Screening for Serum Total Homocysteine in Newborn Children
| Autor: | Åse Fredriksen, Bengt Frode Kase, Anne Berit Guttormsen, Ole Erik Iversen, Klaus Meyer, Jörn Schneede, Helga Refsum, Arve Ulvik, Anne W. Grindflek, Per Magne Ueland |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Serum Vitamin medicine.medical_specialty Hyperhomocysteinemia Time Factors Homocysteine Clinical Biochemistry Methylmalonic acid Cystathionine beta-Synthase Homocystinuria chemistry.chemical_compound Folic Acid Neonatal Screening Sex Factors Reference Values Internal medicine medicine Humans Vitamin B12 Methylenetetrahydrofolate Reductase (NADPH2) Blood Specimen Collection Polymorphism Genetic biology Biochemistry (medical) Infant Newborn Vitamin B 12 Deficiency medicine.disease Cystathionine beta synthase Endocrinology chemistry Methylenetetrahydrofolate reductase biology.protein Female |
| Zdroj: | Clinical Chemistry. 50:1769-1784 |
| ISSN: | 1530-8561 0009-9147 |
| DOI: | 10.1373/clinchem.2004.036194 |
| Popis: | Background: Newborn screening for total homocysteine (tHcy) in blood may identify babies with vitamin B12 (B12) deficiency or homocystinuria, but data on the causes of increased tHcy in screening samples are sparse.Methods: Serum concentrations of tHcy, cystathionine, methionine, folate, and B12 and the methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism were determined in 4992 capillary blood samples collected as part of the routine screening program in newborn children. Methylmalonic acid (MMA), gender (SRY genotyping), and the frequency of six cystathionine β-synthase (CBS) mutations were determined in 20–27% of the samples, including all samples with tHcy >15 μmol/L (n = 127), B12 40 μmol/L (n = 154).Results: The median (5th–95th percentile) tHcy concentration was 6.8 (4.2–12.8) μmol/L. B12 status, as determined by serum concentrations of B12, tHcy, and MMA, was moderately better in boys than in girls. tHcy concentrations between 10 and 20 μmol/L were often associated with low B12, whereas tHcy >20 μmol/L (n = 43) was nearly always explained by increased methionine. tHcy did not differ according to folate concentrations or MTHFR 677C>T genotypes. None of the babies had definite CBS deficiencies, but heterozygosity led to low cystathionine, increased methionine, but normal tHcy concentrations.Conclusion: Increased tHcy is a common but not specific finding in newborns. The metabolite and vitamin profiles will point to the cause of hyperhomocysteinemia. Screening for tHcy and related factors should be further evaluated in regions with high prevalence of homocystinuria and in babies at high risk of B12 deficiency. |
| Databáze: | OpenAIRE |
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