Folate reference interval estimation in the Dutch general population
| Autor: | Maarten B Kok, D.A. Janneke Dijck-Brouwer, L. Joost van Pelt, Jenny E. Kootstra-Ros, Michel J. Vos, M. Rebecca Heiner-Fokkema, Lambert D. Dikkeschei |
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| Přispěvatelé: | Center for Liver, Digestive and Metabolic Diseases (CLDM) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Folate
030213 general clinical medicine One-carbon metabolism medicine.medical_specialty Folic acid Homocysteine Clinical Biochemistry Population Interval estimation HOMOCYSTEINE 030204 cardiovascular system & hematology Article Reference interval lcsh:Chemistry 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Medicine General hospital education education.field_of_study lcsh:R5-920 PLASMA Radiological and Ultrasound Technology VALUES business.industry Obstetrics Folic acid fortification chemistry lcsh:QD1-999 Dutch Population Cohort business lcsh:Medicine (General) |
| Zdroj: | Practical Laboratory Medicine, Vol 16, Iss, Pp-(2019) Practical Laboratory Medicine Practical Laboratory Medicine, 16:00127. Elsevier |
| ISSN: | 2352-5517 |
| Popis: | Background: Folate functions as an enzyme co-factor within the one-carbon metabolic pathway, providing key metabolites required for DNA synthesis and methylation. Hence, insufficient intake of folate can negatively affect health. As correct interpretation of folate status is dependent on a well-established reference interval, we set out to perform a new estimation following the restandardization of the Roche folate assay against the international folate standard. Materials and methods: The folate reference interval was estimated using samples obtained from the Dutch population-based Lifelines cohort. The reference interval was estimated using two methods: a nonparametric estimation combined with bootstrap resampling and by fitting the data to a gamma distribution. The lower reference limit was verified in a patient cohort by combined measurement of folate and homocysteine. Results: Dependent on the method used for estimation and in- or exclusion of individuals younger than 21 years of age, the lower reference limit ranged from 6.8 to 7.3 nmol/L and the upper reference limit ranged from 26 to 38.5 nmol/L. Applying a lower reference limit of 7.3 nmol/L resulted in the following percentage of folate deficiencies over a period of 12 months: general practitioner 15.5% (IQR 4.0%), general hospital 12.8% (IQR 5.3%), academic hospital 9.6% (IQR 4.3%). Conclusions: We estimated the folate reference interval in the Dutch general population which is not affected by a folic acid fortification program and verified the obtained lower reference limit by homocysteine measurements. Based on our results, we propose a folate reference interval independent of age of 7.3–38.5 nmol/L Keywords: Folate, Folic acid, One-carbon metabolism, Homocysteine, Reference interval |
| Databáze: | OpenAIRE |
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