Thilakarathne Shyamali, Jayaweera Udayanga Prasad, Herath Thushari Uthpala, Silva Renuka, Premawardhena Anuja
Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
Faculty of Graduate Studies, University of Kelaniya, Kelaniya, Sri Lanka.
BMJ Open. 2025 Apr 8;15(4):e086825. doi: 10.1136/bmjopen-2024-086825.
Ineffective erythropoiesis, although at a mild degree, could make individuals with beta thalassaemia trait (BTT) vulnerable to folate deficiency. This could be more pronounced in communities where dietary intake of folate is substantially lower. We aimed to assess serum folate levels and dietary folate consumption in individuals with BTT and compare them with healthy matched controls.
A case-control study.
This study was conducted between June 2021 and June 2022 at a regional thalassaemia centre in Sri Lanka.
The study includes 100 sets of samples, including a BTT and an age-matched, sex-matched and body mass index-matched healthy individual from the same household in each set, aged between 6 and 25 years.
The primary outcomes were serum folate levels and the daily dietary intake of folate in BTTs and controls. Serum folate levels were determined using a fully automated Cobas immunoassay analyser. The dietary folate intake was determined by recording 24-hour dietary recall recorded over 3 consecutive days, with the average intake calculated.
The results suggested that 34% of cases and 24% of controls had serum folate deficiency (<3 ng/mL), while 37% of cases and 49% of controls were at risk (3-5.9 ng/mL) for folate deficiency. Overall, the serum folate level was not significantly different between the cases (mean; 4.88 ng/mL) and the controls (mean; 4.76 ng/mL) (p=0.759). Dietary folate intake was lower than the recommended dietary allowances in both groups, but not significantly different between the groups.
There were high levels of folate deficiency in both controls and those with BTT, while those with BTT were no more likely to be folate deficient than the controls. Based on our findings, a policy of indiscriminate folic acid supplementation for all with BTT does not seem rational.
无效红细胞生成，尽管程度较轻，但可能使具有β地中海贫血特征（BTT）的个体易患叶酸缺乏症。在叶酸膳食摄入量显著较低的社区，这种情况可能更为明显。我们旨在评估BTT个体的血清叶酸水平和膳食叶酸摄入量，并将其与健康匹配对照组进行比较。
病例对照研究。
本研究于2021年6月至2022年6月在斯里兰卡的一个地区性地中海贫血中心进行。
该研究包括100组样本，每组包括一名BTT个体以及来自同一家庭的年龄匹配、性别匹配和体重指数匹配的健康个体，年龄在6至25岁之间。
主要观察指标为BTT个体和对照组的血清叶酸水平以及每日膳食叶酸摄入量。血清叶酸水平使用全自动Cobas免疫分析分析仪测定。膳食叶酸摄入量通过记录连续3天的24小时膳食回顾来确定，并计算平均摄入量。
结果表明，34%的病例和24%的对照组存在血清叶酸缺乏（<3 ng/mL），而37%的病例和49%的对照组有叶酸缺乏风险（3 - 5.9 ng/mL）。总体而言，病例组（均值；4.88 ng/mL）和对照组（均值；4.76 ng/mL）的血清叶酸水平无显著差异（p = 0.759）。两组的膳食叶酸摄入量均低于推荐膳食摄入量，但两组之间无显著差异。
对照组和BTT个体中叶酸缺乏水平都很高，而BTT个体并不比对照组更易患叶酸缺乏症。基于我们的研究结果，对所有BTT个体不加区分地补充叶酸的政策似乎不合理。
