Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Acta Paediatr. 2012 Nov;101(11):e486-90. doi: 10.1111/j.1651-2227.2012.02795.x. Epub 2012 Aug 24.
To investigate the maternal homocysteine (Hcy), folate, vitamin B(12) and B(6) , and their relations to neural tube defects (NTDs).
Thirty mothers of NTDs offspring and another 60 mothers of normal children were enrolled as the patient and control groups from Xinjiang, China, from January 2008 to May 2011. The plasma levels of Hcy, folate, vitamin B(12) and B(6) were measured and compared between the two groups.
The morbidity of NTDs was 2.44% in Xinjiang. The Hcy was significantly higher in patient group than in control group (15.1 ± 7.8 vs. 8.5 ± 4.0 μmol/L, p < 0.001). The folate in patient group (9.7 ± 8.1 μg/L) was lower than in control group (15.0 ± 8.1 μg/L, p < 0.001). The vitamin B(12) was 181.3 ± 107.7 and 394.3 ± 386.3 ng/L in patient and control groups, respectively, with a significant difference (p < 0.001). The abnormal frequency of Hcy and vitamin B(12) was statistically different in two groups. The difference of vitamin B(6) between the patients and controls was marginal (48.7 ± 16.5 vs. 42.0 ± 10.5 mg/L, p = 0.051). Moreover, folate and vitamin B(12) levels were negatively correlated with Hcy while vitamin B(6) was positively correlated with Hcy. Positive correlation was observed between folate and vitamin B(12) levels.
Our data confirm that higher Hcy, lower folate and vitamin B(12) are risk factors for NTDs. Besides folate, vitamin B(12) should be supplied to decrease NTDs occurrence. Further study is required to investigate the levels and accurate role of vitamin B(6).
探讨母体同型半胱氨酸(Hcy)、叶酸、维生素 B(12)和 B(6)水平及其与神经管缺陷(NTDs)的关系。
选择 2008 年 1 月至 2011 年 5 月在新疆就诊的 30 例 NTDs 患儿的母亲为病例组,60 例正常儿童的母亲为对照组,检测并比较两组血浆 Hcy、叶酸、维生素 B(12)和 B(6)水平。
新疆地区 NTDs 的发病率为 2.44%。病例组 Hcy 水平显著高于对照组(15.1±7.8μmol/L 比 8.5±4.0μmol/L,p<0.001),叶酸水平显著低于对照组(9.7±8.1μg/L 比 15.0±8.1μg/L,p<0.001)。病例组维生素 B(12)水平为 181.3±107.7ng/L,对照组为 394.3±386.3ng/L,两组比较差异有统计学意义(p<0.001)。病例组 Hcy 和维生素 B(12)异常频率与对照组比较差异有统计学意义。病例组与对照组维生素 B(6)比较差异无统计学意义(48.7±16.5ng/L 比 42.0±10.5ng/L,p=0.051)。Hcy 与叶酸、维生素 B(12)呈负相关,与维生素 B(6)呈正相关,叶酸与维生素 B(12)呈正相关。
高 Hcy、低叶酸和维生素 B(12)是 NTDs 的危险因素。除了叶酸,还应该补充维生素 B(12)以降低 NTDs 的发生。需要进一步研究维生素 B(6)的水平及其确切作用。