Shere Mahvash, Kapur Bhushan M, Koren Gideon
Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON.
Can J Public Health. 2016 Mar 16;106(8):e509-13. doi: 10.17269/cjph.106.5109.
To assess the percentage of women of childbearing age with suboptimal levels of folate for protecting against neural tube defects (<906 nM), and assess folate status among the elderly.
A total of 1,035 anonymous blood samples from a centralized clinical laboratory, with a catchment area across the Greater Toronto Area, were assessed for red blood cell (RBC) folate concentrations using a chemiluminescent immunoassay. Folate analysis was requested by physicians as part of clinical care. Available data included age, sex, and RBC folate concentration. Descriptive statistics were used to characterize the percent of women who had suboptimal blood folate concentrations, and a multiple regression was used to analyze determinants of folate status.
Our data from 2013 show that 7% of women of childbearing age (15-45 years) had RBC folate concentrations below 906 nM, a substantially lower percentage than in our 2006 study (40%). Results from the multiple regression showed that age is a significant positive predictor of higher RBC folate status (p < 0.001).
Compared to our earlier data, we report a significant decrease in the suboptimal folate status among women of childbearing age. We also show that age is a predictor of higher RBC folate levels. Our data are limited due to a lack of information regarding patient or physician characteristics, and to the nature of our sample, yet our results are consistent with the continued increase in folate status observed among several population-level studies in the US and Canada post-fortification. Further research is needed to determine the reasons for and future implications of this continued increase in the elderly.
评估育龄期女性叶酸水平未达预防神经管缺陷的最佳水平（<906 nM）的比例，并评估老年人的叶酸状况。
对来自多伦多地区一家集中临床实验室的1035份匿名血样进行评估，使用化学发光免疫分析法测定红细胞（RBC）叶酸浓度。叶酸分析是医生作为临床护理的一部分要求进行的。可用数据包括年龄、性别和RBC叶酸浓度。描述性统计用于描述血叶酸浓度未达最佳水平的女性比例，多元回归用于分析叶酸状况的决定因素。
我们2013年的数据显示，育龄期（15 - 45岁）女性中有7%的红细胞叶酸浓度低于906 nM，这一比例远低于我们2006年研究中的比例（40%）。多元回归结果表明，年龄是红细胞叶酸水平较高的显著正向预测因素（p < 0.001）。
与我们早期的数据相比，我们报告育龄期女性叶酸水平未达最佳状态的比例显著下降。我们还表明年龄是红细胞叶酸水平较高的预测因素。由于缺乏关于患者或医生特征的信息以及我们样本的性质，我们的数据有限，但我们的结果与美国和加拿大在强化叶酸后多项人群水平研究中观察到的叶酸状况持续改善一致。需要进一步研究以确定老年人中这种持续增加的原因及其未来影响。
