Maternal – neonatal folate and vitamin B<sub>12</sub> serum concentrations in Greeks and in Albanian immigrants

Schulpis, Kleopatra H.; Spiropoulos, Antonia; Gavrili, Stavroula; Karikas, George A.; Grigori, C.; Vlachos, Georgios; Papassotiriou, Ioannis

doi:10.1111/j.1365-277x.2004.00550.x

Cited by 23 publications

(28 citation statements)

References 23 publications

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“…It is interesting that studies concerning Albanian immigrants showed either directly or indirectly low meat consumption or low protein and micronutrients intake. 19,20 It is likely, even though our study did not definitely show it, that there may be a correlation of the occurrence of goiter with the socio-economic level of the patients. It could for instance be hypothesised that patients who can afford to consume meat more frequently are those who are economically better-off than those that do not have this privilege.…”

Section: Discussioncontrasting

confidence: 38%

Thyroid volume, selenium levels and nutritional habits in a rural region in Albania

Doupis¹,

Stavrianos²,

Saltiki³

et al. 2009

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OBJECTIVE Environmental factors are involved in goiter development. An increased number of goitrous patients were identified among outpatients in Gyrocaster, a mountainous region in Southwestern Albania. We examined possible associations of thyroid enlargement with nutritional factors. DESIGN 112 consecutive patients, 104 females, aged 52.8 ±12.1 (mean±SD), who either were taking thyroxine (n=27) or were suspected to have thyroid disease were examined. Thyroid parameters and nutritional habits were recorded and serum selenium and urine iodine levels were determined; thyroid ultrasound was performed. RESULTS The median thyroid volume (TV) was 20.4ml (range 4.4-97.6). All consumed food was home-produced. TV correlated negatively with the frequency of lamb-goat meat and vegetables consumption (p=0.05 and p=0.03, respectively). Mean TV was significantly lower in those eating lamb-goat >1 times/week (21.4±13.3 vs 31.9±23 ml, p<0.01). The association of TV with lamb meat consumption was independent of sex, education or occupation (p<0.009). Selenium levels ranged from 30.6-138μg/L (reference range 43-190). There was no association between selenium levels and TV. 43% of the subjects had TSH<0.3 mU/L (those on thyroxine were excluded). Log TSH correlated negatively with TV and fT4 levels (p<0.007), indicating the presence of autonomy (TSHRab positive in two subjects). Mean urinary iodine excretion was 99.8±35.3μg/gr creatinine (normal >100). CONCLUSIONS Nutritional factors may be involved in the development of goiter in Southwestern Albania. No role of selenium was found. The higher consumption of lamb-goat meat and vegetables, all non-industrialized, appeared to be protective. This finding may reflect better socioeconomic status, although this was not identified. Unrecognized subclinical hyperthyroidism, probably due to thyroid autonomy, was quite common.

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Section: Discussioncontrasting

confidence: 38%

Thyroid volume, selenium levels and nutritional habits in a rural region in Albania

Doupis¹,

Stavrianos²,

Saltiki³

et al. 2009

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“…With respect to folate, mean neonatal plasma concentrations of about 25 nmol/l have been described (Minet et al, 2000;Guerra-Shinohara et al, 2002;Refsum et al, 2004;Schulpis et al, 2004;Couto et al, 2007), which is comparable with our results. These relatively high plasma folate concentrations in newborns compared with adults might explain the loss of correlation with tHcy concentrations in this age category.…”

Section: Discussionsupporting

confidence: 82%

The effect of folinic acid supplementation on homocysteine concentrations in newborns

et al. 2010

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Objective: The incidence of cerebrovascular accidents (CVA) occurring perinatally is relatively high and aspects of the multifactorial pathophysiology remain unclear. Elevated homocysteine concentrations have been shown to be associated with an increased risk for CVA in children and even in newborns. We studied the possible homocysteine lowering effect of folinic acid in newborns. Method: We included 37 newborns in our prospective randomized folinic acid (given as 5-formyltetrahydrofolate) intervention study from patients admitted to our neonatal intensive care unit (18 controls, 19 intervention group). We measured total homocysteine (tHcy) and plasma folate concentrations at three time points (baseline, 1 and 2 weeks after intervention). The intervention group was treated with folinic acid (70 mg/kg/day) for 2 weeks. We calculated median concentrations (25th and 75th percentiles). Results: Median tHcy concentrations at the three time points did not differ from each other in the control group nor in the intervention group. We also could not observe different tHcy concentrations between both groups. Plasma folate concentrations increased in the intervention group (mean increase 167% (95% confidence interval (CI) À291, 625)) compared with control group (mean increase À12% (95% CI À132, 108)), P for treatment effect: 0.03. Conclusion: We could not demonstrate a homocysteine lowering effect of folinic acid administration in newborns. This indicates that one carbon metabolism in newborns differs form adults. Cobalamin might be a better strategy to lower tHcy concentrations in newborns.

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“…However, we also found high rates of vitamin B-12 insufficiency in 4 studies from Turkey and in 1 study from Greece (28,52,65,77,93). The "Mediterranean diet" contains plenty of fruit, vegetables, and pulses compared with meat (118), which may in part explain this observation because stricter adherence to the diet during pregnancy exacerbated vitamin B-12 deficiency (52).…”

Section: B-12 Insufficiency In Pregnancy and Birth Weightmentioning

confidence: 80%

“…An additional striking finding was the pooled insufficiency rate of 65% (I 2 = 95%) ( Figure 4) (28,52,65,77,93) from the 5 studies in the Eastern Mediterranean region. On the contrary, insufficiency rates of ,8% were found in 2 studies conducted in Thailand and Sudan, where the authors attributed the low rates of insufficiency to the consumption of fish and animal/fermented products, respectively (although details of dietary intake were not provided) (49,50).…”

Section: Prevalence Of Vitamin B-12 Insufficiency In Pregnancymentioning

confidence: 98%

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Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Sukumar

Rafnsson

Kandala

et al. 2016

The American Journal of Clinical Nutrition

107

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Background: Vitamin B-12 and folate are micronutrients essential for normal embryogenesis. Vitamin B-12 insufficiency in pregnancy is high in certain parts of the world, such as India, and although this has been linked to low birth weight (LBW) in these populations, the relation between vitamin B-12 and birth weight (BW) elsewhere is unknown. Objectives: We performed a systematic review to assess 1) the worldwide prevalence of vitamin B-12 insufficiency in pregnancy and 2) its association with BW. Design: A search of 5 electronic databases was performed to identify eligible articles. Random-effects meta-analysis was conducted according to geographic regions and pregnancy trimesters for the prevalence subreview and by categorical measures of BW. Results: A total of 57 and 23 articles were included for the prevalence and BW subreviews, respectively. The pooled estimates of vitamin B-12 insufficiency were 21%, 19%, and 29% in the first, second, and third trimesters, respectively, with high rates for the Indian subcontinent and the Eastern Mediterranean. The large heterogeneity between studies was partially addressed by creating a standardized score for each study (mean vitamin B-12 insufficiency O cutoff value), which internally corrected for geographic region, trimester, and assay type. Twelve of the 13 longitudinal studies included showed a decrease in mean or median vitamin B-12 across trimesters. Pooled analysis showed nonsignificantly lower maternal vitamin B-12 concentrations in LBW than in normal-BW infants and higher odds of LBW with lower vitamin B-12 values (adjusted OR: 1.70; 95% CI: 1.16, 2.50), but studies from India largely contributed to the latter. Conclusions: Our review indicates that vitamin B-12 insufficiency during pregnancy is common even in nonvegetarian populations and that concentrations of vitamin B-12 decrease from the first to the third trimester. There is no consistent association between vitamin B-12 insufficiency and LBW. However, given the long-term risks of LBW, this observation warrants further cohort studies and randomized controlled trials.Am J Clin Nutr 2016;103:1232-51.

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Maternal – neonatal folate and vitamin B₁₂ serum concentrations in Greeks and in Albanian immigrants

Cited by 23 publications

References 23 publications

Thyroid volume, selenium levels and nutritional habits in a rural region in Albania

Thyroid volume, selenium levels and nutritional habits in a rural region in Albania

The effect of folinic acid supplementation on homocysteine concentrations in newborns

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

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Maternal – neonatal folate and vitamin B12 serum concentrations in Greeks and in Albanian immigrants

Cited by 23 publications

References 23 publications

Thyroid volume, selenium levels and nutritional habits in a rural region in Albania

Thyroid volume, selenium levels and nutritional habits in a rural region in Albania

The effect of folinic acid supplementation on homocysteine concentrations in newborns

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

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Maternal – neonatal folate and vitamin B₁₂ serum concentrations in Greeks and in Albanian immigrants