Martin Helena, Lindblad Bo, Norman Mikael
Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden.
Pediatrics. 2007 Jun;119(6):1152-8. doi: 10.1542/peds.2006-2706.
Low maternal folate levels during pregnancy correlate with low birth weight, a perinatal risk factor for later cardiovascular disease. We studied relationships between red blood cell folate levels, birth weight, and vascular endothelial function (a key factor in the early pathophysiologic processes of heart disease) in newborn infants.
We included 82 infants (30 low birth weight) and their mothers. A laser Doppler technique was used to measure skin perfusion during transdermal iontophoresis of acetylcholine (an endothelium-dependent vasodilator). Red blood cell folate, vitamin B12, and homocysteine levels were determined.
The perfusion response to acetylcholine was lower in low birth weight infants than in normal birth weight control subjects (mean: 35 vs 76 perfusion units). The neonatal acetylcholine response correlated with red blood cell folate levels in both infants and their mothers. The folate levels of low birth weight and control infants did not differ significantly (mean: 1603 vs 1795 nmol/L), but mothers of low birth weight infants had lower folate levels than did mothers of control infants (mean: 805 vs 1109 nmol/L). In multivariate analysis, low birth weight and red blood cell folate levels contributed independently to endothelial function in newborn infants. The levels of vitamin B12 and homocysteine were similar in the 2 groups and did not correlate with endothelial function.
The data presented here provide the first evidence for a relationship between folate levels and vascular endothelial function in newborn infants.
孕期母亲叶酸水平低与低出生体重相关,低出生体重是后期心血管疾病的围产期危险因素。我们研究了新生儿红细胞叶酸水平、出生体重与血管内皮功能(心脏病早期病理生理过程中的关键因素)之间的关系。
我们纳入了82名婴儿(30名低出生体重儿)及其母亲。使用激光多普勒技术在乙酰胆碱(一种内皮依赖性血管扩张剂)经皮离子导入过程中测量皮肤灌注。测定红细胞叶酸、维生素B12和同型半胱氨酸水平。
低出生体重儿对乙酰胆碱的灌注反应低于正常出生体重的对照受试者(平均值:35 vs 76灌注单位)。新生儿对乙酰胆碱的反应与婴儿及其母亲的红细胞叶酸水平相关。低出生体重儿和对照婴儿的叶酸水平无显著差异(平均值:1603 vs 1795 nmol/L),但低出生体重儿的母亲叶酸水平低于对照婴儿的母亲(平均值:805 vs 1109 nmol/L)。多变量分析显示,低出生体重和红细胞叶酸水平独立影响新生儿的内皮功能。两组的维生素B12和同型半胱氨酸水平相似,且与内皮功能无关。
本文提供的数据首次证明了新生儿叶酸水平与血管内皮功能之间的关系。