canada, the folate intakes of women were low, and their blood folate concentrations while not sufficiently low to produce overt signs of folate deficiency (eg. anemia) were inconsistent with a level known to reduce the risk of an NTD-affected pregnancy. The purpose of this article is to describe the role of folate during the periconceptional period, pregnancy, and during lactation. The rationale for, and history of recommending folic acid-containing supplements during the periconceptional period and pregnancy is described as is folic acid fortification of the food supply. The impact of folic acid fortification in Canada is discussed, and unresolved issues associated with this policy described. While the incidence of NTDs in Canada pre-folic acid fortification were seemingly higherthan that of Korea today, blood folate levels of Korean women are strikingly similar. We will briefly explore these parallels in an attempt to understand whether folic acid fortification of the food supply in Korean might be worth consideration.

어미 쥐의 엽산 영양상태가 자손 쥐의 수초기본단백질(Myelin Basic Protein)발현에 미치는 영향 (Effects of Maternal Folic Acid Nutritional Status on the Expression of Myelin Basic Protein in the Offspring)

  • 채은혜;김수정;이화영;장남수
    • Journal of Nutrition and Health
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    • 제40권2호
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    • pp.130-137
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    • 2007
  • Myelin basic protein (MBP), a major structural protein of the myelin, is thought to be important for the maintenance of myelin in the central nervous system (CNS). We investigated the effect of maternal folic acid nutritional status on the folate level and the synthesis of MBP in the offspring. In order to test this hypothesis, female Sprague-Dawley rats were fed either folic acid sufficient (8 mg/kg diet) or deficient (0 mg/kg diet) diet from 2 wks prior to the mating throughout the entire pregnancy, lactation and weaning period. We examined plasma folate level by the radioimmunoassay and homocysteine level by HPLC, respectively. The MBP expression was measured by the western blot analysis. The maternal folic acid deficiency decreased plasma folate level with a concomitant increase in plasma homocysteine level in their offspring. The maternal folic acid deficiency decreased hepatic levels of SAM and SAM/SAH ratio with a concomitant increase in hepatic levels of SAH and the MBP expression of spinal cord in their offspring at 7 wks of age. These results suggest that maternal folic acid nutritional status affect plasma folate and homocysteine level in their offspring. Moreover, the maternal folic acid deficiency mi호t inhibit the MBP expression of the spinal cord and disrupt many other vital CNS reactions in their offspring.

Effects of dietary supplementation of high-dose folic acid on biomarkers of methylating reaction in vitamin $B_{12}$-deficient rats

  • Min, Hye-Sun
    • Nutrition Research and Practice
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    • 제3권2호
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    • pp.122-127
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    • 2009
  • Folate is generally considered as a safe water-soluble vitamin for supplementation. However, we do not have enough information to confirm the potential effects and safety of folate supplementation and the interaction with vitamin $B_{12}$ deficiency. It has been hypothesized that a greater methyl group supply could lead to compensation for vitamin $B_{12}$ deficiency. On this basis, the present study was conducted to examine the effects of high-dose folic acid (FA) supplementation on biomarkers involved in the methionine cycle in vitamin $B_{12}$-deficient rats. Sprague-Dawley rats were fed diets containing either 0 or $100{\mu}g$ (daily dietary requirement) vitamin $B_{12}/kg$ diet with either 2 mg (daily dietary requirement) or 100 mg FA/kg diet for six weeks. Vitamin $B_{12}$-deficiency resulted in increased plasma homocysteine (p<0.01), which was normalized by dietary supplementation of high-dose FA (p<0.01). However, FA supplementation and vitamin $B_{12}$ deficiency did not alter hepatic and brain S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) concentrations and hepatic DNA methylation. These results indicated that supplementation of high-dose FA improved homocysteinemia in vitamin $B_{12}$-deficiency but did not change SAM and SAH, the main biomarkers of methylating reaction.

Folic acid supplementation reduces oxidative stress and hepatic toxicity in rats treated chronically with ethanol

  • Lee, Soo-Jung;Kang, Myung-Hee;Min, Hye-Sun
    • Nutrition Research and Practice
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    • 제5권6호
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    • pp.520-526
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    • 2011
  • Folate deficiency and hyperhomocysteinemia are found in most patients with alcoholic liver disease. Oxidative stress is one of the most important mechanisms contributing to homocysteine (Hcy)-induced tissue injury. However it has not been examined whether exogenous administration of folic acid attenuates oxidative stress and hepatic toxicity. The aim of this study was to investigate the in vivo effect of folic acid supplementation on oxidative stress and hepatic toxicity induced by chronic ethanol consumption. Wistar rats (n = 32) were divided into four groups and fed 0%, 12%, 36% ethanol, or 36% ethanol plus folic acid (10 mg folic acid/L) diets. After 5 weeks, chronic consumption of the 36% ethanol diet significantly increased plasma alanine transaminase (ALT) (P < 0.05) and aspartate transaminase (AST) (P < 0.05), triglycerides (TG) (P < 0.05), Hcy (P < 0.001), and low density lipoprotein conjugated dienes (CD) (P < 0.05) but decreased total radical-trapping antioxidant potential (TRAP) (P < 0.001). These changes were prevented partially by folic acid supplementation. The 12% ethanol diet had no apparent effect on most parameters. Plasma Hcy concentration was well correlated with plasma ALT (r = $0.612^{**}$), AST (r = $0.652^*$), CD (r = $0.495^*$), and TRAP (r = $-0.486^*$). The results indicate that moderately elevated Hcy is associated with increased oxidative stress and liver injury in alcohol-fed rats, and suggests that folic acid supplementation appears to attenuate hepatic toxicity induced by chronic ethanol consumption possibly by decreasing oxidative stress.

Contemporary Issues Surrounding Folic Acid Fortification Initiatives

  • Choi, Jeong-Hwa;Yates, Zoe;Veysey, Martin;Heo, Young-Ran;Lucock, Mark
    • Preventive Nutrition and Food Science
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    • 제19권4호
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    • pp.247-260
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    • 2014
  • The impact of folate on health and disease, particularly pregnancy complications and congenital malformations, has been extensively studied. Mandatory folic acid fortification therefore has been implemented in multiple countries, resulting in a reduction in the occurrence of neural tube defects. However, emerging evidence suggests increased folate intake may also be associated with unexpected adverse effects. This literature review focuses on contemporary issues of concern, and possible underlying mechanisms as well as giving consideration the future direction of mandatory folic acid fortification. Folate fortification has been associated with the presence of unmetabolized folic acid (PteGlu) in blood, masking of vitamin $B_{12}$ deficiency, increased dosage for anti-cancer medication, photo-catalysis of PteGlu leading to potential genotoxicity, and a role in the pathoaetiology of colorectal cancer. Increased folate intake has also been associated with twin birth and insulin resistance in offspring, and altered epigenetic mechanisms of inheritance. Although limited data exists to elucidate potential mechanisms underlying these issues, elevated blood folate level due to the excess use of PteGlu without consideration of an individual's specific phenotypic traits (e.g. genetic background and undiagnosed disease) may be relevant. Additionally, the accumulation of unmetabolized PteGlu may lead to inhibition of dihydrofolate reductase and other enzymes. Concerns notwithstanding, folic acid fortification has achieved enormous advances in public health. It therefore seems prudent to target and carefully monitor high risk groups, and to conduct well focused further research to better understand and to minimize any risk of mandatory folic acid fortification.

Interactions Between MTHFR C677T - A1298C Variants and Folic Acid Deficiency Affect Breast Cancer Risk in a Chinese Population

  • Wu, Xia-Yu;Ni, Juan;Xu, Wei-Jiang;Zhou, Tao;Wang, Xu
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2199-2206
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    • 2012
  • Background: Our objective was to evaluate the MTHFR C677T-A1298C polymorphisms in patients with breast cancer and in individuals with no history of cancer, to compare the levels of genetic damage and apoptosis under folic acid (FA) deficiency between patients and controls, and to assess associations with breast cancer. Methods: Genetic damage was marked by micronucleated binucleated cells (MNBN) and apoptosis was estimated by cytokinesis-block micronucleus assay (CBMN). PCR-RFLP molecular analysis was carried out. Results: The results showed significant associations between the MTHFR 677TT or the combined MTHFR C677T-A1298C and breast cancer risk (OR = 2.51, CI = 0.85 to 7.37, p = 0.08; OR = 4.11, CI = 0.78 to 21.8, p < 0.001). The MNBN from the combined MTHFR C677T-A1298C was higher and the apoptosis was lower than that of the single variants (p < 0.05). At 15 to 60 nmol/L FA, the MNBN in cases with the TTAC genotype was higher than controls (p < 0.05), whereas no significant difference in apoptosis was found between the cases and controls after excluding the genetic background. Conclusions: Associations between the combined MTHFR C677T-A1298C polymorphism and breast cancer are possible from this study. A dose of 120 nmol/L FA could enhance apoptosis in cases with MTHFR C677T-A1298C. Breast cancer individuals with the TTAC genotype may be more sensitive to the genotoxic effects of FA deficiency than controls.

Effects of parental folate deficiency on the folate content, global DNA methylation, and expressions of FR${\alpha}$, IGF-2 and IGF-1R in the postnatal rat liver

  • Mejos, Karen Kay;Kim, Hye Won;Lim, Eun Mi;Chang, Namsoo
    • Nutrition Research and Practice
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    • 제7권4호
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    • pp.281-286
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    • 2013
  • We examined the effect of parental folate deficiency on the folate content, global DNA methylation, folate receptor-alpha (FR${\alpha}$), insulin-like-growth factor-2 (IGF-2) and -1 receptor (IGF-1R) in the liver and plasma homocysteine in the postnatal rat. Male and female rats were randomly fed a folic acid-deficient (paternal folate-deficient, PD and maternal folate-deficient, MD), or folic acid-supplemented diet (paternal folate-supplemented, PS and maternal-folate-supplemented, MS) for four weeks. They were mated and grouped accordingly: $PS{\times}MS$, $PS{\times}MD$, $PD{\times}MS$, and $PD{\times}MD$. Pups were killed on day 21 of lactation. The hepatic folate content was markedly reduced in the $PD{\times}MD$ and $PS{\times}MD$ and $PD{\times}MS$ as compared with the $PS{\times}MS$ group. The hepatic global DNA methylation was decreased in the $PD{\times}MS$ and $PS{\times}MD$ groups as much as in the $PD{\times}MD$ group, and all the three groups were significantly lower as compared to the $PS{\times}MS$ group. There were no significant differences in the hepatic FR${\alpha}$, IGF-2 and IGF-1R expressions among the groups. Positive correlations were found between the hepatic folate content and global DNA methylation and protein expressions of FR${\alpha}$, IGF-2 and IGF-1R, whereas an inverse correlation was found between hepatic folate content and plasma homocysteine level in the 3-week-old rat pup. The results of this study show that both paternal and maternal folate deficiency at mating can influence the folate content and global DNA methylation in the postnatal rat liver.

뇌출혈(腦出血) 환자의 철결핍성(鐵缺乏性) 빈혈(貧血)을 귀비탕합사물탕(歸脾湯合四物湯)으로 치료한 임상(臨床) 1례(例) (1 Case of Iron Deficiency Anemia treated with Gwibitang(歸脾湯) plus(合) Samultang(四物湯) in the Patient of Cerebral Hemorrhage)

  • 고현;안효명;황규동;이은숙
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.877-881
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    • 2000
  • Anemia is present in adult if the hematocrit is less than 41%(hemoglobin <13.5g/dL) in males or 37%(hemoglobin <12g/dL) in females. In taking the history, congenital anemia may be suggested by the patient's personal and family history. Poor diet results in folic acid deficiency and may contribute to iron deficiency. Bleeding should always be considered in iron deficiency. Object : The symptoms of this patient are easy fatigability, dizziness, anorexia and paleness of the face. This women is the patient of iron deficiency anemia, cerebral hemorrhage and hypertension. Medication : Gwibitang(歸脾湯) plus(合) Samultang(四物湯) and feroba are dispensed for 30 days. Result : After 30 days, HCT Hb Iron of the laboratory findings are increased and TIBC of the laboratory findings is decreased.

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Effect of paternal folate deficiency on placental folate content and folate receptor ${\alpha}$ expression in rats

  • Kim, Hye-Won;Choi, Yun-Jung;Kim, Ki-Nam;Tamura, Tsunenobu;Chang, Nam-Soo
    • Nutrition Research and Practice
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    • 제5권2호
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    • pp.112-116
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    • 2011
  • We investigated the effect of paternal folate status on folate content and expression of the folate transporter folate receptor ${\alpha}$ ($FR{\alpha}$) in rat placental tissues. Rats were mated after males were fed a diet containing 0 mg of folic acid/kg of diet (paternal folate-deficient, PD) or 8 mg folic acid/kg of diet (paternal folate-supplemented, PS) for 4 weeks. At 20 days of gestation, the litter size, placental weight, and fetal weight were measured, and placental folate content (n=8/group) and expression of $FR{\alpha}$ (n=10/group) were analyzed by microbiological assay and Western blot analysis, respectively. Although there was no difference observed in litter size or fetal weight, but significant reduction (10%) in the weight of the placenta was observed in the PD group compared to that in the PS group. In the PD group, placental folate content was significantly lower (by 35%), whereas $FR{\alpha}$ expression was higher (by 130%) compared to the PS group. Our results suggest that paternal folate status plays a critical role in regulating placental folate metabolism and transport.

위암환자의 위절제술 전후의 빈혈 (Preoperative and Postoperative Anemia in Patients with Gastric Cancer)

  • 손준호;유완식
    • Journal of Gastric Cancer
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    • 제5권3호
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    • pp.146-151
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    • 2005
  • 목적: 위암환자에서 수술 전 빈혈의 빈도 및 특성과 위절제술 후 빈혈의 특성에 대해 알아보고 위절제술 전후의 적절한 빈혈 관리 방법을 모색하여 환자 진료에 도움을 얻기 위하여 이 연구를 하였다. 대상 및 방법: 2001년 1월부터 2001년 12월까지 경북대학교병원에서 위암으로 위절제술을 받은 32f명의 환자들을 대상으로 수술 전과 수술 후에 혈색소, 혈청 철, 혈청 페리틴, 혈청 비타민 $B_{12}$, 혈청 엽산을 측정하였다. 결과: 수술 전 빈혈이 있었던 환자는 94명이었다. 수술 전 혈색소, 혈청 철, 혈청 비타민 $B_{12}$는 조기위암 환자에서 진행성 위암환자보다 높았다. 수술 전 혈색소, 혈청 철, 혈청 페리틴 농도는 남자환자에서 여자환자보다 높았다. 수술 전 빈혈이 있었던 환자가 위절제술 후에도 빈혈이 있을 확률이 의미 있게 높게 나타났다(P<0.001). 또한, 수술 전 저장 철 결핍이 있던 환자들이 위절제술 후에도 빈혈에 이환되거나 지속적 저장 철 결핍이 있을 확률이 의미 있게 높게 나타났다(P<0.001). 결론: 위절제술 전 저장 철 결핍이 있던 환자들은 수술 후에도 저장 철 결핍이 지속되거나 철 결핍성 빈혈이 발생할 가능성이 많고, 수술 전 빈혈이 있던 환자가 수술 후에도 빈혈에 이환 될 가능성이 많으므로 빈혈 및 철 결핍의 관리가 중요하며, 위절제술 후 철 결핍과 함께 비타민 $B_{12}$ 및 엽산의 결핍도 관찰되므로 수술 후 빈혈 지표를 추적 관찰하여 교정하는 것이 중요하다고 생각된다

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