1University of Pavia,Department of Public Health,Experimental and Forensic Medicine,Unit of Human Nutrition,Pavia,Italy.
2Department of Medicine and Pediatrics,Massachusetts General Hospital,Harvard Medical School,Boston,MA,USA.
Nutr Res Rev. 2017 Dec;30(2):265-271. doi: 10.1017/S0954422417000142. Epub 2017 Jun 7.
Several studies have described a positive association between elevated BMI and birth defects risk. Data on plasma concentration of folate in pregnant women with obesity have shown values far below those recommended, regardless of diet, while folate levels should increase before pregnancy to reduce neural tube defects. We report a descriptive review of the most recent studies (from 2005 to 2015) to evaluate folate status through a population of women of childbearing age affected by obesity. The literature contains few studies, which present conflicting results regarding folate status in non-pregnant women of childbearing age affected by obesity, and it appears that there is a modification in folate metabolism, with a reduction in plasma folate levels and an increase in erythrocyte folate uptake. In conclusion, the folate status in women of childbearing age should be assessed by both plasma and erythrocyte levels to start a personalised and more adequate supplementation before conception. Further studies need to be conducted in a larger population, which take into account variables that can affect folate metabolism, such as dietary intake, lifestyle and genetic factors, oral contraceptives or other drug use, previous weight-loss programmes, or a history of bariatric surgery.
几项研究描述了 BMI 升高与出生缺陷风险之间的正相关关系。肥胖孕妇血浆叶酸浓度的数据表明,无论饮食如何,其值远低于推荐值,而叶酸水平应在怀孕前增加,以减少神经管缺陷。我们报告了对最近研究(2005 年至 2015 年)的描述性综述,以评估肥胖育龄妇女的叶酸状况。文献中很少有研究,这些研究对于肥胖的育龄非孕妇的叶酸状况提出了相互矛盾的结果,而且似乎存在叶酸代谢的改变,表现为血浆叶酸水平降低和红细胞叶酸摄取增加。总之,应通过血浆和红细胞水平评估育龄妇女的叶酸状况,以便在怀孕前开始个性化和更充分的补充。需要在更大的人群中进行进一步的研究,这些研究应考虑可能影响叶酸代谢的变量,如饮食摄入、生活方式和遗传因素、口服避孕药或其他药物使用、以前的减肥计划或减重手术史。