高推荐剂量叶酸摄入与前瞻性法国-加拿大队列孕妇整个孕期高叶酸状态相关。
Higher Than Recommended Folic Acid Intakes is Associated with High Folate Status Throughout Pregnancy in a Prospective French-Canadian Cohort.
机构信息
School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Laval University Research Center, Quebec City, Canada; NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada.
School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Laval University Research Center, Quebec City, Canada.
出版信息
J Nutr. 2023 May;153(5):1347-1358. doi: 10.1016/j.tjnut.2023.02.027. Epub 2023 Feb 26.
BACKGROUND
Folate and vitamin B12 status during pregnancy are important for maternal and neonatal health. Maternal intake and prepregnancy body mass index (ppBMI) can influence biomarker status.
OBJECTIVES
This study aimed to, throughout pregnancy; 1) assess folate and B12 status including serum total folate, plasma total vitamin B12, and homocysteine (tHcy); 2) examine how these biomarkers are associated with intakes of folate and B12 and with ppBMI; and 3) determine predictors of serum total folate and plasma total vitamin B12.
METHODS
In each trimester (T1, T2, and T3), food and supplement intakes of 79 French-Canadian pregnant individuals were assessed by 3 dietary recalls (R24W) and a supplement use questionnaire. Fasting blood samples were collected. Serum total folate and plasma total vitamin B12 and tHcy were assessed by immunoassay (Siemens ADVIA Centaur XP).
RESULTS
Participants were 32.1 ± 3.7 y and had a mean ppBMI of 25.7 ± 5.8 kg/m. Serum total folate concentrations were high (>45.3 nmol/L, T1: 75.4 ± 55.1, T2: 69.1 ± 44.8, T3: 72.1 ± 52.1, P = 0.48). Mean plasma total vitamin B12 concentrations were >220 pmol/L (T1: 428 ± 175, T2: 321 ± 116, T3: 336 ± 128, P < 0.0001). Mean tHcy concentrations were <11 μmol/L across trimesters. Most participants (79.6%-86.1%) had a total folic acid intake above the Tolerable Upper Intake Level (UL, >1000 μg/d). Supplement use accounted for 71.9%-76.1% and 35.3%-41.8% of total folic acid and vitamin B12 intakes, respectively. The ppBMI was not correlated with serum total folate (P > 0.1) but was weakly correlated with and predicted lower plasma total vitamin B12 in T3 (r = -0.23, P = 0.04; r = 0.08, standardized beta [sβ] = -0.24, P = 0.01). Higher folic acid intakes from supplements predicted higher serum total folate (T1: r = 0.05, sβ = 0.15, P = 0.04, T2: r = 0.28, sβ = 0.56, P = 0.01, T3: r = 0.19, sβ = 0.44, P < 0.0001).
CONCLUSIONS
Most pregnant individuals had elevated serum total folate concentrations, reflecting total folic acid intakes above the UL driven by supplement use. Vitamin B12 concentrations were generally adequate and differed by ppBMI and pregnancy stage.
背景
怀孕期间叶酸和维生素 B12 的状况对母婴健康很重要。母体摄入和孕前体重指数（ppBMI）可能会影响生物标志物的状况。
目的
本研究旨在在整个怀孕期间：1）评估叶酸和 B12 状况，包括血清总叶酸、血浆总维生素 B12 和同型半胱氨酸（tHcy）；2）研究这些生物标志物与叶酸和 B12 摄入量以及 ppBMI 的关系；3）确定血清总叶酸和血浆总维生素 B12 的预测因素。
方法
在每个孕早期（T1）、孕中期（T2）和孕晚期（T3），通过 3 次 24 小时膳食回顾（R24W）和补充剂使用问卷评估 79 名法国加拿大孕妇的食物和补充剂摄入量。采集空腹血样。通过免疫测定法（Siemens ADVIA Centaur XP）评估血清总叶酸和血浆总维生素 B12 和 tHcy。
结果
参与者的年龄为 32.1±3.7 岁，平均孕前体重指数为 25.7±5.8kg/m。血清总叶酸浓度较高（>45.3nmol/L，T1：75.4±55.1，T2：69.1±44.8，T3：72.1±52.1，P=0.48）。平均血浆总维生素 B12 浓度>220pmol/L（T1：428±175，T2：321±116，T3：336±128，P<0.0001）。平均 tHcy 浓度在各孕期均<11μmol/L。大多数参与者（79.6%-86.1%）的总叶酸摄入量超过可耐受上限（UL，>1000μg/d）。补充剂使用分别占总叶酸和维生素 B12 摄入量的 71.9%-76.1%和 35.3%-41.8%。孕前体重指数与血清总叶酸无相关性（P>0.1），但与 T3 时的血浆总维生素 B12 呈弱相关（r=-0.23，P=0.04；r=0.08，标准化β[sβ]=-0.24，P=0.01）。较高的补充叶酸摄入量预测血清总叶酸较高（T1：r=0.05，sβ=0.15，P=0.04，T2：r=0.28，sβ=0.56，P=0.01，T3：r=0.19，sβ=0.44，P<0.0001）。
结论
大多数孕妇血清总叶酸浓度升高，反映了补充剂使用导致的 UL 以上的总叶酸摄入量。维生素 B12 浓度通常充足，且与 ppBMI 和妊娠阶段有关。
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