B族维生素及同型半胱氨酸与复发性流产的关系

目的测定血清叶酸、维生素B。同型半胱氨酸及红细胞叶酸水平,探讨其与早期原因不明复发性流产的关系。方法分别采用磁微粒酶免疫分析方法、ELISA方法及电化学发光法测定流产组与对照组外周血中血清叶酸、维生素B12、同型半胱氨酸及红细胞叶酸水平。结果76例早期原因不明复发性流产患者（流产组）与40例正常同期育龄期妇女（对照组）比较,血清叶酸（t=-3．631,P〈0．005）、维生素B12（t=-4．790,P〈0．005）、同型半胱氨酸（t=3．019,P〈0．005）及红细胞叶酸（t=-3．640,P〈0．005）,均有显著性差异。流产组A组（补充0．4mg／d叶酸片）与B组（补充5mg／d叶酸片及复合维生素B）,2组补充叶酸后1个月与首诊比较,血清叶酸（t=2．131,P〈0．005）及同型半胱氨酸（t=2．685,P〈0．05）,均有显著性差异。结论体内叶酸水平低下可能是早期原因不明复发性流产发生、发展的-个重要因素,它的检测对于早期原因不明复发性流产患者的预防及治疗具有一定的临床意义。     

上海某社区居民叶黄素膳食摄入量与血清含量的相关性分析

[目的]了解某社区40岁～居民叶黄素营养水平,分析膳食叶黄素摄入量和血清叶黄素含量之间有无相关性。[方法]将341名调查对象分为40岁-、50岁～和60岁～年龄组。采用24h和食物定量频率法问卷法进行膳食调查,计算出平均每人每日膳食叶黄素摄入量。采用高效液相色谱法检测血清叶黄素含量。并对膳食叶黄素摄入量和血清叶黄素含量进行相关性分析。[结果]血清叶黄素在0．08～1．6μ／mL范围内线性良好,相关系数为r=0．9973,回收率为97．85％～103．67％,日内和日间变异系数分别为2．32％和3．08％,最低检测限为0．0250edmL。蔬菜是调查对象膳食叶黄素的主要来源,尤其是菠菜、韭菜、西兰花;膳食叶黄素摄入量和血清叶黄素含量分别为（7．77±2．10）mg／d和（0．370±0．183）μmol／L,且60岁～组均明显低于50岁一组（P〈0．05）;膳食叶黄素摄入量与血清三酰甘油呈负相关（r=-0．108,P〈0．05）,与血清胆固醇呈正相关（r=0．231,P〈0．001）,与血清叶黄素含量呈正相关（r=0．681,P〈0．001）.[结论]膳食和血清叶黄素明显相关,后者可以作为反映叶黄素营养状况的指标。老年人更应注重叶黄素的摄入和补充。     

妊娠期高血压疾病患者血浆总同型半胱氨酸水平监测及其干预治疗的研究

目的:研究血浆总同型半胱氨酸(tHcy)水平和血清叶酸、维生素B12(VitB12)水平与妊娠期高血压疾病的关系并进行干预治疗研究。方法:测定350例妊娠期高血压疾病患者(A组)和350例正常晚期妊娠妇女(B组)血浆tHcy水平和血清叶酸、VitB12水平,并对妊娠期高血压疾病伴高同型半胱氨酸(Hcy)血症患者应用叶酸联合甲钴胺进行干预治疗(给予叶酸5mg,每日3次,甲钴胺500μg,每日1次,疗程4周),测定治疗前后患者血浆tHcy水平和血清叶酸、VitB12水平。结果:血浆tHcy水平A组显著高于B组(P<0.01),血清叶酸、VitB12水平A组显著低于B组(P<0.01);A组中83例伴高Hcy血症患者经叶酸联合甲钴胺干预治疗4周后,血浆tHcy水平显著下降(P<0.01),血清叶酸、VitB12水平显著上升(P<0.01)。结论:妊娠期高血压疾病患者血浆tHcy水平显著上升,血清叶酸、VitB12水平显著下降,叶酸联合甲钴胺干预治疗能使妊娠期高血压疾病伴高Hcy血症患者血浆tHcy水平显著下降。     

广州市中老年居民植物甾醇摄入状况调查

目的调查广州市社区中老年人群膳食植物甾醇的摄入状况,分析不同性别人群不同类别植物甾醇的摄人状况和食物来源。方法采取分层整群随机抽样方法,使用食物频数法调查599位45-65岁居民（男性222人,女性377人）的膳食状况,依据国内文献发表的食物中植物甾醇含量计算居民膳食植物甾醇的摄入量。结果研究对象的植物甾醇摄入量为（336．36±142．88）mg／d,其中β-谷甾醇（218．53±95．20）mg／d,菜油甾醇（48．33±23．69）mg／d,豆甾醇（36．40±14．38）mg／d,β-谷甾烷醇（30．65±13．62）mg／d,菜油甾烷醇（4．67±2．77）mg／d。女性植物甾醇摄入量显著高于男性[（345．45±141．06）mg／d比（320．93±144．95）mg／d,P=0．0425]。膳食中植物甾醇的主要来源是植物油类（37．2％）、蔬菜类（19．8％）、谷类（18．5％）和水果类（12．5％）。每兆焦能量中植物甾醇摄人量为（42．94±15．66）mg,摄入能量相同时,女性植物甾醇摄入量显著高于男性[（46．04±15．90）ms／1000kJ比（37．69±13．76）mg／1000kJ,P=0．0000]。结论广州中老年女性植物甾醇摄入量高于男性。     

浙江省成人血清同型半胱氨酸水平的横断面研究

目的 高同型半胱氨酸血症(HHcy)是心血管疾病的独立危险因素。本研究根据不同年龄、性别和季节调查浙江省健康成人血清总同型半胱氨酸(tHcy)浓度和HHcy患病率，以期对浙江省成人tHcy状态有全面了解。方法 对来自浙江省人民医院18岁以上11 843例健康体检者进行横断面研究。tHcy水平通过酶法测定。HHcy定义为tHcy水平高于15μmol/L。结果 全人群tHcy中位数为13.4(11.3,15.8)μmol/L,HHcy患病率为31.69%。男性的tHcy水平中位数为15.0(13.3,17.4)μmol/L,女性为11.4(10.0,13.0)μmol/L,男性的tHcy水平高于女性(P<0.001)。男性的HHcy患病率高于女性(49.33%vs 10.15%,P<0.05)。不同年龄段男性tHcy水平和HHcy患病率均高于女性(P<0.05)。随着年龄增长，男女tHcy水平浓度和HHcy患病率均呈现先降低后升高的趋势。50岁以上男女的tHcy水平和HHcy患病率均增加(P<0.05)。tHcy水平和HHcy患病率有明显的季节差异，且男性在春季、秋...     

轻中度高血压人群叶酸与同型半胱氨酸水平的相关分析

目的探讨轻中度高血压患者血清叶酸水平与血浆总同型半胱氨酸水平（tHcy）的相关性。方法从哈尔滨、沈阳、北京、西安、上海和南京六城市分析455位28～75岁轻中度原发性高血压患者，测定血清叶酸和血浆同型半胱氨酸水平。结果叶酸水平低于15nmol／L时，叶酸水平越低，tHcy水平越高，高tHcy血症的发生率也越高。结论轻中度高血压患者中，血清叶酸水平与血浆tHcy水平呈负相关。     

血清同型半胱氨酸、脂联素及IL-6联合检测在冠心病中的应用价值

目的探讨血清同型半胱氨酸（HCY）、脂联素（APN）及白细胞介素-6（IL-6）联合检测在冠心病中的应用价值。方法60例冠心病患者及40例正常对照组分别进行血清同型半胱氨酸、脂联素及IL-6的检测。结果冠心病组HCY水平为（49．0±17．1）μmol／L,显著高于正常对照组的（12．9±6．7）μmol／L．（P〈0．01）;冠心病组APN水平为（7．9±3．2）mg／L,显著低于正常对照组的（10．4±6．2）mg／L（P〈0．01）;冠心病组IL-6水平为（48．2±16．3）ng／L,显著高于正常对照组的（7．9±5．2）ng／L（P〈0．01）。三者联合检测对于冠心病的诊断指标敏感度、特异度、阳性预期值、阴性预期值分别为91．7％、98．3％、98．2％、92．2％。结论血清同型半胱氨酸、脂联素、IL-6检测在冠心病中有诊断价值,联合应用效果更佳。     

中老年人群同型半胱氨酸分布特点及其健康教育

目的了解某炼化公司中老年人群血清同型半胱氨酸（homocysteine,Hcy）分布特点,为该地区高同型半胱氨酸血症（hyperhomocysteinemia,HHcy）人群提供健康教育对策。方法整理5113名某炼化公司40岁以上人群体检资料,分析不同性别、年龄段血清Hcy水平和HHcy检出率及与传统心血管疾病主要危险因素的相关关系。结果某炼化公司40岁以上中老年人群的血清Hcy水平为（11.52±7.6）μmol/L,各年龄段男性血清Hcy水平及HHcy检出率均高于女性（P〈0.05）;同性别年龄组之间HHcy检出率随年龄的增加呈增高趋势;男性、年龄、收缩压、体质量指数、高血压病和肌酐清除率与HHcy存在相关性（P〈0.05）。结论某炼化公司40岁以上中老年人群的血清Hcy水平存在有性别与年龄的差异,男性、年龄、收缩压、体质量指数、肌酐清除率和高血压病史是HHcy的危险因素。男性40岁、女性60岁以上人群是本地区实施HHcy健康教育的目标人群。     

急性脑梗死患者血清同型半胱氨酸水平分析

目的研究急性脑梗死患者血清同型半胱氨酸（Hcy）含量,可望了解其部分发病机理。方法采用化学发光免疫分析法,测定116例已确诊的急性脑梗死患者的血清Hcy的含量,并与55名健康对照者比较。结果①脑梗组血Hcy平均为（28．97±20．96）μmol／L,对照组平均为（12．11±3．80）μmol／L。脑梗组明显高于正常对照组,急性脑梗死组与正常对照组的Hcy含量比较,差异有统计学意义（t=5．912,P=0．000〈0．01）;②男性脑梗组Hcy的水平（30．69±20．90）μmol／h,女性Hcy的水平（25．16±18．43）μmol／L,经比较,差异无统计学意义（t=1．319,P=0．190〉0．05）。结论同型半胱氨酸在急性脑梗死患者升高。     

血浆同型半胱氨酸水平对糖尿病视网膜病变的预测意义

目的探讨血浆同型半胱氨酸与糖尿病视网膜病变（DR）的关系。方法比较40例DR（DR组）和63例非DR（非DR组）2型糖尿病患者血浆同型半胱氨酸水平、病程、年龄、血压、空腹血糖、糖化血红蛋白（GHbA1c）、血脂、叶酸及维生素B12等与DR可能相关的指标。结果DR组血浆同型半胱氨酸水平中位数为12．9μmol／L,与非DR组的7．8μmol／L比较,差异有统计学意义（P〈0．01）,两组在校正了病程、GHbA1c、年龄、叶酸及维生素B12后仍显著相关（OR值1．23,P〈0．05）。结论高同型半胱氨酸血症为DR的危险因素,并为独立的预测因子。     

Increased dietary micronutrients decrease serum homocysteine concentrations in patients at high risk of cardiovascular disease.

BACKGROUND: Elevated blood homocysteine is a risk factor for cardiovascular disease. A 5-micromol/L increase is associated with an approximately 70% increase in relative risk of cardiovascular disease in adults. For patients with established risk factors, this risk is likely even greater. OBJECTIVE: Effects of increased dietary folate and recommended intakes of vitamins B-12 and B-6 on serum total homocysteine (tHcy) were assessed in individuals at high risk of cardiovascular disease. DESIGN: This trial was conducted at 10 medical research centers in the United States and Canada and included 491 adults with hypertension, dyslipidemia, type 2 diabetes, or a combination thereof. Participants were randomly assigned to follow a prepared meal plan (PMP; n = 244) or a self-selected diet (SSD; n = 247) for 10 wk, which were matched for macronutrient content. The PMP was fortified to provide >/=100% of the recommended dietary allowances for 23 micronutrients, including folate. RESULTS: Mean folate intakes at 10 wk were 601 +/- 143 microgram/d with the PMP and 270 +/- 107 microgram/d with the SSD. With the PMP, serum tHcy concentrations fell from 10.8 +/- 5.8 to 9.3 +/- 4.9 micromol/L (P < 0.0001) between weeks 0 and 10 and the change was associated with increased intakes of folate, vitamin B-12, and vitamin B-6 and with increased serum and red blood cell folate and serum vitamin B-12 concentrations. tHcy concentrations did not change significantly with the SSD. CONCLUSIONS: The PMP resulted in increased intakes and serum concentrations of folate and vitamin B-12. These changes were associated with reduced serum tHcy concentrations in persons at high risk of cardiovascular disease.     

Correlations between folate, B12, homocysteine levels, and radiological markers of neuropathology in elderly post-stroke patients

OBJECTIVE: To investigate serum levels of folate, B12, and total homocysteine (tHcy) in elderly post-stroke patients, and the possible correlations with radiological markers of neuropathology. DESIGN: Cross-sectional study. SETTING: Department of Neurology, Cardinal Tien Hospital. SUBJECTS: Eighty-nine elderly post-stroke patients were enrolled for dietary assessment and blood tests. Neuroradiological assessment was done in 62 of these patients. MAIN OUTCOME MEASURES: Dietary folate and vitamin B12 intakes were evaluated by a 24-h recall system using a semi-quantitative questionnaire. Circulating levels of folate, B12, and tHcy were measured. Magnetic resonance imaging (MRI) or computed tomography (CT) was used for evaluation of brain lesions including infarction and atrophy. RESULTS: Mean folate and B12 intakes of these post-stroke patients were 69% and 261% of the recommended dietary allowances (RDA), respectively. Inadequate folate levels, defined as serum folate < 6 ng/mL, was noted in 68% of these patients. Hyperhomocysteinemia levels (tHcy >or=15 micromol/L) were observed in 48%. According to tertiles of serum tHcy and folate levels, the rate of brain atrophy, but not brain infarctions, are significantly associated with elevated tHcy (P = 0.0126) and decreased folate levels (P = 0.0273). After adjustments for age, sex, disease status, brain infarctions and carotid stenosis, the odds ratio of brain atrophy was 9.8 (95% CI: 1.7-56.4, P = 0.0101) in the hyperhomocysteinemia group and 9.6 (95% CI: 1.1-81.3, P = 0.0377) in the low folate group (serum folate < 3.0 ng/mL) compared with the group with normal tHcy and folate levels. No significant association was noted between vitamin B12 levels and brain lesions. CONCLUSIONS: Our data shows that folate deficiency and hyperhomocysteinemia are prevalent in elderly post-stroke patients. These two conditions are strongly and independently associated with the development of brain atrophy.     

Homocysteine,cardiovascular disease risk factors,and habitual diet in the French Supplementation with Antioxidant Vitamins and Minerals Study

BACKGROUND: An elevated plasma total homocysteine (tHcy) concentration seems to increase the risk of cardiovascular disease. OBJECTIVE: We evaluated the determinants of tHcy in healthy French adults. DESIGN: tHcy was measured by HPLC and fluorometric detection in 1139 women and 931 men aged 35-60 y. Subjects were participants of the Supplementation with Antioxidant Vitamins and Minerals Study, which investigates the effects of antioxidant supplementation on chronic diseases. Red blood cell folate (RBCF), plasma vitamins B-6 and B-12, and cardiovascular disease risk factors were also measured. The habitual diet was assessed in 616 subjects. Cross-sectional analyses were adjusted for age, smoking, energy intake, and concentration or intake of folate and vitamin B-6, where appropriate. RESULTS: The mean (+/-SD) tHcy concentration was 8.74 +/- 2.71 micro mol/L in women and 10.82 +/- 3.49 micro mol/L in men. In women, tHcy was positively related to age (P = 0.001), apolipoprotein B (P < 0.01), serum triacylglycerol (P < 0.01), fasting glucose (P = 0.02), and coffee and alcohol consumption (both P < 0.01) and inversely related to RBCF (P = 0.11) and plasma vitamin B-12 (P = 0.08) and vitamin B-6 (P = 0.01) intakes. In men, tHcy was positively associated with body mass index (P = 0.03), blood pressure (P < 0.02), serum triacylglycerol (P < 0.01), fasting glucose (P = 0.01), and energy intake (P < 0.01) and inversely associated with physical activity (P = 0.04), RCBF (P = 0.02), plasma vitamin B-12 (P = 0.09), and dietary fiber (P < 0.01), folate (P = 0.03), and vitamin B-6 (P = 0.09) intakes. CONCLUSION: To control tHcy, decreasing coffee and alcohol consumption may be important in women, whereas increasing physical activity, dietary fiber, and folate intake may be important in men.     

Association between B vitamin intake and plasma homocysteine concentration in the general Dutch population aged 20-65 y

BACKGROUND: An elevated plasma total homocysteine (tHcy) concentration is associated with an increased risk of cardiovascular diseases. Folate, riboflavin, vitamin B-6, and vitamin B-12 are essential in homocysteine metabolism. OBJECTIVE: The objective was to describe the association between dietary intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and the nonfasting plasma tHcy concentration. DESIGN: A random sample of 2435 men and women aged 20-65 y from a population-based Dutch cohort examined in 1993-1996 was analyzed cross-sectionally. RESULTS: Univariately, intakes of all B vitamins were inversely related to the plasma tHcy concentration. In multivariate models, only folate intake remained inversely associated with the plasma tHcy concentration. Mean plasma tHcy concentrations (adjusted for intakes of riboflavin, vitamin B-6, vitamin B-12, and methionine and for age, smoking, and alcohol consumption) in men with low (first quintile: 161 microg/d) and high (fifth quintile: 254 microg/d) folate intakes were 15.4 and 13.2 micromol/L, respectively; in women, plasma tHcy concentrations were 13.7 and 12.4 micromol/L at folate intakes of 160 and 262 microg/d, respectively. In men, the difference in the mean plasma tHcy concentration between men with low and high folate intakes was greater in smokers than in nonsmokers (2.8 compared with 1.6 micromol/L) and greater in nondrinkers than in drinkers of >2 alcoholic drinks/d (3.5 compared with 1.4 micromol/L). In women, the association between folate intake and plasma tHcy was not modified by smoking or alcohol consumption. CONCLUSIONS: In this Dutch population, folate was the only B vitamin independently inversely associated with the plasma tHcy concentration. Changing dietary habits may substantially influence the plasma tHcy concentration in the general population.     

The association between betaine and choline intakes and the plasma concentrations of homocysteine in women

BACKGROUND: Elevated total homocysteine (tHcy), a risk factor for many chronic diseases, can be remethylated to methionine by folate. Alternatively, tHcy can be metabolized by other 1-carbon nutrients, ie, betaine and its precursor, choline. OBJECTIVE: We aimed to assess the association between the dietary intakes of betaine and choline and the concentration of tHcy. DESIGN: We conducted a cross-sectional analysis in 1477 women by using linear regression models to predict mean fasting tHcy by intakes of of betaine and choline. RESULTS: tHcy was 8% lower in the highest quintile of total betaine + choline intake than in the lowest quintile, even after control for folate intake (P for trend = 0.07). Neither choline nor betaine intake individually was significantly associated with tHcy. Choline from 2 choline-containing compounds, glycerophosphocholine and phosphocholine, was inversely associated with tHcy. These inverse associations were more pronounced in women with folate intake < 400 mug/d than in those with intakes >or=400 microg/d (P for interaction = 0.03 for phosphocholine) and in moderate alcohol drinkers (>or=15 g/d) than in nondrinkers or light drinkers (<15 g/d) (P for interaction = 0.02 for glycerophosphocholine and 0.04 for phosphocholine). The strongest dose response was seen in women with a low-methyl diet (high alcohol and low folate intake) (P for interaction = 0.002 for glycerophosphocholine and 0.001 for phosphocholine). CONCLUSIONS: Total choline + betaine intake was inversely associated with tHcy, as was choline from 2 water-soluble choline-containing compounds. Remethylation of tHcy may be more dependent on the betaine pathway when methyl sources are low as a result of either inadequate folate intake or heavier alcohol consumption.     

Dietary strategies for lowering homocysteine concentrations

BACKGROUND: Elevated plasma total homocysteine (tHcy) concentrations are associated with increased risk of vascular disease, and there is a strong inverse association between dietary and blood folate and blood tHcy concentrations. Increased folate consumption may lower the risk of tHcy-mediated cardiovascular disease. OBJECTIVES: The objective was to determine the most appropriate means of increasing dietary folate to reduce plasma tHcy. DESIGN: Sixty-five free-living subjects aged 36-71 y with tHcy concentrations >/=9 micromol/L participated in a randomized, controlled trial to compare 3 approaches for increasing dietary folate to approximately 600 microg/d: folic acid supplementation, consumption of folic acid-fortified breakfast cereals, and increased consumption of folate-rich foods. RESULTS: An intake of 437 microg folic acid/d from supplements resulted in a 27-nmol/L increase in serum folate and a 21% reduction in tHcy, relative to the change in a control group. In subjects who consumed folic acid-fortified breakfast cereal, folate intake increased by an average of 298 microg, serum folate increased by 21 nmol/L, and tHcy concentrations decreased by 24%. Increased intakes of folate-rich foods resulted in a 418-microg increase in dietary folate, a 7-nmol/L increase in serum folate, and a 9% reduction in tHcy concentrations. The decrease in tHcy was negatively correlated (r = -0.66) with the increase in serum folate. CONCLUSIONS: Daily consumption of folic acid-fortified breakfast cereals and the use of folic acid supplements appear to be the most effective means of reducing tHcy concentrations. The reduction in tHcy was significantly negatively correlated with the increase in serum folate, which may be a useful marker for measuring dietary change.     

Dietary counseling to increase natural folate intake: a randomized,placebo-controlled trial in free-living subjects to assess effects on serum folate and plasma total homocysteine

BACKGROUND: The association between vascular disease and elevated plasma total homocysteine (tHcy) concentrations is caused, in part, by inadequate intakes of dietary folate. Increasing folate intake either through supplements or foods naturally rich in folates has been shown to decrease tHcy concentrations. OBJECTIVE: The aim of this study was to determine whether a similar reduction in tHcy was possible in free-living persons receiving dietary counseling. DESIGN: The study included a 4-wk placebo-controlled dietary intervention trial in which participants consumed either unfortified breakfast cereal (control group) or an extra 350 micro g folate derived from food/d (dietary group). Serum folate and tHcy concentrations in both groups were measured before and after the intervention period, and the concentrations in the dietary group were also measured 17 wk after the intervention period. RESULTS: During the 4-wk intervention, mean dietary folate intake in the dietary group increased from 263 (95% CI: 225, 307) to 618 micro g/d (535, 714), resulting in a mean increase in serum folate of 37% (15%, 63%) and a decrease in tHcy from 12.0 (10.9, 13.3) to 11.3 micro mol/L (10.2, 12.5). A further decrease in tHcy occurred in the dietary group during follow-up, with a final tHcy concentration of 9.7 micro mol/L (8.8, 10.8). CONCLUSIONS: Increasing natural folate intake improved folate status and decreased tHcy concentrations to an extent that may significantly reduce the risk of vascular disease. Dietary modification may have advantages over folic acid fortification because the altered food-consumption patterns lead to increased intakes of several vitamins and minerals and decreased intakes of saturated fatty acids.     

Dietary choline and betaine assessed by food-frequency questionnaire in relation to plasma total homocysteine concentration in the Framingham Offspring Study

BACKGROUND: Epidemiologic studies of choline and betaine intakes have been sparse because a food-composition database was not available until recently. The physiologic relevance of a variation in dietary choline and betaine in the general population and the validity of intake assessed by food-frequency questionnaire (FFQ) have not been evaluated. OBJECTIVE: This study was conducted to examine the physiologic relevance and validity of choline and betaine intakes measured by an FFQ. DESIGN: We examined the relations between choline and betaine intakes measured by FFQ and plasma total homocysteine (tHcy) concentrations in 1960 participants from the Framingham Offspring Study. RESULTS: Higher intakes of dietary choline and betaine were related to lower tHcy concentrations independent of other determinants, including folate and other B vitamins. For the lowest and highest quintiles of dietary choline plus betaine, the multivariate geometric means for tHcy were 10.9 and 9.9 mumol/L (P for trend < 0.0001). The inverse association was manifested primarily in participants with low folate intakes (P for interaction < 0.0001). Among participants with folate intakes < or =250 microg/d, the geometric mean tHcy concentrations in the lowest and highest quintiles of choline plus betaine intakes were 12.4 and 10.2 micromol/L (P for trend < 0.0001). Except for choline from phosphatidylcholine, individual forms of choline were inversely associated with tHcy concentrations. CONCLUSIONS: Our findings provide support for a physiologically important variation in choline and betaine intakes in the general population and for the validity of intake measured by FFQ.     

Folate Status Worsens in Recently Institutionalized Elderly People without Evidence of Functional Deterioration

Objective: To follow folate status, hematological and cognitive changes during the first year of institutionalization among elderly subjects.

Design: Prospective study.

Setting: Long-stay unit of the Dijon University Geriatric Hospital.

Subjects: Twenty women and four men older than 65 years admitted consecutively.

Main outcome measures: Folate and vitamin B-6 dietary intake was evaluated by a five-day record on admission (day 1 or d 1), at day 45 (d 45), day 90 (d 90), day 135 (d 135), day 180 (d 180), day 360 (d 360). Circulating levels of folate, vitamin B-6, total homocysteine (tHcy), blood counts and cognitive performance were determined in parallel.

Results: From d 1 to d 360, mean folate and vitamin B-6 intakes remained below the French RDA and mean folate intakes decreased significantly (Δ = ?10.2%, p <0.05). Mean plasma or erythrocyte folate decreased significantly (Δ = ?33.7%, p <0.05 and Δ = ?30.2%, p <0.001, respectively) from d 1 to d 360; no significant change was observed for the other blood parameters. The incidence of folate deficiency increased (8% vs. 37% for plasma folate <6.8 nmol/L and 8% vs. 17% for erythrocyte folate <340 nmol/L) from d 1 to d 360. Mean plasma pyridoxal 5′-phosphate (PLP) remained <20 nmol/L during the one-year follow-up. There was no difference between genders for plasma tHcy. Although mean plasma tHcy was <14 μmol/L, plasma tHcy was >14 μmol/L in about one-third of the subjects. At each period, 50% or more subjects were anemic (Hct <35% in women and Hct <40% in men), but the anemia was normocytic (MCV <100 fL). Subjects had a moderate dementia at admission, and no change was observed during the study.

Conclusions: Subjects were already vitamin B-6 deficient at admission. Folate status was impaired during the study. Low vitamin intakes were the main cause of vitamin B-6 deficiency and folate status deterioration. Hematology and mental status capacity were not aggravated by folate status deterioration. Plasma tHcy didn’t appear to be an earlier predictor of folate deficiency.     

Frequent consumption of milk, yogurt, cold breakfast cereals, peppers, and cruciferous vegetables and intakes of dietary folate and riboflavin but not vitamins B-12 and B-6 are inversely associated with serum total homocysteine concentrations in the US population

BACKGROUND: Elevated circulating total homocysteine (tHcy) is an independent risk factor for vascular diseases. OBJECTIVE: We investigated the relation between dietary intakes and serum tHcy in the US population. DESIGN: Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to investigate the associations between food consumption frequency and dietary B vitamin intakes and serum tHcy in 5996 persons. RESULTS: Multivariate-adjusted tHcy concentrations were approximately 15.2% higher in subjects who never consumed milk than in those who consumed milk >30 times/mo, approximately 6.4% higher in subjects who never consumed yogurt than in those who consumed yogurt >15 times/mo, approximately 7.4% higher in subjects who never consumed cold breakfast cereals than in those who consumed cold breakfast cereals >30 times/mo, approximately 6.3% higher in subjects who never consumed peppers (includes red, yellow, green, and hot chili peppers) than in those who consumed peppers >30 times/mo, and approximately 16.5% higher in subjects who never consumed cruciferous vegetables than in those who consumed cruciferous vegetables >30 times/mo. Consumption of citrus fruit and juices, cheese, meats, coffee, or tea had no significant association with tHcy. Folate (beta=-0.0017, P for trend=0.004) and riboflavin (beta=-0.2851, P for trend=0.027), but not vitamin B-6 (beta=0.0505, P for trend=0.70) and cobalamin (beta=-0.0035, P for trend=0.58), were inversely related to serum tHcy after adjustment for confounders. CONCLUSIONS: In this population-based study, milk, yogurt, cold breakfast cereals, peppers, and cruciferous vegetables were inversely related to serum tHcy. This association may be explained by increased intakes of folate and riboflavin.