Chen Yuyi, Che Xiaoyu, Raghavan Ramkripa
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Precis Nutr. 2024 Jun;3(2). Epub 2024 Jun 13.
BACKGROUND: Precision nutrition emphasizes tailoring dietary requirements across populations and life stages. Optimal folate and vitamin B12 levels are important for normal growth and development, but data are lacking for low-income minority U.S. children during early life periods. This study aimed to describe folate, vitamin B12, homocysteine (Hcy) levels, and influencing factors to address the gaps. METHODS: Blood samples from children aged 6 months to 9 years and mothers 48-72 hours postpartum in the Boston Birth Cohort (BBC) were tested for folate, vitamin B12, and Hcy. Maternal and child characteristics, sociodemographic factors, and feeding status were obtained from a standard maternal questionnaire interview at the enrollment and follow-up, and medical records. The distribution of children's folate, vitamin B12, and Hcy were described and factors influencing these biomarkers were analyzed. RESULTS: A wide distribution of folate, vitamin B12, and Hcy levels was observed in this sample, with longitudinal trends consistent with National Health and Nutrition Examination Survey (NHANES) data. Multivariate analysis showed that very preterm birth correlated with higher folate levels (adjusted β 4.236; 95% CI: 1.218, 7.253; p=0.006). Children aged 1-2 years and 3-8 years had lower folate levels compared to those <1 year (adjusted β -10.191 and -7.499 respectively; p<0.001). Vitamin B12 levels were higher in Black children (adjusted fold change 1.139; 95% CI: 1.052, 1.233; p=0.001) and those children whose mothers' B12 levels were at the highest quartile (Q4) (adjusted fold change 1.229; 95% CI: 1.094, 1.380; p=0.001). Delayed solid food introduction (> 6 months) correlated with lower children's B12 levels (adjusted fold change 0.888; 95% CI: 0.809, 0.975; p=0.013). Hcy levels were lower in Black children (adjusted fold change 0.962; 95% CI: 0.932, 0.993; p=0.018), higher in children with maternal Hcy levels in Q4 (adjusted fold change 1.081; 95% CI: 1.03, 1.135; p=0.002) and in children aged 3-8 years (adjusted fold change 1.084; 95% CI: 1.040, 1.131; p< 0.001). CONCLUSIONS: This study revealed wide variations in plasma folate, vitamin B12, and Hcy levels among low-income minority U.S. children and identified race, maternal levels, child's age, prematurity, and timing of solid food introduction as significant correlates.
背景：精准营养强调根据不同人群和生命阶段定制饮食需求。最佳的叶酸和维生素B12水平对正常生长发育很重要，但美国低收入少数族裔儿童在生命早期阶段的数据尚缺。本研究旨在描述叶酸、维生素B12、同型半胱氨酸（Hcy）水平及影响因素，以填补这些空白。 方法：对波士顿出生队列（BBC）中6个月至9岁儿童及产后48 - 72小时母亲的血样进行叶酸、维生素B12和Hcy检测。通过入组和随访时的标准母亲问卷调查访谈以及医疗记录获取母婴特征、社会人口学因素和喂养状况。描述儿童叶酸、维生素B12和Hcy的分布情况，并分析影响这些生物标志物的因素。 结果：本样本中叶酸、维生素B12和Hcy水平分布广泛，纵向趋势与美国国家健康与营养检查调查（NHANES）数据一致。多变量分析显示，极早产与较高的叶酸水平相关（调整后β 4.236；95%置信区间：1.218，7.253；p = 0.006）。与1岁以下儿童相比，1 - 2岁和3 - 8岁儿童的叶酸水平较低（调整后β分别为 - 10.191和 - 7.499；p < 0.001）。黑人儿童的维生素B12水平较高（调整后倍数变化1.139；95%置信区间：1.052，1.233；p = 0.001），其母亲维生素B12水平处于最高四分位数（Q4）的儿童也是如此（调整后倍数变化1.229；95%置信区间：1.094，1.380；p = 0.001）。固体食物引入延迟（> 6个月）与儿童较低的维生素B12水平相关（调整后倍数变化0.888；95%置信区间：0.809，0.975；p = 0.013）。黑人儿童的Hcy水平较低（调整后倍数变化0.962；95%置信区间：0.932，0.993；p = 0.018），母亲Hcy水平处于Q4的儿童以及3 - 8岁儿童的Hcy水平较高（调整后倍数变化1.081；95%置信区间：1.03，1.135；p = 0.002），3 - 8岁儿童的Hcy水平也较高（调整后倍数变化1.084；95%置信区间：1.040，1.131；p < 0.001）。 结论：本研究揭示了美国低收入少数族裔儿童血浆叶酸、维生素B12和Hcy水平存在广泛差异，并确定种族、母亲水平、儿童年龄、早产情况以及固体食物引入时间为显著相关因素。
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