Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, 5012 Bergen, Norway.
Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway.
Int J Environ Res Public Health. 2022 May 9;19(9):5754. doi: 10.3390/ijerph19095754.
Substance use disorder (SUD) is associated with poor nutrition. Vitamin B9, or folate, is an important micronutrient for health. The aim of this prospective longitudinal cohort study was to assess serum folate levels among people with SUD and to investigate the impact of factors related to substance use severity on folate status. Participants were recruited from outpatient clinics for opioid agonist therapy (OAT) and municipal health-care clinics for SUD in Western Norway. They were assessed annually, including blood sampling for determination of micronutrient status. Overall, 663 participants with a total of 2236 serum folate measurements were included. A linear mixed model was applied, and measures are presented as β-coefficients with 95% confidence interval (CI). Forty-eight percent (CI: 44−51) of the population had low serum folate levels (s-folate < 10 nmol/L), and 23% (CI: 20−26) were deficient (s-folate < 6.8 nmol/L) at baseline. Sixty percent (CI: 53−65) sustained their poor folate status in at least one subsequent assessment. Except for weekly use of cannabis (mean difference in serum folate [nmol/L]: −1.8, CI: −3.3, −0.25) and alcohol (1.9, CI: 0.15, 3.6), weekly use of no other substance class was associated with baseline differences in serum folate when compared to less frequent or no use. Injecting substances was associated with a reduction in serum folate over time (−1.2, CI: −2.3, −0.14), as was higher dosages of OAT medication (−1.1, CI: −2.2, −0.024). Our findings emphasize the need of addressing nutrition among people with severe SUD.
物质使用障碍（SUD）与营养状况不佳有关。维生素 B9，又称叶酸，是健康的重要微量营养素。本前瞻性纵向队列研究旨在评估 SUD 患者的血清叶酸水平，并探讨与物质使用严重程度相关的因素对叶酸状况的影响。参与者从挪威西部的阿片类激动剂治疗（OAT）门诊诊所和市立 SUD 诊所招募。他们每年进行评估，包括血液采样以确定微量营养素状况。共有 663 名参与者，共进行了 2236 次血清叶酸测量，包括在内。应用线性混合模型，测量结果以β系数和 95%置信区间（CI）表示。48%（CI：44-51）的人群血清叶酸水平较低（s-叶酸<10nmol/L），23%（CI：20-26）存在叶酸缺乏（s-叶酸<6.8nmol/L）基线时。60%（CI：53-65）在至少一次后续评估中维持其叶酸状况不佳。除了每周使用大麻（血清叶酸差异[nmol/L]：-1.8，CI：-3.3，-0.25）和酒精（1.9，CI：0.15，3.6）外，与不频繁或不使用相比，每周使用任何其他物质类别与基线血清叶酸差异无关。与注射物质相关的血清叶酸随时间减少（-1.2，CI：-2.3，-0.14），OAT 药物剂量较高也与血清叶酸减少相关（-1.1，CI：-2.2，-0.024）。我们的研究结果强调了在严重 SUD 患者中解决营养问题的必要性。
