Low Folate Levels Research Articles

Folate and B12 Levels Correlate with Histological Severity in NASH Patients.

Background: The correlation between abnormal vitamin serum levels and chronic liver disease has been previously described in literature. However, the association between the severity of folate serum levels (B9), vitamin B12 and nonalcoholic steatohepatitis (NASH) has not been widely evaluated. Therefore, the aim of this study was to investigate the existence of such a correlation in a cohort of NASH patients. Methods: All patients aged 18 years and older who were diagnosed with biopsy-proven NASH at the EMMS hospital in Nazareth during the years 2015–2017 were enrolled in this study. Data regarding demographic, clinical and laboratory parameters was collected. Patients with other liver diseases were excluded. Results: Eighty-three NASH patients were enrolled during the study period. The mean age was 41 ± 11 years and the majority of patients were male. Mean values of folate and B12 were 9.85 ± 10.90 ng/mL and 387.53 ± 205.50 pg/mL, respectively. Half of the patients were presented with a grade 1 steatosis (43.4%), a grade 2 fibrosis (50.6%) and a grade 3 activity score (55.4%). The fibrosis grade was significantly correlated with low folate levels on multivariate analysis (p-value < 0.01). Similarly, low B12 levels were significantly associated with a higher fibrosis grade and NASH activity (p-value < 0.001 and p-value < 0.05 respectively). Conclusion: Our study demonstrated a statistically significant correlation between low levels of folate and vitamin B12 with the histological severity of NASH. These findings could have diagnostic and therapeutic implications for patient management and follow-up.

T44. A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF THE EFFECTS OF VITAMIN B12, B6 AND FOLIC ACID ON COGNITION AND SYMPTOMS IN FIRST-EPISODE PSYCHOSIS: THE VITAMINS IN PSYCHOSIS STUDY

BackgroundVitamin B12, vitamin B6 and folic acid are homocysteine-reducing agents. People with schizophrenia have been found to have increased homocysteine levels. Elevated homocysteine has been associated with impaired cognition. Previous research in chronic schizophrenia has shown that supplementation with folate plus vitamin B12 can improve cognition and clinical symptoms. Whether homocysteine lowering agents are effective in first-episode psychosis is unknown. The aim of this study was to investigate if adjunctive vitamin B12, B6 and folic acid can lower homocysteine and improve symptomatology and cognition in people with first-episode psychosis.MethodsThis was a randomised, double-blind, placebo-controlled trial conducted at the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Australia. One hundred and twenty patients aged 15–26 years with first-episode psychosis consented and were randomised to receive folic acid 5mg, vitamin B12 0.4mg, and vitamin B6 50mg or placebo, each taken once-daily for 12 weeks as an adjunct to antipsychotic medication. Co-primary measures were change in cognition as measured by a composite score from a battery of 11 tests and total symptomatology (PANSS) over 12 weeks. Secondary outcomes included additional cognitive, symptom, functioning, tolerability and safety measures.ResultsOf the 120 participants randomised in the study, 20 dropped out with no follow-up assessments and were excluded from analysis. Of the remaining 100 participants, 52 were in the vitamins group and 48 the placebo group. At baseline, the two treatment groups had lower levels of folate and vitamin B12 intake than healthy controls, but did not differ from each other. Vitamin B12, B6 and folic acid reduced homocysteine levels in the vitamin group over 12 weeks. The homocysteine lowering effects of the vitamins did not confer a major advantage over placebo therapy in improving the co-primary PANSS (p=.75) or composite cognition (p=0.79) outcomes over 12 weeks. There was a significant difference between groups among females in the cognitive domain of speed of processing (p=.049) and attention/vigilance (p=0.002), in which the mean performance of the placebo group declined over 12 weeks, whereas performance in the vitamin group remained showed improvement.DiscussionFolic acid, B12 and B6 supplementation appears well tolerated and safe in first-episode psychosis and lowers homocysteine levels in this population. However, supplementation may not offer extra benefits to all patients with first-episode psychosis, with the possible exception of speed of processing and attention/vigilance. Although previous research suggests that males preferentially benefit, our findings suggest that there may be a specific beneficial effect on cognition for females with first-episode psychosis.

The association of serological tests and anemia in celiac disease

Aim: Celiac disease (CD) is a common immune-mediated enteropathy caused by gluten. These patients may apply with many different clinical forms. The aim of this study is to determine the association of serological tests and type of anemia in CD. Methods: Totally117 biopsy proven CD patients aged between 1-17 years were included. Serological and hematological parameters of all patients were studied. Results: Anemia was identified in 71 (60.7%) cases. Patients with anemia were diagnosed earlier than other patients (5.2±4.5 vs. 15.3±33.8 years, p=0.012). Among CD patients with anemia 39 (54.9%) were having iron deficiency, 22 (30.9%) were having folate deficiency and 10 (14%) were having vitamin B 12 deficiency. In patients with tissue transglutaminase (tTG) seropositivity serum iron levels and ferritin levels were significantly lower compared to anti-gliadin antibody (AGA) or anti-endomysium antibody (EMA) seropositivity (35±23.5 vs. 57.5±33.3, p=0.007 and 12.4±21.9 vs. 24.2±18.5, p=0.026, respectively). Low serum folate levels were more frequent in the presence of tTG seropositivity compared with AGA+EMA seropositivity (81.8% vs. 25%, p=0.015). Conclusions: Anemia is an important cause of admission in CD. These patients are diagnosed earlier as a result of anemia. Alone tTG seropositivity is more valuable to demonstrate anemia associated with iron or folate deficiencies.

Assessment of dietary intake and mineral status in pregnant women

PurposeTo evaluate the dietary intake of pregnant women and their nutritional status of Ca, Mg, Fe, Zn, and Cu, as the nutritional status of pregnant women is an important factor for the proper progression of a pregnancy and the development and health of the foetus.MethodsThe study was conducted on 108 pregnant women ages 18–42, at 6–32 weeks of gestation. We used a questionnaire and a 24-h recall nutrition interview. Hair samples were taken for testing and the level of each mineral was assessed using atomic absorption spectrometry. The results were analysed using the Dietetyk and Statistica 10 software.ResultsLow levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid intake were seen in the pregnant women, with the use of dietary supplements significantly increasing their intake of Fe, Zn, and folic acid. The concentration of zinc and magnesium in the women’s hair was shown to be affected by their age and, in the case of magnesium, by the week of pregnancy.ConclusionsIt was observed that the diet of pregnant women is characterised by low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid. Dietary supplementation with vitamins and minerals significantly increases the daily Fe and folic acid intake in pregnant women. The concentration of Zn and Mg in hair depends on the age of pregnant women and Mg level in the hair of women decreases during pregnancy.

The effect of vitamin B12 and folic acid supplementation on routine haematological parameters in older people: an individual participant data meta-analysis.

Low vitamin B12 and folate levels in community-dwelling older people are usually corrected with supplements. However, the effect of this supplementation on haematological parameters in older persons is not known. Therefore, we executed a systematic review and individual participant data meta-analysis of randomised placebo-controlled trials (RCTs). We performed a systematic search in PubMed, EMBASE, Web of Science, Cochrane and CENTRAL for RCTs published between January 1950 and April 2016, where community-dwelling elderly (60+ years) who were treated with vitamin B12 or folic acid or placebo. The presence of anaemia was not required. We analysed the data on haematological parameters with a two-stage IPD meta-analysis. We found 494 full papers covering 14 studies. Data were shared by the authors of four RCTs comparing vitamin B12 with placebo (n = 343) and of three RCTs comparing folic acid with placebo (n = 929). We found no effect of vitamin B12 supplementation on haemoglobin (change 0.00 g/dL, 95% CI: -0.19;0.18), and no effect of folic acid supplementation (change -0.09 g/dL, 95% CI: -0.19;0.01). The effects of supplementation on other haematological parameters were similar. The effects did not differ by sex or by age group. Also, no effect was found in a subgroup of patients with anaemia and a subgroup of patients who were treated >4 weeks. Evidence on the effects of supplementation of low concentrations of vitamin B12 and folate on haematological parameters in community-dwelling older people is inconclusive. Further research is needed before firm recommendations can be made concerning the supplementation of vitamin B12 and folate.

Comparison of folic acid levels in schizophrenic patients and control groups

Folic acid deficiency is a risk factor for schizophrenia through epidemiology, biochemistry and gene-related studies. Compared with healthy people, schizophrenic patients may have high homocysteine plasma values and homocysteine or low levels of folic acid, which seems to correlate with extrapyramidal motor symptoms caused by neuroleptic therapy and with symptoms of schizophrenia. In this present study, we focus on the difference of folic acid level between schizophrenic patient and control group. The study sample consisted of schizophrenic patients and 14 people in the control group and performed blood sampling to obtain the results of folic acid levels. The folic acid level in both groups was within normal range, but the schizophrenic patient group had lower mean folic acid values of 5.00 ng/ml (sb 1.66), compared with the control group with mean folic acid values of 10.75 ng/ml (sb 4.33). there was the group of the control group had a higher value of folic acid than the schizophrenic group.

Serum folate levels and urinary arsenic methylation profiles in the US population: NHANES, 2003-2012.

Arsenic is a prevalent environmental contaminant, and its folate-dependent methylation is important for detoxification in the body. In this study, we investigated the association between serum folate levels and methylation using data from the US National Health and Nutrition Examination Survey (NHANES) (2003-2012) (N = 11,016). Multivariate linear regression and penalized spline regression models were used to examine the association and possible upper limit of folate level regarding its impact on methylation in children (≤18 years) and adults (>18 years), respectively. Serum folate levels, methylation metabolites including urinary monomethylarsonic acid (MMA(V)) and dimethylarsinic acid (DMA(V)), and demographic variables were extracted from NHANES. Results showed that urinary percentage of DMA(V) (%DMA(V)) was positively associated with log(serum folate levels) after adjustment in children (β = 1.93, p < 0.01); urinary percentage of MMA(V) (%MMA(V)) was positively associated with log (serum folate levels) after adjustment in adults (β = 0.40, p < 0.01). No upper limit of folate level regarding its impact on arsenic methylation was identified. More than 50% of Non-Hispanic black and smokers with high total urinary arsenic levels had low serum folate levels. Our results indicate that folate promotes arsenic methylation, but the patterns are different in children versus in adults. Future interventions may be needed for the population exposed to high level of arsenic but with low serum folate to protect against the potential adverse health effects of arsenic.

Assessment of the sufficiency of Moscow population with folic acid, depending on the combined effect of polymorphism of MTHFR and FTO genes

The results of assessing the sufficiency of folic acid of the residents of the Moscow region have been presented depending on rs1801133 MTHFR gene polymorphism and rs9939609 FTO gene polymorphism. A total of 326 people were examined, including 74 men and 252 women aged 20 to 65 years. The results of determining the level of folic acid in blood serum showed insufficiency of this vitamin among the population of the Moscow region of the Russian Federation. The expressed vitamin deficit (level <3,0 ng/ml) was detected in 24.2% of the surveyed residents, in 22.8% folic acid level was at the lower bound of the norm (3.0-4.5 ng/ml). The results of genotyping showed a statistically significant association of low folic acid level with rs1801133 MTHFR gene polymorphism in carriers of A allele of rs9939609 FTO gene polymorphism both in the homozygous state (genotype AA) and in the heterozygous (genotype AT) state, OR=4.26; CI (1.40-12.9), p=0.008, as well as with rs9939609 FTO gene polymorphism in carriers of the T allele of rs1801133 MTHFR gene polymorphism both in the homozygous (genotype TT) and heterozygous (CT genotype) state, OR=3.29; CI (1.07-10.1), p=0.03. In carriers of 3 alleles of risk of folic acid deficiency [rs9939609 FTO gene polymorphism and rs1801133 MTHFR gene polymorphism (genotypes CT/AA and TT/AT)] blood serum level of folic acid was below the norm, that indicated folate deficiency in this category of persons.

Níveis de Ácido Fólico numa Amostra de Doentes Psiquiátricos Portugueses em Ambulatório

Introdução: Há múltiplas evidências da associação entre doenças mentais e baixos níveis de ácido fólico. O objetivo deste estudo foi avaliar a prevalência da deficiência de ácido fólico numa amostra de doentes da consulta externa de psiquiatria.Métodos: O estudo foi retrospetivo e incluiu 428 doentes da consulta externa de psiquiatria com os diagnósticos de depressão ou de psicose não afetiva, nos quais os níveis de ácido fólico tinham sido avaliados em análises de rotina. Foram também registados os níveis de ácido fólico de outros doentes do hospital, no mesmo período temporal.Resultados e Discussão: A prevalência de deficiência de ácido fólico nesta amostra foi de 18%. Os doentes não psiquiátricos com fatores de risco para deficiência de ácido fólico tiveram uma prevalência de 15% de deficiência. Nos homens e em doentes mais jovens os níveis de ácido fólico foram significativamente mais baixos, a prevalência de deficiência atingiu os 26%.Conclusão: A alta frequência de deficiência de ácido fólico nesta amostra de doentes comprova que os níveis de ácido fólico devem ser avaliados sistematicamente em doentes da consulta de psiquiatria com diagnósticos de depressão ou psicose, para evitar persistência de sintomas e resistência ao tratamento.

STUDY OF THE ANTIDEPRESSANT ACTIVITY OF FOLIC ACID AND VITAMIN-D ON RESERPINE INDUCED DEPRESSION IN MICE.

Objective: Low levels of folic acid and deficiency of Vitamin D have been found to be associated with poor mood and depression. This study was designed to investigate whether these vitamins show antidepressant activity in models of depression in mice.Methods: Reserpine was used to induce depression in the study groups. Low and high doses of folic acid and Vitamin D as well as combinations of these vitamins in low and high doses were administered after induction of depression. The test animals were then tested on forced swim test, tail suspension test, and open field test models for evaluation of the antidepressant activity.Results: After 2 weeks of drug treatment, all the treated groups showed a significant reduction in immobility time in both the test models (p&lt;0.05). High dose folic acid showed consistently greater antidepressant property in all the test models throughout the study period. High dose Vitamin D (p&lt;0.05) also showed good antidepressant activity after 2 weeks, the delayed antidepressant effect of which might be attributable to the molecular mechanism of action of Vitamin D.Conclusion: Our study demonstrates that both folic acid and Vitamin D have antidepressant activity. The antidepressant activity of high dose folic acid (50 mg/kg) in reserpine-induced depression in mice at the end of 2 weeks was more pronounced in our study. Studies with longer duration of treatment are warranted to further evaluate their antidepressant effect.

Homocysteine, folate, hs-C-reactive protein, tumor necrosis factor alpha and inflammatory proteins: are these biomarkers related to nutritional status and cardiovascular risk in childhood-onset systemic lupus erythematosus?

BackgroundChildhood-onset systemic lupus erythematosus (c-SLE) is a chronic autoimmune disease which increases cardiovascular risk factors (CRF) such as elevated homocysteine, TNF-α, and hs-C reactive protein.MethodsWe evaluated BMI, waist circumference (WC), 24-h recalls, SLEDAI-2 K, SLICC/ACR-DI, serum levels of homocysteine, folate, TNF-α, hs-C reactive protein, lipid profile, proteomic data, and duration of corticosteroid therapy in 19 c-SLE and 38 healthy volunteers. Physiological and anthropometric variables of c-SLE and healthy controls were compared by ANCOVA. k-cluster was used to separate c-SLE into two different groups with the best and the worst metabolic profile according to previous analysis showing some metabolites that were statistically different from controls, such as homocysteine, TNF-α, hs-CRP and folate levels. These two clusters were again compared with the control group regarding nutritional parameters, lipid profile and also proteomic data.ResultsIndividuals with c-SLE presented higher BMI, WC, homocysteine, triglycerides, TNF-α, hs-CRP and lower folate levels when compared to controls. We found 10 proteins whose relative abundances were statistically different between control group and lupus clusters with the best (LCBMP) and the worst metabolic profile (LCWMP). A significant positive correlation was found between TNF-α and triglycerides and between hs-CRP and duration of corticosteroid therapy.ConclusionCardiovascular disease (CVD) risk parameters were worse in c-SLE. A less protective CVD proteomic profile was found in LCWMP.

Association between Decreased Plasma Folate Levels and MTHFR C677T, and MTRR A66G Gene Polymorphisms as Determinants for Elevated Total Homocysteine Concentrations in Pregnant Women

Aims: The aims of this paper were to examine the association between gene polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G with levels of plasma folate and tHcy. Methods: Peripheral venous blood samples were obtained from 143 pregnant women, who had been fasted for more than 10 hours. Plasma tHcy and folate concentrations were measured in plasma specimens. The genotypes for polymorphisms were identified by the PCR-restriction fragment length polymorphism (RFLP). Results: Our results demonstrated that MTHFR 677T allele was the predictors of plasma folate levels in pregnant women. While MTHFR 677TT genotype and MTRR 66G allele were the predictors of plasma tHcy concentrations. Plasma folate levels were negatively correlated with tHcy concentrations (Pearson’s correlation coefficient r=-0.358, p=0.000012). With the increase of gestational weeks, the levels of plasma folate was first risen and then fall, whereas, there was a downtrend between gestational weeks and tHcy levels. Conclusion: Plasma folate status and total homocysteine level associated with MTHFR C677T and MTRR A66G gene polymorphisms in pregnant women. According to our study, the pregnant women of homozygous mutation of MTHFR 677TT and/or MTRR 66GG genes generally have lower levels of folate. Therefore, we recommend that pregnant women with 677TT and 66GG genotypes should supplement the appropriate dosage of folic acid based on their genotypes.

Folate, vitamin B12, and negative symptoms in schizophrenia

Introduction Negative symptomatology has been demonstrated to be the most relevant predictor of increased future socio-occupational dysfunction and poorer quality of life. Negative symptoms and functional outcomes have consistently been linked, with several studies reporting worse functional outcomes in individuals with more prominent negative symptoms. Folate deficiency has been identified as a risk factor for schizophrenia and its negative symptoms. Aim The aim of this study was to assess the serum levels of folate and vitamin B12 in a sample of schizophrenic patients and their relation to negative symptoms in these patients. Patients and methods It is a cross-sectional study aiming to assess the serum level of folate and vitamin B12 in schizophrenic patients. All patients were recruited from the Kuwait Center for Mental Health after taking approval from the scientific and ethics committee of the hospital. The study was conducted in the period from January 2016 to April 2016; the total number of patients was 41 after applying the inclusion and exclusion criteria. We applied the Positive and Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms; serum levels of vitamin B12 and folate were measured by radioimmunoassay technique. Results About 41.5% of the patients have low folate level and about 39% of the patients have low B12 level. There are significant positive correlations between severity of negative symptoms and duration of illness and number of hospital admissions. Also there are significant positive correlations between serum levels of vitamin B12 and folate. There are significant negative correlations between serum levels of vitamin B12. All negative symptoms were assessed by the Scale for the Assessment of Negative Symptoms (affective flattening, alogia, attention, aviolation, and anhedonia). We cannot find a significant correlation between serum levels of folic acid and negative symptoms. Conclusion Folate and vitamin B12 deficiency may be a risk factor for schizophrenia and negative symptoms; so we suggest to evaluate the serum vitamin B12 and folate levels for schizophrenic patients followed by dietary supplementation for patients with low vitamin B12 or folate.

Effect of homocysteine and folic acid on vaso-occlusive crisis in children with sickle cell disease

Introduction Vaso-occlusion is a determinant for most manifestations of sickle cell anemia (SCA). Elevated concentration of homocysteine contributes to thrombosis, a frequent event in SCA. Folic acid deficiency leads to increase in plasma homocysteine. The aim of study was to test whether children with SCA have elevated serum homocysteine with diminished folate level and to determine whether hyperhomocysteinemia has a correlation with the frequency of vaso-occlusive crisis. Patients and methods A case–control study was carried over a period of 1 year (January to December 2014) in the hematology clinic, Abo El-Reesh Hospital, Cairo University. A total of 50 patients with SCA were included together with 30 age-matched and sex-matched healthy children recruited from Menoufia Hospital. Venous blood samples were obtained from both groups to measure serum homocysteine and folic acid levels. Results The mean±SD of age of the patients and controls were 6.20±2.55 and 6.03±2.64 years, respectively. Homocysteine level was significantly higher in the patients group compared with control group, with a mean±SD of 44.68±9.096 and 18.81±3.76 µmol/l, respectively (P>0.01). Folic acid level was lower in the patients group than control group, with 12.02±2.76 and 14.68±2.99 ng/ml, respectively (P Conclusion Patients with sickle cell disease have high serum homocysteine with low folate levels. This hyperhomocysteinemia is positively correlated with the frequency of vaso-occlusive crisis.

Relationship between the Methylation of Folic Acid Metabolism-Related Genes and the Incidence and Prognosis of Esophageal Cancer among Ethnic Kazakhs.

Objective: To investigate the relationship between the hypermethylation of folic acid metabolism-related genes and the incidence and prognosis of esophageal cancer among ethnic Kazakhs in Xinjiang (China).Methods: According to the standard of esophageal cancer diagnosis, exclusion and epidemiological investigation of the experimental and control groups. Ion capture immunoassays were used to measure serum folic acid levels, while methylation-specific polymerase chain reaction was used to detect gene promoter methylation levels. Log-rank tests and Cox regression models were used to identify prognostic factors in the patient population.Results: Serum folic acid levels in the experimental (cancer) group were significantly lower than in the control (non-cancer) group (Z = -9.13, P < 0.001). Furthermore, the methylation rates of MTHFR, CBS, MGMT, P16, FHIT, and RASSF1A in the experimental group were significantly higher than in the control group. Multivariate analysis identified depth of tumor invasion, regional lymph node metastasis, tumor-node-metastasis stage, and CBS and RASSF1A gene methylation status as independent prognostic factors; female gender and high serum folic acid levels were favorable prognostic factors.Conclusions: Low serum folic acid level is a risk factor for esophageal cancer among ethic Kazakhs. Moreover, methylation of MTHFR, CBS, MGMT, P16, FHIT, and RASSF1A is closely related to esophageal cancer tumorigenesis.

The Correlation between Depression and Folate Deficiency

Background: Folate is a naturally occurring B vitamin, is needed in the brain for the synthesis of norepinephrine, serotonin, and dopamine. Thus, previous researches suggested that folate levels play an important role in the etiology and course of depression. However, the literature has been inconsistent regarding differences in folate level between individuals with and without depression. The present meta-analysis synthesized the results of previous studies to examine whether individuals with depression had lower levels of folate than individuals without depression. Aim of the Study: to assess the relationship between Depression and Folate deficiency. Methods: A review of the scientific literature (PubMed Search 1994 to 2017) Pubmed, Embase and CENTRAL were searched to identify randomized controlled trials that investigated The Correlation between Depression and Folate Deficiency as the primary outcome. Identification of papers and data extraction was performed by two independent researchers. We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to October 2017. Results: 8 studies were included enrolling 173000 participants; 1813 patients with depression and 15487 control subjects. Pooling of all estimates showed a significant correlation between folate status and depression (OR pooled unadjusted = 1.41; 95% CI 1.19 to 1.82), (OR pooled adjusted = 1.39; 95% CI 1.04 to 1.76). Conclusion: Low folate and B12 serum levels seem to be associated with depression Folate has been linked to depression and there is a strong body of evidence suggesting the introduction of folate supplement in the prevention and treatment of depression at the population and individual levels.

Risk factors and peripheral biomarkers for schizophrenia spectrum disorders: an umbrella review of meta-analyses.

This study aimed to systematically appraise the meta-analyses of observational studies on risk factors and peripheral biomarkers for schizophrenia spectrum disorders. We conducted an umbrella review to capture all meta-analyses and Mendelian randomization studies that examined associations between non-genetic risk factors and schizophrenia spectrum disorders. For each eligible meta-analysis, we estimated the summary effect size estimate, its 95% confidence and prediction intervals and the I2 metric. Additionally, evidence for small-study effects and excess significance bias was assessed. Overall, we found 41 eligible papers including 98 associations. Sixty-two associations had a nominally significant (P-value <0.05) effect. Seventy-two of the associations exhibited large or very large between-study heterogeneity, while 13 associations had evidence for small-study effects. Excess significance bias was found in 18 associations. Only five factors (childhood adversities, cannabis use, history of obstetric complications, stressful events during adulthood, and serum folate level) showed robust evidence. Despite identifying 98 associations, there is only robust evidence to suggest that cannabis use, exposure to stressful events during childhood and adulthood, history of obstetric complications, and low serum folate level confer a higher risk for developing schizophrenia spectrum disorders. The evidence on peripheral biomarkers for schizophrenia spectrum disorders remains limited.

Prevalence and Predictors of Subclinical Micronutrient Deficiency in German Older Adults: Results from the Population-Based KORA-Age Study.

Subclinical micronutrient deficiency in older adults is associated with chronic age-related diseases and adverse functional outcomes. In Germany, the older population is at risk of insufficient micronutrient intake, but representative studies on micronutrient status in old and very old adults are scarce. This study’s objectives were to estimate the prevalence of subclinical vitamin D, folate, vitamin B12 and iron deficiencies among older adults, aged 65 to 93, from the KORA-Age study in Augsburg, Germany (n = 1079), and to examine associated predictors, using multiple logistic regression. Serum concentrations of 25-hydroxyvitamin D (25OHD), folate, vitamin B12, and iron were analyzed. The prevalence of subclinical vitamin D and vitamin B12 deficiencies were high, with 52.0% and 27.3% of individuals having low 25OHD (<50 nmol/L) and low vitamin B12 concentrations (<221 pmol/L), respectively. Furthermore, 11.0% had low iron (men <11.6 µmol/L, women <9.0 µmol/L) and 8.7% had low folate levels (<13.6 nmol/L). Common predictors associated with subclinical micronutrient deficiency included very old age, physical inactivity, frailty and no/irregular use of supplements. Subclinical micronutrient deficiency is a public health concern among KORA-Age participants, especially for vitamins D and B12. The predictors identified provide further rationale for screening high-risk subgroups and developing targeted public health interventions to tackle prevailing micronutrient inadequacies among older adults.

The impact of folate intake on the risk of head and neck cancer in the prostate, lung, colorectal, and ovarian cancer screening trial (PLCO) cohort

Background:Although low levels of folate leads to disturbances in DNA replication, DNA methylation and DNA repair, the association between dietary folate intake and head and neck cancer (HNC) risk remains unclear.Methods:We evaluated the association between folate intake and HNC risk using prospective cohort data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. This study included 101 700 participants and 186 cases with confirmed incident HNC. The median follow-up was 12.5 years. We estimated hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) using Cox proportional hazard model including age, sex, body mass index, education, race, tobacco smoking, alcohol drinking and total fruit and vegetable intake.Results:Higher intake of food folate and fortified folic acid in foods was associated with a decreasing HNC risk in a dose–response manner. The HRs of highest vs the lowest quartile of intake were 0.35 (95%CI: 0.18–0.67) for food folate, and 0.49 (95%CI: 0.30–0.82) for fortified folic acid. Intakes of total folate, natural folate and supplemental folic acid were not associated with the risk of HNC and its subsites. We did not detect any interaction between smoking, drinking and food folate intake on HNC risk.Conclusions:These findings provide evidence of the protective role of dietary folate intake on HNC risk.

Predictors of Success in Bariatric Surgery: the Role of BMI and Pre-operative Comorbidities.

This is a retrospective review of 204 patients who underwent bariatric surgery. The impact of weight regain (WR), pre-operative comorbidities and BMI values on the recurrence of comorbidities was evaluated, and an equation was elaborated to estimate BMI at 5years of bariatric surgery. Pre-operative data, after 1year and after 5years, was collected from the medical records. Descriptive analyses and bivariate hypothesis tests were performed first, and then, a generalised linear regression model with Tweedie distribution was adjusted. The hit rate and the Kendall coefficient of concordance (Kendall's W) of the equation were calculated. At the end, the Mann-Whitney test was performed between the BMI, WR and the presence of comorbidities, after a post-operative period of 5years. The adjustment of the model resulted in an equation that estimates the mean value of BMI 5years after surgery. The hit rate was 82.35% and the value of Kendall's W was 0.85 for the equation. It was found that patients with comorbidities presented a higher median WR (10.13%) and a higher mean BMI (30.09kg/m2) 5years after the surgery. It is concluded that the equation is useful for estimating the mean BMI at 5years of surgery and that patients with low pre-operative HDL and folic acid levels, with depression and/or anxiety and a higher BMI, have a higher BMI at 5years of surgery and higher incidence of comorbid return and dissatisfaction with post-operative results.