María de Lourdes Samaniego-Vaesken, Carmen Morais-Moreno, Alejandra Carretero-Krug, Ana María Puga, Ana María Montero-Bravo, Teresa Partearroyo, Varela-Moreiras Gregorio
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Folate metabolism is complex and associated with various metabolic pathways, all of which confer protection on the cell and allow its survival. <b>Methods</b>: We conducted a non-systematic search of articles published in English and Spanish including controlled trials, cohort studies, systematic re-views, and meta-analyses were included, as well as key studies in animal models related to pharmacokinetic studies. Search terms encompassed: \"folic acid\", \"folates\", \"5-metyltetrahydrofolate\", \"5-MTHF\", \"neural tube defects\", \"supplementation\", \"fortification\", AND \"homocysteine\" <b>Results</b>: A crucial role demonstrated for FA is to help prevent neural tube defects (NTDs). However, more studies are definitely still needed to establish 5-MTHF as a safe and effective therapeutic approach comparable with FA. Moreover, there is a lack of clinical studies that evaluate the efficacy of 5-MTHF supplementation in the prevention of NTDs. 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引用次数: 0
摘要
背景:叶酸(FA)的化学式为蝶酰谷氨酸,是维生素 B9 的完全氧化、水溶性、单谷氨酸形式。这种化合物属于叶酸类,但生物利用率更高,可在维生素补充剂、强化食品和药品中找到。叶酸的代谢非常复杂,与各种代谢途径有关,所有这些途径都能保护细胞并使其存活。研究方法我们对以英语和西班牙语发表的文章进行了非系统性检索,包括对照试验、队列研究、系统性复查和荟萃分析,以及与药代动力学研究相关的动物模型关键研究。搜索关键词包括"叶酸"、"叶酸盐"、"5-甲基四氢叶酸"、"5-MTHF"、"神经管缺陷"、"补充"、"强化 "和 "同型半胱氨酸" 结果:已证明 FA 的一个重要作用是帮助预防神经管缺陷(NTD)。然而,要将 5-MTHF 确立为与 FA 相媲美的安全有效的治疗方法,无疑还需要更多的研究。此外,目前还缺乏评估补充 5-MTHF 对预防 NTD 疗效的临床研究。本循证综述从结构、代谢、生物利用度、临床疗效和安全性等方面讨论了 FA 和 5-MTHF 的差异。结论:尽管 5-MTHF 作为 FA 的替代品具有潜在价值,但仍急需开展临床研究,以支持其作为补充剂的功效、剂量、时间和/或安全性。
Supplementation with Folic Acid or 5-Methyltetrahydrofolate and Prevention of Neural Tube Defects: An Evidence-Based Narrative Review.
Background: Folic acid (FA), which in its chemical form is pteroylglutamic acid, is the fully oxidised, water-soluble, monoglutamic form of vitamin B9. This compound is part of the folate group but with higher bioavailability, and it is found in vitamin supplements and fortified foods and drugs. Folate metabolism is complex and associated with various metabolic pathways, all of which confer protection on the cell and allow its survival. Methods: We conducted a non-systematic search of articles published in English and Spanish including controlled trials, cohort studies, systematic re-views, and meta-analyses were included, as well as key studies in animal models related to pharmacokinetic studies. Search terms encompassed: "folic acid", "folates", "5-metyltetrahydrofolate", "5-MTHF", "neural tube defects", "supplementation", "fortification", AND "homocysteine" Results: A crucial role demonstrated for FA is to help prevent neural tube defects (NTDs). However, more studies are definitely still needed to establish 5-MTHF as a safe and effective therapeutic approach comparable with FA. Moreover, there is a lack of clinical studies that evaluate the efficacy of 5-MTHF supplementation in the prevention of NTDs. The present evidence-based narrative review discusses differences between FA and 5-MTHF in terms of structure, metabolism, bioavailability, clinical efficacy, and safety. Conclusions: Despite the potential value of 5-MTHF as an alternative to FA, clinical studies would be urgently needed to support the efficacy, dosage, timing, and/or safety of its use as a supplement.
期刊介绍:
Nutrients (ISSN 2072-6643) is an international, peer-reviewed open access advanced forum for studies related to Human Nutrition. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.