Neuropsychomotor development and genomic stability associated to folate and blood iron levels in preschool children

Maiara De Queiroz Fischer,Luana Beatriz Limberger,Silvia Isabel Rech Franke,Daniel Prá,Jane Dagmar Pollo Renner,Jorge André Horta,Caroline Dos Santos,Liziane Hermes,Diene Da Silva Schlickmann,Patrícia Molz

doi:10.1590/1806-93042017000300006

Abstract

Abstract Objectives: to evaluate the neuropsychomotor development and the genomic stability associated to folate and blood iron levels in preschool children. Methods: a cross-sectional study in which evaluated the biochemical exams (complete hemogram, serum ferritin, iron and folate), neuropsychomotor development (Denver II Test) and genotoxicity (micronuclei cytome in buccal mucosa cells) of 55 children aging 36-59 months old. Student´s T test, Kruskal-Wallis and Pearson's or Spearman's correlation tests were applied with a significance level of p<0.05 for data analysis. Results: the prevalence of anemia was 1.8%. The Denver II test classified 32.7% of the children as normal and 67.3% were suspected of having a delay. The children suspected of having a delay presented a slight reduction on hemoglobin and hematocrit (p=0.05 and p=0.14), intermediate reduction on iron and folate (p=0.29 and p=0.23) and a notable reduction on ferritin (p=0.03). Folate and iron were significantly associated to the frequency of cells with DNA damages (p<0.05). The frequency of binucleated cells was positively associated to the Red Cell Distribution Width (RDW) (r=0.56; p=0.02) in children without a delay and negatively with folate (r=-0.334; p=0.047) in children with a delay. Conclusions: this study showed a low prevalence of anemia, but a high rate of children suspected of having a neuropsychomotor, possibly associated to low ferritin levels. Additionally, iron and folate were associated to DNA damage which may have contributed to the psychomotor development delay.

Highlights

Considering essential nutrients, iron and folate play a primordial role in the human metabolism, and are fundamental to produce energy and cellular metabolism
The prevalence of anemia found in this present study is considered normal, according to the classification of importance level as a public health problem, defined by the World Health Organization (WHO),[5] which classifies as normal, the prevalence of anemia ≤4.9%
Prá et al.[15] while conducting a research in Santa Cruz do Sul city in RS, which belongs to the Vale of Taquari and Rio Pardo regions, evaluated 30 healthy children with an average age of 11.5±2.5 years old and observed a prevalence of anemia similar to the one found in our study (3.3%, only one individual with anemia)

Summary

Introduction

Considering essential nutrients, iron and folate play a primordial role in the human metabolism, and are fundamental to produce energy and cellular metabolism. The deficiency of both nutrients represents a worldwide public health problem affecting all age groups, especially pregnant women and preschool children.[1,2]. Evidence suggests that iron deficiency provokes long term effects, such deficiencies as cognitive and psychomotor development, as well as reduction on the productive capacity. Folate plays a key role at the normal cell division and during growth and development periods. The causes of folate deficiency range from an inadequate eating habit to conditions associated to the increase of cellular renewal. Its deficiency can affect the memory and the language capacity, as well as the onset of megaloblastic anemia.[1,5,6]

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