Department of Laboratory Medicine, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Department of Otolaryngology Head and Neck Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, 030001, China.
Sci Rep. 2024 Oct 21;14(1):24692. doi: 10.1038/s41598-024-76456-0.
Folates play a crucial role as cofactors in metabolic pathways, influencing biological methylation and nucleotide synthesis, which has a significant impact on overall health and disease susceptibility. Diabetic nephropathy (DN) is a prevalent and severe complication of diabetes mellitus (DM). The correlation between RBC folate and DN remains unclear currently. This study aims to assess whether RBC folate is associated with DN. Based on data from the NHANES (2011-2018), we conducted a cross-sectional study involving 3070 adults with type 2 DM (T2DM). Demographic factors, levels of folate and vitamin B12, dietary folate intakes, and relevant laboratory data were obtained from all participants. Logistic regression, fitting smooth curves, interaction effects were utilized to support the research objectives. Regression analyses demonstrated a positive relation between RBC folate and DN. (P < 0.001). A positive association between levels of RBC folate and the risk of DN was observed after full adjustment for all the confounding variables (odds ratio: 1.38, 95% confidence interval: 1.27-1.49, P < 0.001). Similar patterns of association were observed for subgroup analysis (all P values for interaction > 0.05). In addition, curve fitting after adjusting for all the confounding variables demonstrated that there was a linear relationship between RBC folate and DN (P for non-linearity = 0.147). Increased RBC folate levels were linked to a higher risk of DN in type 2 diabetes. RBC folate should be considered as a crucial indicator for folate status in DN.
叶酸在代谢途径中作为辅助因子发挥着至关重要的作用，影响着生物甲基化和核苷酸合成，这对整体健康和疾病易感性有着重要影响。糖尿病肾病（DN）是糖尿病（DM）的一种常见且严重的并发症。目前，红细胞叶酸（RBC folate）与 DN 之间的相关性尚不清楚。本研究旨在评估 RBC folate 是否与 DN 相关。基于 NHANES（2011-2018 年）的数据，我们进行了一项横断面研究，纳入了 3070 名 2 型糖尿病（T2DM）患者。所有参与者均提供了人口统计学因素、叶酸和维生素 B12 水平、叶酸饮食摄入量以及相关实验室数据。我们利用逻辑回归、拟合平滑曲线和交互作用效应来支持研究目标。回归分析表明 RBC folate 与 DN 之间存在正相关关系（P < 0.001）。在充分调整所有混杂因素后，发现 RBC folate 水平与 DN 风险之间存在正相关关系（优势比：1.38，95%置信区间：1.27-1.49，P < 0.001）。在所有亚组分析中都观察到了类似的关联模式（所有交互作用 P 值均大于 0.05）。此外，在充分调整所有混杂因素后进行的曲线拟合显示，RBC folate 与 DN 之间存在线性关系（非线性 P 值=0.147）。RBC folate 水平升高与 2 型糖尿病患者发生 DN 的风险增加相关。RBC folate 应被视为 DN 中叶酸状况的一个关键指标。
