Internal Medicine, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Italy.
Surgery Department, San Giovanni Battista Hospital, Foligno, Perugia, Italy.
Int J Vitam Nutr Res. 2020 Jun;90(3-4):295-301. doi: 10.1024/0300-9831/a000538. Epub 2019 Mar 4.
Previous studies showed a high prevalence of micronutrient deficiencies in obese subjects, with low folate and vitamin B12 serum levels and intakes. Correlations between vitamins and lipids have been investigated both in animal and human studies. The aim of our study is to evaluate the influence of dietetic and serum levels of folate and vitamin B12 on lipid pattern in morbidly obese subjects. We also analysed the relationship between serum concentrations and dietary intake of these micronutrients, and compared the intakes to the Recommended Levels of Nutrients and Energy Intakes (LARN). In 122 morbidly obese patients, mean BMI 45 ± 7 kg/m, we evaluated anthropometric parameters, hepatic, glyco/lipid profile, total folate and vitamin B12, blood pressure, and finally nutritional intakes in a subgroup of 68 patients using a food frequency questionnaire about the frequency of food consumption and daily water intake. These values were determined in obese patients before and one year after sleeve gastrectomy. Both before and after surgery, levels of vitamins and minerals remained in normal range compared to LARN. According to univariate analysis, at baseline folate showed a significantly positive correlation with high-density lipoprotein cholesterol (p = 0.028, ρ = 0.204), apolipoprotein A-I (p = 0.006, ρ = 0.268) and vitamin B12 (p = 0.040, ρ = 0.192), and a significantly negative correlation with triglycerides (p = 0.049, ρ = -0.184). Folate and vitamin B12 levels do not correlate with their nutritional intakes, which remain within recommended range after surgery. In conclusion the correlation between folate and anti-atherogenic lipid profile is confirmed also in a large group of morbid obese patients.
先前的研究表明,肥胖人群中微量营养素缺乏的患病率较高,叶酸和维生素 B12 的血清水平和摄入量较低。在动物和人体研究中已经研究了维生素和脂质之间的相关性。我们研究的目的是评估饮食和血清叶酸和维生素 B12 水平对病态肥胖患者血脂谱的影响。我们还分析了这些微量营养素的血清浓度与饮食摄入量之间的关系,并将摄入量与营养素和能量推荐摄入量(LARN)进行了比较。在 122 名病态肥胖患者中,平均 BMI 为 45 ± 7 kg/m,我们评估了人体测量参数、肝、糖脂谱、总叶酸和维生素 B12、血压,最后在 68 名患者的亚组中使用食物频率问卷评估了营养摄入量,了解食物消费频率和日常水摄入量。这些值在肥胖患者行袖状胃切除术前和术后一年进行了测定。手术前后,维生素和矿物质水平均保持在正常范围,与 LARN 相比。根据单因素分析,在基线时,叶酸与高密度脂蛋白胆固醇(p=0.028,ρ=0.204)、载脂蛋白 A-I(p=0.006,ρ=0.268)和维生素 B12(p=0.040,ρ=0.192)呈显著正相关,与甘油三酯(p=0.049,ρ=-0.184)呈显著负相关。叶酸和维生素 B12 水平与其营养摄入量不相关,术后仍处于推荐范围内。总之,叶酸与抗动脉粥样硬化脂质谱之间的相关性在一大群病态肥胖患者中得到了证实。