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Yeroshkina K, Rossokha Z, Fishchuk L, Gorovenko N. Betaine consumption as a new clinical approach to treatment and prophylaxis of folate-related pathologies. Nutr Rev 2022; 81:716-726. [PMID: 36164833 DOI: 10.1093/nutrit/nuac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The most important pathway in the development of folate-related pathologies is an increase in the level of homocysteine (HC). HC, a cytotoxic and neurotoxic amino acid (when its level is ≥12 μmol/L), is 1 of the most widely studied compounds in cardiology, neurobiology, oncology, and embryology for the last 20 years. Given its toxicity, the processes of endogenous detoxification of HC are of particular interest to medicine. To date, the most studied pathway is that of remethylation (the conversion of HC to methionine), with the participation of B12- and B9-dependent methionine synthase. Less studied is remethylation with the participation of the choline derivatives betaine and betaine-HC-S-methyltransferase (BHMT). Therefore, the aim of this review was to conduct a theoretical analysis of available information regarding the contribution of betaine metabolism, its enzyme, and its genetic polymorphism to folate metabolism disturbances, and the development of folate-related pathologies. This review emphasizes the potential clinical significance of 2 factors that can influence the remethylation reaction of HC: the use of betaine and identifying the BHMT gene variants and their impact on the risk for developing certain folate-related pathologies, and treatment options. Moreover, with a high level of methylation of the BHMT gene and in the presence of its low-function variants (eg, rs3733890), it is necessary to use betaine as an additional methyl donor, especially during folate therapy. More clinical research is needed to identify the effects of the different BHMT gene variants on the individual risk for folate-related pathologies to better assess the clinical significance, the need for genetic testing, and betaine consumption.
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Affiliation(s)
- Krystyna Yeroshkina
- State Institution "Reference-Centre for Molecular Diagnostic of Public Health Ministry of Ukraine," Kyiv, Ukraine
| | - Zoia Rossokha
- State Institution "Reference-Centre for Molecular Diagnostic of Public Health Ministry of Ukraine," Kyiv, Ukraine.,State Institute of Genetic and Regenerative Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Liliya Fishchuk
- State Institution "Reference-Centre for Molecular Diagnostic of Public Health Ministry of Ukraine," Kyiv, Ukraine.,State Institute of Genetic and Regenerative Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Nataliia Gorovenko
- State Institute of Genetic and Regenerative Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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2
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Profiling the Influence of Gene Variants Related to Folate-Mediated One-Carbon Metabolism on the Outcome of In Vitro Fertilization (IVF) with Donor Oocytes in Recipients Receiving Folic Acid Fortification. Int J Mol Sci 2022; 23:ijms231911298. [PMID: 36232598 PMCID: PMC9569987 DOI: 10.3390/ijms231911298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Nutritional status and gene polymorphisms of one-carbon metabolism confer a well-known interaction that in pregnant women may affect embryo viability and the health of the newborn. Folate metabolism directly impacts nucleotide synthesis and methylation, which is of increasing interest in the reproductive medicine field. Studies assessing the genetic influence of folate metabolism on IVF treatments have currently been performed in women using their own oocytes. Most of these patients seeking to have a child or undergoing IVF treatments are advised to preventively intake folate supplies that restore known metabolic imbalances, but the treatments could lead to the promotion of specific enzymes in specific women, depending on their genetic variance. In the present study, we assess the influence of candidate gene variants related to folate metabolism, such as Serine Hydroxymethyltransferase 1 SHMT1 (rs1979276 and rs1979277), Betaine-Homocysteine S-Methyltransferase BHMT (rs3733890), Methionine synthase reductase MTRR (rs1801394), Methylenetetrahydrofolate reductase MTHFR (rs1801131 and rs1801133), methionine synthase MTR (rs12749581), ATP Binding Cassette Subfamily B Member 1 ABCB1 (rs1045642) and folate receptor alpha FOLR1 (rs2071010) on the success of IVF treatment performed in women being recipients of donated oocytes. The implication of such gene variants seems to have no direct impact on pregnancy consecution after IVF; however, several gene variants could influence pregnancy loss events or pregnancy maintenance, as consequence of folic acid fortification.
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3
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Grželj J, Mlinarič-Raščan I, Marko PB, Marovt M, Gmeiner T, Šmid A. Polymorphisms in GNMT and DNMT3b are associated with methotrexate treatment outcome in plaque psoriasis. Biomed Pharmacother 2021; 138:111456. [PMID: 33714108 DOI: 10.1016/j.biopha.2021.111456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/14/2022] Open
Abstract
Methotrexate is used as first-line treatment of moderate to severe psoriasis. Despite the marked variability in treatment outcomes, no pharmacogenetic markers are currently used for personalised management of therapy. In this retrospective study, we investigated the effects of genetic predisposition on efficacy and toxicity of low-dose methotrexate in a cohort of 137 patients with moderate to severe plaque psoriasis. We genotyped 16 polymorphisms in genes for enzymes involved in the folate-methionine pathway and in methotrexate transport, and analysed their association with treatment efficacy and toxicity using classification and regression tree analysis and logistic regression. The most pronounced effect observed in this study was for GNMT rs10948059, which was identified as a risk factor for inadequate efficacy leading to treatment discontinuation. Patients carrying at least one variant allele had ~7-fold increased risk of treatment failure compared to patients with the wild-type genotype, as shown by the classification and regression tree analysis and logistic regression (odds ratio [OR], 6.94; p = 0.0004). Another risk factor associated with insufficient treatment responses was DNMT3b rs2424913, where patients carrying at least one variant allele had a 4-fold increased risk of treatment failure compared to patients with the wild-type genotype (OR, 4.10; p = 0.005). Using classification and regression tree analysis, we show that DNMT3b rs2424913 has a more pronounced role in patients with the variant GNMT genotype, and hence we suggest an interaction between these two genes. Further, we show that patients with the BHMT rs3733890 variant allele had increased risk of hepatotoxicity (OR, 3.17; p = 0.022), which is the most prominent reason for methotrexate discontinuation. We also show that variants in the genes for methotrexate transporters OATP1B1 (rs2306283/rs4149056 SLCO1B1 haplotypes) and ABCC2 (rs717620) are associated with increased risk of treatment failure. The associations identified have not been reported previously. These data suggest that polymorphisms in genes for enzymes of the methionine cycle (which affect cell methylation potential) might have significant roles in treatment responses to methotrexate of patients with psoriasis. Further studies are warranted to validate the potential of the pharmacogenetic markers identified.
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Affiliation(s)
- Jasna Grželj
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva cesta 7, Ljubljana, Slovenia; Krka, d. d., Novo mesto, Šmarješka cesta 6, Novo mesto, Slovenia
| | - Irena Mlinarič-Raščan
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva cesta 7, Ljubljana, Slovenia
| | - Pij B Marko
- Department of Dermatovenerology, University Medical Centre Maribor, Ljubljanska ulica 5, Maribor, Slovenia
| | - Maruška Marovt
- Department of Dermatovenerology, University Medical Centre Maribor, Ljubljanska ulica 5, Maribor, Slovenia
| | - Tanja Gmeiner
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva cesta 7, Ljubljana, Slovenia
| | - Alenka Šmid
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva cesta 7, Ljubljana, Slovenia.
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4
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Mujica-Coopman MF, Tan A, Schroder TH, Sinclair G, Vallance HD, Lamers Y. Serum Betaine and Dimethylglycine Are Higher in South Asian Compared with European Pregnant Women in Canada, with Betaine and Total Homocysteine Inversely Associated in Early and Midpregnancy, Independent of Ethnicity. J Nutr 2019; 149:2145-2155. [PMID: 31504713 DOI: 10.1093/jn/nxz178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/11/2019] [Accepted: 07/08/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As a methyl donor required in the folate-vitamin B-12 independent remethylation of total homocysteine (tHcy) to methionine, betaine is critical for fetal development. Pregnant South Asian women living in Canada had a higher reported prevalence of low vitamin B-12 status compared with Europeans; betaine concentrations in this population are unknown. OBJECTIVES We aimed to compare serum betaine concentrations between South Asian and European pregnant women, and to determine the relation between betaine and tHcy concentrations in early pregnancy. METHODS A retrospective cohort study was conducted using biobanked serum samples of 723 apparently healthy pregnant women of South Asian (50%) and European ethnicity residing in British Columbia, Canada. Betaine, dimethylglycine (DMG), tHcy, and related metabolites were quantified in samples collected in the first (8-13 weeks of gestation) and second (14-20 weeks of gestation) trimesters. The relation between betaine and tHcy concentrations was assessed using a generalized regression model adjusted for weeks of gestation, ethnicity, prepregnancy BMI, maternal age, neonatal sex, parity, total vitamin B-12, folate, pyridoxal 5'-phosphate, and methionine concentrations. RESULTS Median serum concentrations of betaine and its metabolite DMG were higher in South Asian women in the first (19.8 [IQR: 16.3-25.0] and 1.55 [IQR: 1.30-1.96] $\mu {\rm mol/L} $, respectively) and second trimesters (16.1 [IQR: 12.9-19.8] and 1.42 [IQR: 1.14-1.81] $\mu {\rm mol/L} $, respectively) compared with European women (17.6 [IQR: 13.7-22.6] and 1.38 [IQR: 1.12-1.77] $\mu {\rm mol/L} $, respectively) and (12.9 [IQR: 10.6-16.7] and 1.19 [IQR: 0.97-1.52] $\mu {\rm mol/L} $, respectively; all P values < 0.0001). Betaine was inversely associated with tHcy concentration (β = -0.0208; 95% CI: -0.0341, -0.00742; P = 0.002). Additionally, total vitamin B-12 was associated with tHcy concentration (β = -0.0312; 95% CI: -0.0401, -0.0224), after adjusting for confounding factors. CONCLUSIONS Pregnant South Asian women residing in Canada had higher betaine and DMG concentrations, compared with women of European ethnicity, while betaine and total vitamin B-12 predicted tHcy independent of ethnicity. Our results emphasize the role of betaine, as methyl donor, in the remethylation of tHcy in a folate-replete population.
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Affiliation(s)
- Maria F Mujica-Coopman
- Food, Nutrition, and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Amy Tan
- Food, Nutrition, and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Theresa H Schroder
- Food, Nutrition, and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Graham Sinclair
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Hilary D Vallance
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Yvonne Lamers
- Food, Nutrition, and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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Chmurzynska A, Seremak‐Mrozikiewicz A, Malinowska AM, Różycka A, Radziejewska A, KurzawiŃska G, Barlik M, Wolski H, Drews K. Associations between folate and choline intake, homocysteine metabolism, and genetic polymorphism of
MTHFR, BHMT
and
PEMT
in healthy pregnant Polish women. Nutr Diet 2019; 77:368-372. [DOI: 10.1111/1747-0080.12549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/27/2019] [Accepted: 04/08/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Agata Chmurzynska
- Institute of Human Nutrition and DieteticsPoznań University of Life Sciences Poznań Poland
| | - Agnieszka Seremak‐Mrozikiewicz
- Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
- Laboratory of Molecular Biology, Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
| | - Anna M. Malinowska
- Institute of Human Nutrition and DieteticsPoznań University of Life Sciences Poznań Poland
| | - Agata Różycka
- Department of Biochemistry and Molecular BiologyPoznań University of Medical Sciences Poznań Poland
| | - Anna Radziejewska
- Institute of Human Nutrition and DieteticsPoznań University of Life Sciences Poznań Poland
| | - Grażyna KurzawiŃska
- Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
- Laboratory of Molecular Biology, Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
| | - Magdalena Barlik
- Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
- Laboratory of Molecular Biology, Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
| | - Hubert Wolski
- Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
- Division of Gynecology and ObstetricsPodhale Multidisciplinary Hospital Nowy Targ Poland
| | - Krzysztof Drews
- Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
- Laboratory of Molecular Biology, Division of Perinatology and Women's DiseasesPoznań University of Medical Sciences Poznań Poland
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Shiralizadeh J, Barmaki H, Haiaty S, Faridvand Y, Mostafazadeh M, Mokarizadeh N, Kamrani A, Isazadeh A, Maroufi NF. The effects of high and low doses of folic acid on oxidation of protein levels during pregnancy: a randomized double-blind clinical trial. Horm Mol Biol Clin Investig 2018; 33:/j/hmbci.ahead-of-print/hmbci-2017-0039/hmbci-2017-0039.xml. [DOI: 10.1515/hmbci-2017-0039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/17/2017] [Indexed: 12/31/2022]
Abstract
AbstractObjectiveOxidants include important active molecules which are created in the body and attack biological molecules especially lipids, carbohydrates, nucleic acids and proteins, and cause oxidation and various diseases in the body. Antioxidants existing in the body help to avoid the incidence of these injuries. Pregnant women are among those where oxidation of biological molecules may do irreparable damage to them and their embryos. So, the purpose of this study was to review the effect of folic acid with both high (5 mg/day) and low (0.5 mg/day) doses on the changes of oxidative protein in reducing plasma homocystein concentration during pregnancy.Materials and methodsForty-five pregnant women participated in this study. They were divided into two groups: group 1 included 23 women who received 5 mg/day folic acid and group 2 included 23 women who took 0.5 mg/day folic acid before pregnancy till the 36th week pregnancy. We measured the biochemical variables in the serum of pregnant women at the beginning and at the end of the study.ResultsFolic acid reduced plasma homocytein in both low and high dose groups (p = 0.035, p = 0.012, respectively). Also, the results showed that folic acid prescription led to reduce plasma level of carbonyl groups in both low and high dose groups (p = 0.01, p = 0.03, respectively). Furthermore, the results showed that there is no significant difference between two groups and folic acid affects both groups equally.ConclusionIt is possible that folic acid administration can reduce plasma homocysteine and carbonyl levels during pregnancy in dose independent manner
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Solé-Navais P, Salat-Batlle J, Cavallé-Busquets P, Fernandez-Ballart J, Ueland PM, Ballesteros M, Ornosa-Martín G, Inglès-Puig M, Colomina JM, Murphy MM. Early pregnancy folate-cobalamin interactions and their effects on cobalamin status and hematologic variables throughout pregnancy. Am J Clin Nutr 2018; 107:173-182. [PMID: 29529156 DOI: 10.1093/ajcn/nqx041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 11/20/2017] [Indexed: 12/21/2022] Open
Abstract
Background Periconception folic acid supplementation is widespread, but how it interacts with cobalamin status is rarely considered. Objective The aim of this study was to investigate whether first-trimester folate-cobalamin interactions affect pregnancy cobalamin status, hematologic variables, and pregnancy outcomes. Design In the longitudinal Reus-Tarragona Birth Cohort study from <12 gestational weeks throughout pregnancy, fasting plasma and red blood cell (RBC) folate, plasma cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA), total homocysteine (tHcy), hemoglobin, mean cell volume (MCV), postglucose-load serum glucose, gestational hypertension, gestational age at birth, and birth weight were recorded in 563 participants. Results The highest plasma folate concentrations occurred in the first trimester when folic acid supplement use was extensive. Supplementation beyond the first trimester interacted with time of pregnancy on plasma folate, RBC folate, and tHcy throughout pregnancy (P-interaction <0.001). Plasma folate and RBC folate were higher and tHcy was lower in continued supplement users than in nonusers. Elevated plasma folate (≥30 nmol/L) occurred in 78.9% of women who exceeded the recommended 400 µg folic acid/d. First-trimester folate-cobalamin status interactions were associated with MMA (P-interaction <0.001) throughout pregnancy. When plasma cobalamin was suboptimal (≤221 pmol/L; n = 36), participants with elevated plasma folate (n = 11) had higher MMA concentrations than did those with nonelevated plasma folate (n = 23). First-trimester folate-MMA status interactions were associated with MCV throughout pregnancy (P-interaction <0.01) and with cord plasma holoTC (P-interaction <0.05). The mean difference (95% CI) in MCV (fL) between women with elevated and nonelevated plasma folate status was -2.12 (-3.71, -0.52) for top-quartile plasma MMA (≥0.139 µmol/L) and 0.60 (-0.39, 1.60) for plasma MMA <0.139 µmol/L. Cord plasma holoTC was higher in women with elevated compared with nonelevated plasma folate status only for MMA <0.139 µmol/L. Folate-cobalamin interactions were not associated with the other investigated outcomes. Conclusion First-trimester folate-cobalamin status interactions were associated with plasma MMA and MCV throughout pregnancy. This trial was registered at www.clinicaltrials.gov as NCT01778205.
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Affiliation(s)
- Pol Solé-Navais
- Units of Preventive Medicine and Public Health, Department of Basic Medical Sciences and Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain
| | - Judith Salat-Batlle
- Units of Preventive Medicine and Public Health, Department of Basic Medical Sciences and Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain
| | - Pere Cavallé-Busquets
- Units of Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain.,Units of Obstetrics and Gynecology, University Hospitals Sant Joan, Reus and Joan XXIII, Tarragona, Spain.,Biomedical Research Networking Center for the Pathophysiology of Obesity, Carlos III Institute of Health, Madrid, Spain
| | - Joan Fernandez-Ballart
- Units of Preventive Medicine and Public Health, Department of Basic Medical Sciences and Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain.,Biomedical Research Networking Center for the Pathophysiology of Obesity, Carlos III Institute of Health, Madrid, Spain
| | - Per M Ueland
- Section of Pharmacology, Department of Internal Medicine, University of Bergen, Bergen, Norway
| | - Mónica Ballesteros
- Units of Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain.,Units of Joan XXIII, Tarragona, Spain
| | - Gemma Ornosa-Martín
- Units of Preventive Medicine and Public Health, Department of Basic Medical Sciences and Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain
| | - Montserrat Inglès-Puig
- Units of Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain.,Units of Obstetrics and Gynecology, University Hospitals Sant Joan, Reus and Joan XXIII, Tarragona, Spain
| | - Jose M Colomina
- Units of Preventive Medicine and Public Health, Department of Basic Medical Sciences and Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain
| | - Michelle M Murphy
- Units of Preventive Medicine and Public Health, Department of Basic Medical Sciences and Obstetrics and Gynecology, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Pere Virgili Institute of Health Research, Rovira i Virgili University, Reus, Spain.,Biomedical Research Networking Center for the Pathophysiology of Obesity, Carlos III Institute of Health, Madrid, Spain
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8
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Obeid R, Murphy M, Solé-Navais P, Yajnik C. Cobalamin Status from Pregnancy to Early Childhood: Lessons from Global Experience. Adv Nutr 2017; 8:971-979. [PMID: 29141978 PMCID: PMC5683008 DOI: 10.3945/an.117.015628] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Low cobalamin intake and status during pregnancy or lactation have been linked to adverse maternal and perinatal health outcomes, whereas low cobalamin status during early childhood is associated with impaired development in children. Women who begin pregnancy with depleted stores (low or very low plasma cobalamin) will give birth to depleted infants who are likely to develop deficiency symptoms during the first few weeks or months postpartum. Newly ingested cobalamin during pregnancy and lactation (from diet or supplements) is transferred to the child and is not likely to correct cobalamin status in depleted women. The prevalence of low cobalamin status is high especially in low-income settings or in populations with a low intake of animal products. Folate and cobalamin play interdependent roles in one-carbon metabolism. Although folic acid supplementation during early pregnancy is widely recommended and practiced, cobalamin supplementation during pregnancy and lactation has received little attention. Furthermore, the intake recommendations for pregnant and lactating women and in early life need reevaluation in the light of newly available evidence in the field.
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Affiliation(s)
- Rima Obeid
- Aarhus Institute of Advanced Studies, University of Aarhus, Aarhus, Denmark
| | - Michelle Murphy
- Area of Preventive Medicine and Public Health, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Pere Virgili Institute for Health Research, Reus, Spain;,Centros de Investigación Biomédica en Red (CB06/03), Instituto de Salud Carlos III; and
| | - Pol Solé-Navais
- Area of Preventive Medicine and Public Health, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Pere Virgili Institute for Health Research, Reus, Spain
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