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Dangosydd eitem ddigidol (DOI)

  • Ben Carter
    King's College London
  • Zohra Zenasni
    King's College London
  • Stuart J Moat
    School of Healthcare Sciences, Cardiff University
  • Peter R Hudson
    Cobalz Limited, Chester, United Kingdom
  • Ian T Russell
    Swansea University
  • Andrew McCaddon
    Glyndwr University
  • Rhiannon Whitaker
  • Joshua Pink
  • Seren Roberts
  • Clare Wilkinson
  • Dyfrig Hughes
  • Emma Betson
    Xi'an Jiaotong‐Liverpool University
  • Diana Carr
    Xi'an Jiaotong‐Liverpool University
  • Andrea Jorgenson
    Xi'an Jiaotong‐Liverpool University
  • Munir Pirmohamed
    Xi'an Jiaotong‐Liverpool University
  • Nevyn Williams
    Xi'an Jiaotong‐Liverpool University
  • Helen Lewis
    York University
  • Keith Lloyd
    Swansea University
  • Yvonne Sylvesture
    Swansea University
  • Richard Tranter
    University of Otago
ABSTRACT Background Individuals with low serum vitamin B-12 and high serum folate have higher plasma concentrations of methylmalonic acid (MMA). Whether folic acid (FA) causes an increase in MMA is not known. Objectives We aimed to determine the impact of FA supplementation on plasma MMA concentration in people with low or marginal serum vitamin B-12. Methods We conducted a multicenter double-blind placebo-controlled randomized trial of oral FA (5 mg/d for 12 wk) in middle-aged patients treated with antidepressant medication participating in the FoLATED (Folate Augmentation of Treatment—Evaluation for Depression) trial. Participants defined as having “low” serum vitamin B-12 (vitamin B-12 ≥150 and <220 ng/L) or “marginal” serum vitamin B-12 (vitamin B-12 ≥ 220 and <280 ng/L) were included. The primary outcome of this substudy was MMA at week 12. A mixed-effects linear regression was fitted and reported using the adjusted mean difference (aMD). Results A total of 177 participants were included (85 randomly assigned to placebo and 92 to FA); the mean ± SD age was 46.2 ± 11.8 y, and 112 (63.3%) were female. The MMA analysis included 135 participants and the aMD was −0.01 (95% CI: −0.06, 0.04; P = 0.71). Serum folate was measured on 166 participants and increased in the supplementation group; the aMD was 21.6 μg/L (95% CI: 8.13, 25.02 μg/L; P < 0.001). A total of 117 participants were assessed for RBC folate, which also increased in the supplementation group; the aMD was 461 μg/L (95% CI: 387, 535 μg/L; P < 0.001). Conclusions Supplementation of FA leads to an increase of serum and RBC folate, but does not change plasma MMA concentration in individuals with serum vitamin B-12 between 150 and 280 ng/L. We cannot exclude effects in older people or those with serum vitamin B-12 <150 ng/L. Previously reported associations may arise from effects of impaired vitamin B-12 status on folate metabolism. This trial was registered at www.isrctn.com as ISRCTN37558856.

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Iaith wreiddiolSaesneg
CyfnodolynJournal of Nutrition
Dyddiad ar-lein cynnar11 Medi 2021
Dynodwyr Gwrthrych Digidol (DOIs)
StatwsE-gyhoeddi cyn argraffu - 11 Medi 2021

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