Wang Meng, Tong Zonghang, Li Chaoxue, Wang Yanhong, Yang Xueli, Gong Zhongying, Zhang Qiang, Wang Xuan, Zhang Xumei
Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China.
Front Nutr. 2025 Apr 10;12:1547844. doi: 10.3389/fnut.2025.1547844. eCollection 2025.
This study aims to explore the associations between RBC folate, several serum folate forms [serum total folate, 5-methyltetrahydrofolate (5-mTHF), and unmetabolized folic acid (UMFA)], and obesity risk in middle-aged and older populations.
Data from NHANES (2011-2018) included 11,615 participants. Generalized linear models (GLMs) were applied to investigate associations of RBC folate and various serum folate forms with obesity risk after multivariable adjustment. Potential effect modifications were examined through stratified analyses and multiplicative interaction testing.
Among the total sample, middle-aged, and older participants, 4578 (39.4%), 3613 (40.0%), and 965 (37.2%) were obese, respectively. A positive association between RBC folate and obesity risk was observed, with the highest risks of obesity were consistently found in the fourth quartile (≥ 1,430 nmol/L) for the middle-aged adults (OR = 1.104, 95% CI: 1.045-1.166) and the older participants (OR = 1.157, 95% CI: 1.036-1.293). A significant negative association between serum total folate levels and obesity risk in middle-aged participants, with an OR of 0.804 (95% CI: 0.773-0.835) in the highest quartile (≥ 54.2 nmol/L). Similarly, serum 5-mTHF levels were negatively associated with obesity risk, with an OR of 0.800 (95% CI: 0.772-0.830) in the highest quartile (≥ 51.2 nmol/L). Most importantly, older participants with UMFA levels in the fourth quartile (≥ 1.06 nmol/L) had a higher risk of obesity (OR, 1.056; 95% CI: 1.004-1.110) compared with those with lower UMFA levels, but this association was not found in the total participants or the middle-aged participants.
Significant positive relationships exist between RBC folate and obesity risk. Additionally, low serum 5-mTHF in middle-aged participants and high UMFA in older adults were associated with increased obesity risk, highlighting the importance of monitoring folate concentrations for guiding future clinical trials on folate supplementation.
本研究旨在探讨红细胞叶酸、几种血清叶酸形式[血清总叶酸、5-甲基四氢叶酸（5-mTHF）和未代谢叶酸（UMFA）]与中老年人群肥胖风险之间的关联。
来自美国国家健康与营养检查调查（2011 - 2018年）的数据包括11,615名参与者。应用广义线性模型（GLMs）在多变量调整后研究红细胞叶酸和各种血清叶酸形式与肥胖风险的关联。通过分层分析和乘法交互作用检验来检查潜在的效应修饰。
在总样本、中年和老年参与者中，分别有4578人（39.4%）、3613人（40.0%）和965人（37.2%）肥胖。观察到红细胞叶酸与肥胖风险之间存在正相关，中年成年人（OR = 1.104，95% CI：1.045 - 1.166）和老年参与者（OR = 1.157，95% CI：1.036 - 1.293）在第四四分位数（≥1,430 nmol/L）时肥胖风险始终最高。中年参与者中血清总叶酸水平与肥胖风险之间存在显著负相关，在最高四分位数（≥54.2 nmol/L）时OR为0.804（95% CI：0.773 - 0.835）。同样，血清5-mTHF水平与肥胖风险呈负相关，在最高四分位数（≥51.2 nmol/L）时OR为0.800（95% CI：0.772 - 0.830）。最重要的是，与UMFA水平较低的老年参与者相比，UMFA水平处于第四四分位数（≥1.06 nmol/L）的老年参与者肥胖风险更高（OR，1.056；95% CI：1.004 - 1.110），但在总参与者或中年参与者中未发现这种关联。
红细胞叶酸与肥胖风险之间存在显著正相关。此外，中年参与者血清5-mTHF水平低和老年成年人UMFA水平高与肥胖风险增加有关，这突出了监测叶酸浓度对指导未来叶酸补充临床试验的重要性。
