Acute myocardial infarction (AMI) is a major cause of death and loss of quality of life worldwide. Folate deficiency is an emerging risk factor for AMI. This case-control study was conducted in the Department of Biochemistry and Molecular Biology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital, Dhaka, Bangladesh, between July 2021 and June 2022, to determine the possible correlation between serum folate and troponin-I levels in acute myocardial infarction among type 2 diabetic patients. A total 80 type 2 diabetes mellitus (DM) patients were included in the study: 40 patients with acute myocardial infarction (AMI) were in group-I (case) and 40 patients without AMI were in group-II (control). We adopted a convenient sampling technique. After 8-12 hours fasting blood specimens were collected from study participants to estimate serum troponin-I, folate, fasting blood glucose and HbA1C levels. Serum folate level was significantly lower in group-I compared to group-II (3.87±3.17ng/ ml vs. 8.19±3.07ng/ml; P<0.01), while serum troponin-I level was significantly higher in group-I than that of group-II (3035.82±728.16pc/ml vs. 7.58±3.19pc/ml; P<0.01). Regarding glycaemic status, fasting blood glucose (FBG) level was found significantly higher in group-I than that of group-II (10.17±3.56mmol/L vs. 8.64±2.28mmol/L; P<0.01), while HbA1C was also observed significantly higher in group-I compared to group-II (9.81±4.28% vs. 8.45±1.92%; P<0.01). A significant negative correlation was found between serum folate and troponin-I level (r=–0.301; P<0.01). Multiple logistic regression also showed a significant negative association of folate with troponin-I level (P<0.001) To conclude, serum folate level is decreased in AMI in diabetic patients compared to diabetic patients without AMI. Therefore, early detection of serum folate level helps to prevent of AMI and its recurrence in Type 2 diabetic patients. International Journal of Human and Health Sciences Vol. 10 No. 01 Jan’26 Page: 48-52

Concerns about fetal safety limit acne treatments during pregnancy. The 308-nm excimer light offers targeted UVB exposure to lesions with less impact on healthy skin compared to whole-body NB-UVB. We assessed the efficacy and safety of lesion-directed excimer light for inflammatory acne in pregnancy, including folate monitoring and obstetric outcomes. This single-center, single-arm pilot study was conducted in 13 pregnant women with inflammatory acne in the second trimester. Lesion-directed 308-nm excimer light was delivered to facial lesions twice weekly for 8 weeks with erythema-guided escalation; serum folate was monitored, and obstetric outcomes were captured prospectively. For assessment of improvement, the Investigator's Global Assessment (IGA) and the Dermatology Life Quality Index (DLQI) were applied. Analyses emphasized estimation with 95% CIs; exploratory patient-reported/assessor correlations used Spearman's ρ with exact p-values. Both inflammatory and non-inflammatory lesions improved; the primary endpoint showed a 48.3% mean reduction in inflammatory lesions at Week 8, 5/13 achieved a ≥ 2-grade IGA improvement, and mean DLQI improved by 5.9 points. Serum folate remained within the reference range, and obstetric outcomes were reassuring. Excimer light was associated with clinically meaningful reductions in inflammatory acne lesions with reassuring safety signals and obstetric outcomes. It may be a pregnancy-compatible option when other therapies are limited and merits evaluation in controlled trials.

Background: Ovarian cancer is the third most common cancer of the female genital tract in females in the global population. CA125 is the most widely used diagnostic serum biomarker of ovarian cancer but is not specific. Osteopontin (OPN), a cell attachment molecule and Folate Receptor Alpha (FRα), a molecule that helps transport Folate across the cell membrane, are over-expressed in some cancers, including ovarian cancer. Objective: The present study is designed to evaluate OPN and FRα as potential biomarkers for diagnosing ovarian carcinoma. Method: Twenty-five patients with epithelial ovarian carcinoma, 25 patients with benign ovarian tumor and 25 healthy subjects as controls were enrolled in this study. Serum CA125 and Folate levels were measured using ECLIA, and serum OPN and FRα levels were measured using ELISA. Their levels were compared in 3 groups, ROC was used to determine the optimum cut-off of these markers. Results: Optimum cut-off (Sensitivity & specificity) of CA125, OPN & FRα to differentiate ovarian cancer from healthy controls was 27 U/mL (92% & 92%), 3390.4 pg/mL (64% & 64%) and 149 pg/mL (80% & 72%) respectively; similarly to differentiate ovarian cancer from benign ovarian tumour it was 52.5 U/mL (76% & 76%), 3527.4 pg/mL ( 64% & 60%) and 283.5 pg/mL, in that order. The area under the curve of ROC when CA125 & FRα were combined was more than either of them individually. Conclusion: FRα as a biomarker in adjunct to CA125 might improve the chance of diagnosis of ovarian cancer. Keywords Ovarian Cancer, FRα, FOLR1, Osteopontin, OPN, Markers

IntroductionAnemia remains a critical public health challenge in India, particularly among pregnant women, where its multifactorial etiology is often underappreciated. Despite long-standing supplementation programs, anemia prevalence in Gujarat remains high, necessitating granular, region-specific investigations.ObjectivesTo assess the prevalence of anemia among pregnant women across ten districts of Gujarat, and to identify key sociodemographic, nutritional, hematological, and biochemical determinants contributing to anemia and its geographic disparities.MethodologyThis community-based study included 2,805 pregnant women from diverse settings (tribal/rural/urban). Hematological and biochemical assessments included serum ferritin, iron, C-Reactive Protein (CRP), folate, vitamin B12, prealbumin, and hemoglobinopathy screening. A logistic regression analysis was conducted to determine the independent factors associated with anemia, with the findings presented as adjusted odds ratios (aOR) along with their 95% confidence intervals (CI).ResultsOverall anemia prevalence was 64.2%, with mild anemia comprising 82.1% of cases. Tribal women had 2.21-fold higher odds of anemia than urban counterparts (aOR = 2.21, 95% CI: 1.88–2.61, p < 0.001). Anemia was also associated with illiteracy (aOR = 2.16, p < 0.001), underweight status (aOR = 1.58, p < 0.001), and low dietary diversity (aOR = 2.26, p < 0.001). Biochemical assessments revealed absolute iron deficiency in 17.2%, folate deficiency in 15.5%, and vitamin B12 deficiency in 60.3% of anemic women. Elevated CRP levels indicated inflammation in 34.7%. Multivariable binary logistic regression revealed five significant and independent predictors of anemia: reduced red blood cell count (aOR = 0.26; 95% CI: 0.22–0.31), elevated red cell distribution width (RDW-CV) (aOR = 1.39; 95% CI: 1.33–1.46), diminished serum prealbumin (aOR = 0.92; p < 0.001), lower folate levels (aOR = 0.97; p < 0.001), and decreased ferritin concentrations (aOR = 0.99; p < 0.001), each independently contributing to anemia risk.ConclusionAnemia in Gujarat's pregnant women is highly prevalent and multifactorial, shaped by overlapping nutritional, inflammatory, and social determinants. Region-specific, integrated strategies targeting biochemical deficits and structural inequities are essential for effective anemia mitigation.

This study examines the associations between different forms of dietary, serum, and red blood cell folate and frailty in US NHANES participants using two frailty assessment tools: the frailty index (FI) and phenotype.Folate levels in various forms were assessed using 24-h dietary recalls and fasting blood sample. Frailty status was determined using a FI based on 36 frailty items or the five criteria of the frailty phenotype. Logistic regression and restricted cubic splines were used to analyze the associations between folate levels and frailty.Among 31719 participants (mean age 50.4 [SD, 17.9] years, 51.2% female), 8340 (26.3%) were classified as frailty by the FI. Penalized spline logistic models revealed significant L-shaped associations between natural food folate and frailty, and U-shaped associations for fortified foods folic acid with frailty (p-nonlinear<0.05). Compared to the second intake quartile, participants in the lowest quartiles of natural food folate had a higher prevalence of frailty (OR, 1.17; 95% CI, 1.07-1.28), while those in the third (OR, 0.90; 95% CI, 0.82-0.99) and fourth quartiles (OR, 0.83; 95% CI, 0.75-0.92) had lower prevalence. U-shaped associations were also observed for serum total folate, 5-methylTHF, non-methyl folate, and RBC folate with frailty (p-nonlinear<0.001), along with positive associations for serum UMFA and Mefox with frailty. Higher frailty prevalence was found in participants in the lowest quartile of serum total folate, 5-methylTHF, and non-methyl folate (ORs ranging from 1.16 to 1.29) and in the fourth quartile of non-methyl folate and RBC folate (ORs 1.18-1.31).U-shaped associations were observed for fortified foods folic acid and blood folate (serum total folate, 5-methylTHF, non-methyl folate, and RBC folate), an L-shaped association for natural food folate, and positive associations for serum UMFA and Mefox with frailty.

Background Most Indian women have a low folate and vitamin B 12 status that can progress to clinical deficiency and contributes to over 100 000 births annually with neural tube defects (NTDs). A common, widely accepted, Indian food vehicle for fortification with folate and vitamin B 12 has long remained elusive. Earlier, we employed folate and vitamin B 12 -fortified teabags to brew a daily cup of black tea and documented improvement in serum folate and vitamin B 12 concentrations among women from Maharashtra state within 60 days. Because most Indian households prefer hot-brewed (‘loose’) black tea prepared by the ‘crush, tear, curl’ (CTC) method in large commercial tea factories, we tested the feasibility of directly fortifying CTC tea with folate and vitamin B 12 and assessed its efficacy in improving the folate and vitamin B 12 status among women from Assam state within 90 days. Methods Two groups of women studying nursing (n=30) or pharmacy (n=30) at Assam Medical College and Hospital consumed a daily cup of hot tea prepared from 2 g of either unfortified CTC tea (control group) or vitamin-fortified CTC tea containing 1 mg folate and 1 mg vitamin B 12 (experimental group) for 90 days. We then compared their pre-interventional versus post-interventional changes in serum folate and vitamin B 12 status, iron status and haemoglobin concentration. Results At baseline, 89% of all women had low folate status (serum folate ≤5 ng/mL) and 72% had low vitamin B 12 status (serum vitamin B 12 ≤300 pg/mL). After 90 days daily consumption of unfortified CTC tea, the control group had clinically insignificant mean increases in serum folate of 1.3 ng/mL and serum vitamin B 12 of 1 pg/mL. By contrast, the experimental group consuming vitamin-fortified CTC tea exhibited a mean rise in serum folate of 5.3 ng/mL (95% CI 3.9 to 6.8; p&lt;0.001) and serum vitamin B 12 of 194.6 pg/mL (95% CI 154.7 to 234.5; p&lt;0.001). Moreover, 28/30 women receiving vitamin-fortified CTC tea had a post-interventional rise in mean serum folate of 9.2±3.6 (SD) ng/mL, and 25/30 women normalised their serum vitamin B 12 ≥300 pg/mL. However, only a minority achieved the higher serum folate concentration required to reduce their risk of NTDs. Despite borderline low normal iron status in most women, there was no adverse impact of CTC tea—consumed ~2 hours between meals—on either per cent-transferrin saturation or haemoglobin concentration. Conclusions Consumption of a daily cup of hot brewed folate and vitamin B 12 -fortified CTC tea is feasible, efficacious, and safe to clinically normalise the folate and vitamin B 12 status of Indian women within 90 days in Assam. Therefore, CTC tea is an ideal and eminently scalable food vehicle for fortification with these vitamins. The next challenge is to determine the optimum duration and/or dose of vitamins required to fortify CTC tea sufficient to lower the risk of NTDs among women across India. Trial registration number CTRI/2022/10/046289.

Folate deficiency has been reported in humans and dogs with immune-mediated haemolytic anaemia (IMHA) but not in cats. Cats with IMHA and without primary intestinal disease were included. Serum folate was measured at varying timepoints following IMHA diagnosis. Five cats (three with non-associative IMHA and two with possible concurrent acute pancreatitis) were followed for a median of 300 days (range: 40‒540 days). Serum folate concentration was evaluated 36 times (median: 6 per cat; range: 1‒19) and ranged from 5.1 to 20.1ng/mL (median: 7.4ng/mL), including nine samples in three cats receiving folic acid (400µg/day). Hypofolataemia in the 27 samples without supplementation was detected in all cats on at least one occasion (median: 3 times; range: 1‒4) for a total of 13 episodes. The median time to detection was 13 days after diagnosis (range: 1‒310 days). The median haemoglobin concentration at the time of hypofolataemia was 7.01g/dL (range: 3.9‒9.92 g/dL). Oral folate supplementation normalised folate concentration (median: 16.0ng/mL; range: 11.8‒20.1ng/mL) in all nine tested samples. Small sample size and lack of a control group prevented analysing the IMHA and folate link. Hypofolataemia occurred in all five cats with IMHA, possibly due to increased demand.

Joint and nonlinear associations of serum folate and physical activity with depressive symptoms.

Cerebral folate receptor α (FRα) is essential for transporting folate into the central nervous system, supporting normal biological functions and fetal neurodevelopment. We aimed to provide in vivo measurements of folic acid dynamics at FRα in non-human primate brains using positron emission tomography (PET) and [18F]AzaFol, a high-affinity FRα radioligand. A 0.01 mg/kg intravenous dose of folic acid, comparable to pregnancy supplementation doses (400-800 µg), dramatically reduced FRα availability in the choroid plexus (CP), based on uptake profiles and exploratory kinetic modeling. Following this dose, [18F]AzaFol uptake increased, potentially capturing (1) FRα-mediated transport of folic acid and (2) real-time FRα recycling, which may restore binding sites as serum folic acid levels decline, reducing receptor competition. Experiments with constant infusion of folic acid during PET imaging aimed to identify the possible folic acid transport rate and serum concentrations at which this process reaches a steady state. Pharmacokinetic analysis suggests full FRα blockage with serum folic acid concentrations within the range of 63-90 ng/mL and cumulative dose slightly above 0.01 mg/kg. Findings enhance the understanding of folic acid's in vivo pharmacology at cerebral FRα and may inform future studies on disorders in which impaired folic acid transport is suspected, either at the CP or at the placenta.

Hypertension is a leading global cardiovascular risk, and emerging evidence suggests that genetic variants particularly polymorphisms in the MTHFR (methylenetetrahydrofolate reductase) gene may influence blood pressure by modulating gut microbiota, folate, and homocysteine metabolism. In an Iraqi case-control study involving 180 adults (90 hypertensive, 90 normotensive), researchers genotyped the MTHFR C677T and A1298C variants via PCR-RFLP, measured serum homocysteine, folate, and vitamin B₁₂ by ELISA and chemiluminescence assays, and profiled gut microbiota using 16S rRNA sequencing. They found that the 677 T allele was more common in hypertensive individuals (p = 0.021), who also had significantly higher homocysteine (18.1 ± 5.2 vs 12.6 ± 4.3 µmol/L, p &lt; 0.001), lower folate (6.8 ± 2.4 vs 9.2 ± 2.8 ng/mL, p &lt; 0.001), and reduced B₁₂ (280 ± 85 vs 340 ± 92 pg/mL, p = 0.004). Microbiome analysis revealed gut dysbiosis in hypertensives, marked by reduced diversity (Shannon index 3.25 ± 0.42 vs 3.68 ± 0.39, p = 0.002), decreased Bifidobacterium (3.6 ± 1.4% vs 6.1 ± 1.7%, p &lt; 0.001), and an increased Firmicutes/Bacteroidetes ratio (2.9 ± 0.8 vs 1.7 ± 0.5, p &lt; 0.001). Critically, there was a significant gene–microbiome interaction: individuals with the TT genotype and low microbial diversity had the highest homocysteine levels (21.9 ± 5.3 µmol/L, p = 0.018 for interaction). These findings highlight a complex interplay between MTHFR polymorphisms and gut microbiota in regulating homocysteine metabolism in hypertensive Iraqi adults—and suggest that personalized nutritional or probiotic interventions might help manage hypertension.

Taurine plays a key role in cardiovascular and gastrointestinal health in dogs and may be deficient in some predisposed breeds despite consuming complete petfood. This study aimed to explore potential associations between serum taurine concentration and gut microbiota composition in clinically healthy Golden Retrievers, a breed predisposed to taurine deficiency-associated dilated cardiomyopathy. Eleven adult dogs, which were fed the same extruded commercial diet and living in the same kennel, underwent a nutritional evaluation, fecal analysis, and measurement of serum concentrations of taurine, folates, and vitamin B12. Taurine levels were below reference values in eight out of eleven dogs, and 50% of the tested dogs showed reduced serum folate. Microbiota analysis based on 16S rRNA sequencing revealed subtle compositional shifts in dogs with lower taurine levels, including a depletion of mucus-associated Deferribacterota and an enrichment of bile-sensitive taxa such as Lactobacillus and Streptococcus. While alpha and beta diversity metrics did not differ significantly between groups, unweighted UniFrac indicated a trend toward separation. These findings suggest that hypotaurinemia in Golden Retrievers may be associated with specific alterations in the gut microbiota, potentially reflecting subclinical dysbiosis. Further studies integrating metabolomic profiling are needed to clarify the functional implications of these microbial changes on taurine metabolism.

Background: Vitamin B12 deficiency, hyperhomocysteinemia, and diabetes are emerging determinants of cardiovascular risk, particularly among women. Early detection and treatment represent an important public health opportunity to reduce the burden of disease and promote health equity. Objective: We aimed to quantify the prevalence of vitamin B12 deficiency, hyperhomocysteinemia, and diabetes, and to evaluate the potential impact of detecting and addressing these conditions on reducing CVD risk in adult Mexican women. Methods: We analyzed data from 1197 women aged 20–49 years from Mexico’s 2022–2023 National Health and Nutrition Survey (ENSANUT). Serum vitamin B12, folate, and homocysteine were quantified, and 10-year CVD risk was estimated using Framingham and Globorisk models. Population-attributable fractions and cost–benefit analyses were used to assess preventable CVD cases and the economic feasibility of nationwide vitamin B12 supplementation. Results: Nationwide, 37.2% of women have vitamin B12 deficiency, and 30.6% have borderline levels. In Southern Mexico, the prevalence of vitamin B12 deficiency is higher, reaching 52.4%. Elevated homocysteine levels were detected in 12.3% of women. The predicted number of preventable CVD cases ranged from 10,000 to 14,000, and the benefit–cost ratio exceeded 1, supporting economic feasibility. Conclusions: Vitamin B12 deficiency and hyperhomocysteinemia are very common among Mexican women and are associated with an increased cardiovascular risk, especially in those aged 40 to 49. The analysis showed that implementing a national vitamin B12 supplementation strategy could be a cost-effective preventive measure, with a benefit–cost ratio ranging from 1.93 in the base case to 2.98 when broader societal savings are taken into account. These findings highlight the potential of targeted nutritional interventions to reduce the burden of cardiovascular disease in women.

Vitamin homeostasis plays a critical role in inflammatory bowel disease management, yet the protective mechanisms and clinical utility of specific vitamins remain incompletely characterized. Within this context, a two-sample Mendelian randomization analysis leveraging genetic instruments for measuring circulating vitamin levels identified folate as a protective factor against ulcerative colitis (UC). To validate these findings, a DSS-induced colitis model was established with serial serum folate measurements. Therapeutic folate supplements were subsequently administered, followed by a comprehensive evaluation of epithelial barrier modulation through in vivo and recombinant TNF-α/IFN-γ-induced in vitro models. This included assessment of junctional proteins, ultrastructural analysis by transmission electron microscopy, and functional quantification of barrier integrity using transepithelial electrical resistance with paracellular permeability assays in epithelial monolayers. Molecular mechanisms were investigated through RNA sequencing complemented by immunoblot validation of key pathway components. The results demonstrated decreased serum folate levels in DSS-induced colitis mice, whereas folate supplementation ameliorated disease severity and attenuated intestinal inflammation and histopathological damage. Crucially, folate restored epithelial barrier structural integrity and function both in vivo and in vitro. Mechanistically, folate mediated barrier restoration through suppression of the PI3K/AKT/NF-κB/MLCK/MLC2 signaling axis. Collectively, the results of this study provide mechanistic insights that support the use of folate as an active therapeutic molecule in patients with UC.

Purpose: To assess the association between hair loss in females and various biomarkers including hemoglobin, iron, ferritin, zinc, selenium, calcium, vitamin D, vitamin B12, folic acid, and thyroid hormones. Patients and methods: This study enrolled 100 women presenting with hair loss and 100 age-matched healthy controls. Venous blood samples were collected for analysis of hematological, hormonal and biochemical parameters. Results: The mean age of participants was comparable between groups (43.06 ± 10.76 vs. 41.39 ± 7.94 years; p = 0.88). Hair loss in females had significantly lower mean levels of Hb (11.45 ± 0.39 vs. 13.09 ± 0.46 g/dL; p < 0.001), iron (70.14 ± 7.85 vs. 94.42 ± 5.61 µg/dL; p < 0.001) and ferritin (39.34 ± 3.71 vs. 48.09 ± 5.31 ng/mL), all with p < 0.001. Serum levels of selenium (67.11 ± 5.53 vs. 71.45 ± 4.05 µg/L), zinc (86.07 ± 3.98 vs. 88.87 ± 2.03 µg/L), copper (90.71 ± 3.48 vs. 104.84 ± 5.38 µg/L), and calcium (8.61 ± 0.28 vs. 9.11 ± 0.27 mg/dL) were significantly reduced in women with hair loss (p < 0.001). Thyroid hormones were also significantly lower in the hair loss group, including TSH (1.74 ± 0.25 vs. 2.35 ± 0.39 µIU/mL) and FREE T4 (1.11 ± 0.11 vs. 1.32 ± 0.12 ng/dL), despite remaining within the normal reference ranges. Patients also showed lower serum folate (6.17 ± 0.63 vs. 6.96 ± 0.41 ng/mL), vitamin B12 (185.52 ± 35.27 vs. 258.30 ± 52.84 pg/mL), and vitamin D (26.32 ± 2.98 vs. 32.20 ± 3.76 ng/dL) levels (p < 0.001). Conclusions: Hair loss in females is significantly associated with reduced levels of circulating hemoglobin, iron, copper, selenium, vitamin D, vitamin B12, folate, thyroid-stimulating hormone and FREE T4 hormone.

Disclosure: L. Collado: None. F.J. Bennett: None. K.M. Oppat: None. V.J. Muralidharan: None. A.S. Jackson: None. S.G. Patel: None. N. Saunders: None. C. Weber: None. J. Sharma: None. T. Yamashita: None.Introduction: Folate is a vitamin that has been linked to altered metabolism in abnormal tissue growth and different types of neoplasia. In primary hyperparathyroidism (PHPT) abnormal growth of parathyroid gland(s) in the form of an adenoma, multigland disease, or rarely, carcinoma, leads to autonomous overproduction of parathyroid hormone (PTH), resulting in elevated serum calcium (Ca) levels. A correlation between folate levels and PHPT has not previously been studied. Methods: Using the National Health and Nutrition Examination Survey (NHANES) database, we identified patients (pts) with and without PHPT, defined as either PTH ≥ 65pg/mL with Ca ≥ 10.2mg/dL or as Vitamin D >30ng/mL and Ca≥ 10.2mg/dL in pts without available PTH levels. Logistic regression was used to evaluate the relationship between serum folate (Sf) and Red Blood Cell folate (RBCf) and Ca and PTH levels. Given cohort size discrepancy, PHPT pts were matched 1:2 to pts without PHPT based on demographics. Results: Of the 96,374 pts identified within the NHANES dataset from 2003-2016, 402 (0.42%) were identified to have PHPT and 95,972 (99.58%) did not. The mean age was 31.1 overall, 31.0 for non-PHPT and 39.8 for PHPT. Sex distribution was 50.8% female and 49.2% male. Within the total cohort, RBCf had a negative linear correlation with Ca (p<0.05) and positive linear correlation with PTH (p<0.05). Sf demonstrated a positive linear correlation with Ca (p<0.05) overall. This relationship held true within the non-PHPT cohort of unmatched pts only. When comparing PHPT to non-PHPT, the mean RBCf was higher in the non-PHPT cohort (102.64ng/mL vs. 155.63ng/mL, p< 0.05), while the mean Sf was higher in the PHPT cohort (28.08ng/mL vs. 9.4ng/mL, p< 0.05). RBCf had a positive linear correlation with Ca and PTH in the PHPT cohort (p< 0.05) while in the non-PHPT cohort there was a negative linear correlation with Ca (p=0.78) and PTH (p=0.3). Sf had a negative linear correlation on Ca (p=0.55) in the PHPT cohort yet a positive linear correlation on Ca (p=0.08) in the non-PHPT cohort. Conclusion: Significant differences were identified in serum levels and relationships between folate, Ca and PTH in pts with and without PHPT. Although mean RBCf was lower in PHPT, it presented a positive linear correlation with Ca and PTH, the opposite of what was seen in the non-PHPT cohort. Interestingly, Sf had the opposite effect on Ca; positive on non-PHPT and negative on PHPT. This suggests folate metabolism may be altered in parathyroid cells in PHPT, but additional studies are required to elucidate the exact mechanism driving this relationship and if causality exists.Presentation: Monday, July 14, 2025

Objectives: The aim of this study was to assess nutrient intake among individuals adhering to the Christian Orthodox Church (COC) fasting and to investigate potential differences in dietary intake according to Body Mass Index (BMI) classification. Methods: This cross-sectional study enrolled participants through announcements at public universities, churches, and monasteries, targeting both urban and religious adult populations. A total of 228 adults with a BMI exceeding 25 kg/m2 were enrolled. Of these, 121 had followed COC fasting practices for at least 10 years or since childhood, while 107 non-fasters were age-matched. Exclusion criteria included age under 18 years, refusal to provide consent, absence from measurements, non-communicable diseases, food allergies, pregnancy, or lactation. Results: Overweight and obesity rates were similar in both groups. Furthermore, there were no statistically significant differences in body composition measurements [body fat %, fat mass (kg), fat free mass (kg), waist circumference]. Diastolic and systolic blood pressure was significantly higher in non-fasters. Non-fasters reported higher intake of sugar, dietary protein, fats (saturated and polyunsaturated), and cholesterol. Fasters consumed lower amounts of vitamin A, vitamins B (B2, B3, B6, B12, folate, pantothenic acid), iron, phosphorus, sodium, zinc, and calcium. Serum folic acid levels were higher, and fasting glucose and phosphorus levels were lower in fasters. Distinct dietary patterns were observed between groups, with fasters consuming more fish and traditional plant-based foods, while non-fasters consumed higher amounts of meat, dairy products, and alcohol. Conclusions: COC fasting is associated with favorable dietary and metabolic profiles, including improved glucose regulation. However, its impact on weight status appears limited.

Background and study aimsRoux-en-Y gastric bypass (RYGB) is an effective long-term weight loss operation with improvements in metabolic diseases. Nutritional deficiencies, however, are highly prevalent despite supplementation, largely due to exclusion of the proximal small bowel. In RYGB patients who require pancreaticobiliary access, the EUS-directed transgastric ERCP (EDGE) procedure provides a stable gastro-gastric (GG) fistula using a lumen-apposing metal stent (LAMS). The metabolic and nutritional effects of temporary food diversion remain unknown.MethodsWe conducted a review of 60 consecutive RYGB patients from two tertiary centers who underwent EDGE. Nutritional and metabolic parameters were assessed before LAMS placement and after removal.ResultsMean age was 63.2 ± 11.05 years; 23% were male. Significant improvements were observed in serum hemoglobin (mean difference (MD) 1.1 g/dL;P= 0.004), vitamin B12 levels (MD 204.4 pg/mL;P= 0.021), iron (MD 57.9 mcg/dL;P= 0.017), albumin (MD 0.4 g/dL;P= 0.013), and magnesium levels (MD 0.24 mg/dL;P= 0.016). In addition, serum folate (MD 2.2 μg/mL;P= 0.873), and ferritin levels (MD 315.5 μg/mL;P= 0.335), showed improvement trends, but these did not reach statistical significance. No significant changes were observed in total body weight, body mass index, serum glucose, hemoglobin A1c, serum triglycerides, low-density lipoprotein, or high-density lipoprotein (P> 0.05 for all).ConclusionsTemporary partial-reversal of RYGB using a LAMS improves key nutritional parameters without compromising metabolic benefits of RYGB. These findings may support a therapeutic role for iatrogenic GG fistulas as a minimally invasive option for RYGB patients with refractory nutritional deficiencies.

Our preliminary study identified two metabolically distinct thrombus subtypes, demonstrating enhanced lipid metabolic signatures but downregulated folate biosynthesis pathways associated with poor prognosis. This study aimed to assess the prognostic value of routine laboratory parameters involved in lipid and folate metabolism for predicting 90-day futile recanalization (FR) in patients with anterior circulation acute ischemic stroke caused by large vessel occlusion (AIS-LVO) who achieved successful recanalization by endovascular thrombectomy. Consecutive patients with anterior circulation AIS-LVO who achieved successful recanalization (modified Thrombolysis in Cerebral Infarction score of 2b-3) were retrospectively screened from April 2019 to February 2024. Admission serum levels of traditional and non-traditional lipid parameters, folate, and homocysteine (Hcy) were measured. FR was defined as a 90-day modified Rankin Scale score of 3-6, despite successful recanalization. Multivariable logistic regression was performed to identify predictors for FR, which were incorporated into a predictive nomogram. Among 446 enrolled patients [median age 65 (IQR, 56-72.75) years; 32.1% female], 210 (47.1%) experienced 90-day FR. Multivariate logistic regression analysis revealed that lower admission serum folate and higher Hcy levels were independently associated with increased 90-day FR risk. In contrast, neither admission traditional or non-traditional lipid parameters were independent predictors. The addition of folate and Hcy, individually or combined, significantly improved the predictive performance of conventional clinical factor-based model, as reflected by significant increases in net reclassification improvement and integrated discrimination improvement. Finally, a predictive nomogram was developed incorporating age, admission National Institute of Health Stroke Scale, puncture-to-recanalization time, and admission serum glucose, folate, and Hcy levels. Admission serum folate and Hcy levels are independent predictors of 90-day FR risk and may enhance risk stratification and guide personalized secondary prevention strategies in patients with successfully recanalized AIS-LVO.

Abstract Background Recent Statistics Canada surveys show high and increasing use of legalized recreational drugs; alcohol, tobacco, and cannabis amongst Canadian adults. In Newfoundland and Labrador, alcohol use rose to 80% of adults by 2019, while cannabis use bounced from under 10% in 2013 to nearly 25% in 2019. Tobacco use, primarily through cigarette smoking, varies by sex and age, with 8–12% of adults regularly smoking, though total nicotine use is higher when vaping is included. These substances impact food consumption, digestion, and nutrient absorption, affecting caloric intake and essential vitamins. Heavy alcohol use is linked to B vitamin deficiencies, tobacco negatively affects vitamin levels, and cannabis increases high-calorie food intake while reducing vegetable consumption, potentially worsening vitamin status. The objective of this study is to examine how recreational drug use, as indicated by biomarkers, relates to poor nutrition and increased risk for folate and vitamin B12 deficiencies, affecting hematologic parameters. Methods We analyzed serum samples from 299 archived blood specimens across three age groups: under 45, 45–64, and over 64 years of both sexes for commonly used legalized recreational drugs targeting nicotine, cotinine, THC, and THC-COOH (cannabis) levels by a LC-MS/MS assay developed in our laboratory. The samples were also tested for serum folate and vitamin B12 concentrations using immunoassay. We hypothesized that recreational drug use correlates with poorer nutrition and increased risk of folate and vitamin B12 deficiencies. Results The presence of nicotine, cotinine, and THC-COOH was significantly higher in males under 45 compared to over 65-year-olds. However, females did not exhibit significant differences of any recreational drug concentrations amongst the age groups. Although plasma vitamin B12 concentrations showed no association with recreational drug use, plasma folate levels negatively correlated with nicotine, cotinine, and THC-COOH concentrations. Conclusion These findings suggest that above recreational drugs may negatively impact plasma folate concentrations, potentially contributing to nutritional deficiencies. This study also provides insights into age-specific patterns of legalized recreational drug use and a potential link to risk for nutritional deficiencies.

To investigate changes in gastrointestinal biomarkers over time in dogs undergoing elective orthopedic surgery and in dogs with acute nonspecific diarrhea (AD). Prospective cohort study of 20 dogs undergoing surgical repair of cranial cruciate ligament disease (CCL cohort) and 8 dogs with AD. Serum concentrations of cobalamin, folate, methylmalonic acid, and C-reactive protein and fecal calprotectin concentrations were measured before and 12 to 18 hours, 4 weeks, and 8 weeks after surgery in the CCL group. These biomarkers were also measured in AD dogs at initial evaluation and 4 and 8 weeks postrecovery. Serum cobalamin (437 ± 186 ng/L) and folate concentrations (10.5 ± 4.8 ng/mL) at 12 to 18 hours were lower than corresponding cobalamin (630 ± 235 ng/L; P < .001) and folate concentrations (14.61 ± 6.3 ng/mL; P = .001) before surgery in CCL dogs. However, serum cobalamin (637 ± 195 ng/L) and folate concentrations (13.8 ± 5.7 ng/mL) at 4 weeks were higher than at 12 to 18 hours (P < .001 and P = .01, respectively) and similar to baseline. All 3 AD dogs with serum cobalamin concentrations below the reference interval at baseline had serum cobalamin concentrations within the reference interval at 4 weeks. Major orthopedic surgery and acute nonspecific enteropathy transiently lowered serum cobalamin and folate concentrations in dogs. Serum folate and cobalamin should be interpreted cautiously in the immediate postoperative setting or during acute gastrointestinal illness. Abnormalities should be reevaluated at a later date before pursuing other diagnostics or instituting supplementation.