Serum folate levels, but not vitamin B12, are associated with slower progression in carotid intima-media thickness in a population exposed to mandatory folic acid fortification

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-11-28 DOI:10.1016/j.clnesp.2024.11.034

Cecília Zanin Palchetti , Natália Gomes Gonçalves , Claudia Kimie Suemoto , Itamar S. Santos , Paulo Andrade Lotufo , Isabela M. Bensenor , Dirce Maria Lobo Marchioni

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引用次数: 0

Abstract

Background&aims

Folate and vitamin B12 are vitamins involved in one carbon metabolism. Carotid intima-media thickness (cIMT) is a non-invasive test and an early atherosclerosis marker. The relationship between these vitamins and cIMT is not well established. This study aimed to investigate the association between baseline vitamins and cIMT changes during a median follow-up of 8 years.

Methods

Prospective cohort study involving 5061 ELSA-Brasil participants from São Paulo state aged 35–74 years at baseline. Serum folate and vitamin B12 levels and dietary intake were assessed at baseline. Ultrasound cIMT measurements were performed at baseline and wave 3. Linear mixed-effects models, adjusted for covariables, assessed the association between vitamins at baseline and changes in cIMT.

Results

4260 participants were included; mean (SD) age was 51.4 (8.9) years and 54.5 % were women. Folate (0.02 %) and vitamin B12 (2.6 %) deficiencies were almost nonexistent. Participants in the 4th quartile of serum folate had a slower cIMT increase during 8 years of follow-up than those in the 1st quartile (1st vs. 4th quartile comparison: β (95 % CI): −0.015 (−0.026; −0.004), P: 0.006 for model 3). These findings remained the same after sensitivity analysis for overall dietary supplements and specifically multivitamins use. No association was found between vitamin B12 biomarker and the outcome. Dietary folate intake was also not associated with cIMT changes.

Conclusion

In this population exposed to mandatory folic acid food fortification, prevalence of vitamins deficiencies was very low. Highest quartile of serum folate seemed to slow down the increment of cIMT measurements over time.

查看原文本刊更多论文

在接受强制性叶酸强化的人群中，血清叶酸水平（而非维生素B12）与颈动脉内膜-中膜厚度的缓慢进展有关。

背景与目的：叶酸和维生素B12是参与单碳代谢的维生素。颈动脉内膜-中膜厚度（cIMT）是一种无创测试，也是动脉粥样硬化的早期标志。这些维生素和cIMT之间的关系还没有很好的确定。本研究旨在调查基线维生素与中位随访8年期间cIMT变化之间的关系。方法：前瞻性队列研究涉及来自圣保罗州的5061名elsa - brazil参与者，基线年龄为35-74岁。在基线时评估血清叶酸和维生素B12水平以及饮食摄入量。超声cIMT测量在基线和波3进行。线性混合效应模型，调整协变量，评估基线维生素和cIMT变化之间的关系。结果：纳入4260名受试者；平均（SD）年龄为51.4（8.9）岁，54.5%为女性。叶酸（0.02%）和维生素B12（2.6%）缺乏症几乎不存在。血清叶酸第4四分位数的参与者在8年随访期间的cIMT增加速度比第1四分位数的参与者慢(第1和第4四分位数比较：β (95% CI): -0.015 (-0.026；-0.004)，模型3的P: 0.006)。在对总体膳食补充剂，特别是多种维生素的使用进行敏感性分析后，这些发现仍然相同。没有发现维生素B12生物标志物与结果之间的关联。饮食中叶酸的摄入量也与cIMT的变化无关。结论：在接受强制性叶酸食品强化的人群中，维生素缺乏症的患病率非常低。随着时间的推移，血清叶酸的最高四分位数似乎减缓了cIMT测量的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.