Serum folate levels and fatality among diabetic adults: A 15-y follow-up study of a national cohort

Afriyie-Gyawu, Evans; Ifebi, Emeka; Ampofo-Yeboah, Akwasi; Kyte, Brittany; Shrestha, Sambridhi; Zhang, Jian

doi:10.1016/j.nut.2015.10.021

Cited by 11 publications

(13 citation statements)

References 28 publications

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“…Although our results differ from several studies [8,14], they are largely in agreement with a number of reports [9,[15][16][17]. Although the underlying mechanisms by which lower folate status contributes to mortality remain unclear, some possible explanations could be considered.…”

Section: Discussionsupporting

confidence: 78%

“…Recent studies have explored the effects of serum folate concentrations on CVD, cancer and all-cause mortality and the findings regarding the associations are controversial. A prospective study conducted in the United States observed the inverse association between folate concentrations and all-cause mortality [5], while others failed to detect significant association [6,7] or even noticed a positive correlation [8]. The inconsistency also exists in both CVD [5,6] and cancer [8,9] mortality studies.…”

Section: Introductionmentioning

confidence: 99%

“…A prospective study conducted in the United States observed the inverse association between folate concentrations and all-cause mortality [5], while others failed to detect significant association [6,7] or even noticed a positive correlation [8]. The inconsistency also exists in both CVD [5,6] and cancer [8,9] mortality studies. In addition, although there appears to be a nonlinear dose-response relationship between folate status and mortality [10,11], the strengths and patterns of the relationship are very limited and inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Yang

Dong

Wang

2016

International Journal of Cardiology

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Yang

Dong

Wang

2016

International Journal of Cardiology

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“…16, 17 Further, some evidence suggests high serum folate may actually increase mortality in diabetes patients. 24 Finally, observational associations may also be a result of reverse causality. Animal models have shown diabetes can alter OCM functioning and metabolite levels, including reductions in vitamin B 6 .…”

Section: Discussionmentioning

confidence: 99%

Arsenic, one carbon metabolism and diabetes-related outcomes in the Strong Heart Family Study

Spratlen

Grau-Pérez

Umans

et al. 2018

Environment International

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Background: Inorganic arsenic exposure and inter-individual differences in its metabolism have been associated with cardiometabolic risk. A more efficient arsenic metabolism profile (lower MMA%, higher DMA%) has been associated with reduced risk for arsenic-related health outcomes; however, this profile has also been associated with increased risk for diabetes-related outcomes. The mechanism behind these contrasting associations is equivocal; we hypothesized one carbon metabolism (OCM) may play a role. Methods: We evaluated the association between OCM-related variables (nutrient intake and genetic variants) and both arsenic metabolism biomarkers (iAs%, MMA% and DMA%) and diabetes-related outcomes (metabolic syndrome, diabetes, HOMA2-IR and waist circumference) in 935 participants free of prevalent diabetes and metabolic syndrome from the Strong Heart Family Study, a family-based prospective cohort comprised of American Indian tribal members aged 14+ years. Results: Of the 935 participants free of both diabetes and metabolic syndrome at baseline, 279 (29.8%) developed metabolic syndrome over a median of 5.3 years of follow-up and of the 1,458 participants free of diabetes at baseline, 167 (11.3%) developed diabetes over follow-up. OCM nutrients were not associated with arsenic metabolism, however, higher vitamin B6 was associated with diabetes-related outcomes (higher HOMA2-IR and increased risk for diabetes and metabolic syndrome). A polymorphism in an OCM-related gene, methionine synthase (MTR), was associated with both higher MMA% (β=2.57, 95% CI: 0.22, 4.92) and lower HOMA2-IR (GMR=0.79, 95% CI=0.66, 0.93 per 5 years of follow-up). Adjustment for OCM variables did not affect previously reported associations between arsenic metabolism and diabetes-related outcomes; however, the association between the MTR variant and all diabetes-related outcomes were attenuated or reversed direction after adjustment for arsenic metabolism Conclusions: Our findings suggest MMA% may be a partial mediator in the association between OCM and diabetes-related outcomes. Formal mediation analyses with longer follow-up period are needed to confirm this finding. Additional research is needed to determine whether excess B vitamin intake is associated with increased risk for diabetes-related outcomes.

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“…In this study, the term “mortality” generally refers to cumulative mortality (i.e., prevalence of death). In addition, we also calculated mortality rates per 1,000 person-years, where the number of person-years was calculated as the time between baseline examination and date of death or the termination date of the study (December 31, 2011) ( 27 ). The association between urinary lead concentration and cancer-specific death rate was examined by Cox proportional hazards regression using “PHREG” procedure.…”

Section: Methodsmentioning

confidence: 99%

Urinary Lead Concentration Is an Independent Predictor of Cancer Mortality in the U.S. General Population

Wang

Zhang

et al. 2018

Front. Oncol.

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Lead is a ubiquitous pollutant that constitutes an environmental hazard worldwide. Although lead has been known as a carcinogenic factor in animal models, its role in human carcinogenesis is still a topic of debate with limited epidemiological evidence. Moreover, the association between urinary lead, as the most non-invasive and accessible way for lead measurement in human, and cancer mortality in general population has never been explored. We addressed this subject using continuous National Health and Nutrition Examination Survey 1999–2010 data and its Mortality Follow-Up Study. Of 5,316 subjects in study population, 161 participants died due to cancer. Cancer-specific mortality was associated with urinary lead levels after multivariable adjustment. Kaplan–Meier survival curve and cubic regression spline analyses indicated that high concentration of urinary lead exhibited significant association with raised death rate of cancer. Despite the marked decrease in environmental lead levels over the past three decades, lead exposure is still the significant determinant of cancer mortality in general population in U.S., and quantification of urinary lead may serve as a non-invasive approach to facilitate biomarker discovery and clinical translational research.

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Serum folate levels and fatality among diabetic adults: A 15-y follow-up study of a national cohort

Cited by 11 publications

References 28 publications

Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Arsenic, one carbon metabolism and diabetes-related outcomes in the Strong Heart Family Study

Urinary Lead Concentration Is an Independent Predictor of Cancer Mortality in the U.S. General Population

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