Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
OBJECTIVES: We aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.METHODS: A total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).RESULTS: Elevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.CONCLUSIONS: Non-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
Abstract
OBJECTIVES: We aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.METHODS: A total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).RESULTS: Elevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.CONCLUSIONS: Non-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
참고문헌 (50)
- "Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases" (2018)[URL]
- "Goal 3: ensure healthy lives and promote well-being for all at all ages"[URL]
- "Noncommunicable diseases" (2021)[URL]
- "Cardiovascular diseases (CVDs)" (2021)[URL]
- WHO CVD Risk Chart Working Group, "World Health Organization cardiovascular disease risk charts : revised models to estimate risk in 21 global regions", Lancet Glob Health, 7, pp.e1332~e1345 (2019)
- "Global health observatory data repository"[URL]
- Yoonjung Kim, "Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: Findings from the 1998–2018 Korea National Health and Nutrition Examination Survey", Epidemiology and Health, 43, pp.1~12 (2021), 한국역학회[DOI]
- Bailey LB, "Biomarkers of nutrition for development-folate review", J Nutr, 145, pp.1636S~1680S (2015)
- Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, "Other B Vitamins, and Choline. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline", pp.196~ (1998), National Academies Press
- Ministry of Health and Welfare, "Dietary reference intakes for Koreans 2020", Ministry of Health and Welfare, 21~ (2020)
- Giles WH, "Serum folate and risk for coronary heart disease : results from a cohort of US adults", Ann Epidemiol, 8, pp.490~496 (1998)
- Bazzano LA, "Effect of folic acid supplementation on risk of cardiovascular diseases : a meta-analysis of randomized controlled trials", JAMA, 296, pp.2720~2726 (2006)
- Miller ER 3rd, "Meta-analysis of folic acid supplementation trials on risk of cardiovascular disease and risk interaction with baseline homocysteine levels", Am J Cardiol, 106, pp.517~527 (2010)
- Peng Y, "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)", Int J Cardiol, 219, pp.136~142 (2016)
- Kim HN, "Serum folate and vitamin B12 levels are not associated with the incidence risk of atherosclerotic events over 12 years : the Korean Genome and Epidemiology Study", Nutr Res, 63, pp.34~41 (2019)
- Asbaghi O, "Beneficial effects of folic acid supplementation on lipid markers in adults: a GRADE-assessed systematic review and dose-response meta-analysis of data from 21,787 participants in 34 randomized controlled trials", Crit Rev Food Sci Nutr, pp.1~19 (2021)
- Li WX, "Joint associations of folate, homocysteine and MTHFR, MTR and MTRR gene polymorphisms with dyslipidemia in a Chinese hypertensive population : a cross-sectional study", Lipids Health Dis, 14, pp.101~ (2015)
- Semmler A, "Plasma folate levels are associated with the lipoprotein profile : a retrospective database analysis", Nutr J, 9, pp.31~ (2010)
- Kweon S, "Data resource profile : the Korea National Health and Nutrition Examination Survey(KNHANES)", Int J Epidemiol, 43, pp.69~77 (2014)
- Kim Y, "he Korea National Health and Nutrition Examination Survey (KNHANES): current status and challenges", Epidemiol Health, 36, pp.e2014002~ (2014)
- Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge", Clin Chem, 18, pp.499~502 (1972)
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)", JAMA, 285, pp.2486~2497 (2001)
- "The Asia-Pacific perspective: redefining obesity and its treatment" (2000)[URL]
- Houghton LA, "Association between dietary fiber intake and the folate status of a group of female adolescents", Am J Clin Nutr, 66, pp.1414~1421 (1997)
- Bingham SA, "Is the association with fiber from foods in colorectal cancer confounded by folate intake?", Cancer Epidemiol Biomarkers Prev, 14, pp.1552~1556 (2005)
- "Guidelines on food fortification with micronutrients" (2006)[URL]
- McDowell MA, "Blood folate levels : the latest NHANES results", NCHS Data Brief, pp.1~8 (2008)
- Liu S, "A comprehensive evaluation of food fortification with folic acid for the primary prevention of neural tube defects", BMC Pregnancy Childbirth, 4, pp.20~ (2004)
- Hertrampf E, "Folic acid fortification of wheat flour: Chile", Nutr Rev, 62(Suppl 1), pp.S44~S48 (2004)
- "National Diet and Nutrition Survey Rolling Programme (NDNS RP): supplementary report: blood folate results for the UK as a whole, Scotland, Northern Ireland (years 1 to 4 combined) and Wales (years 2 to 5 combined)" (2017)[URL]
- Planells E, "Vitamins B6 and B12 and folate status in an adult Mediterranean population", Eur J Clin Nutr, 57, pp.777~785 (2003)
- Hao L, "Geographical, seasonal and gender differences in folate status among Chinese adults", J Nutr, 133, pp.3630~3635 (2003)
- Chen KJ, "Trends in folate status in the Taiwanese population aged 19 years and older from the Nutrition and Health Survey in Taiwan 1993-1996 to 2005-2008", Asia Pac J Clin Nutr, 20, pp.275~282 (2011)
- Zhao R, "Membrane transporters and folate homeostasis : intestinal absorption and transport into systemic compartments and tissues", Expert Rev Mol Med, 11, pp.e4~ (2009)
- da Silva RP, "Novel insights on interactions between folate and lipid metabolism", Biofactors, 40, pp.277~283 (2014)
- Wierzbicki AS, "Homocysteine and cardiovascular disease : a review of the evidence", Diab Vasc Dis Res, 4, pp.143~150 (2007)
- Fox JT, "Folate-mediated one-carbon metabolism", Vitam Horm, 79, pp.1~44 (2008)
- Ducker GS, "One-carbon metabolism in health and disease", Cell Metab, 25, pp.27~42 (2017)
- Cole LK, "Phosphatidylcholine biosynthesis and lipoprotein metabolism", Biochim Biophys Acta, 1821, pp.754~761 (2012)
- Yao ZM, "The active synthesis of phosphatidylcholine is required for very low density lipoprotein secretion from rat hepatocytes", J Biol Chem, 263, pp.2998~3004 (1988)
- Williams KT, "Homocysteine metabolism and its relation to health and disease", Biofactors, 36, pp.19~24 (2010)
- Christensen KE, "High folic acid consumption leads to pseudo-MTHFR deficiency, altered lipid metabolism, and liver injury in mice", Am J Clin Nutr, 101, pp.646~658 (2015)
- Selhub J, "Excessive folic acid intake and relation to adverse health outcome", Biochimie, 126, pp.71~78 (2016)
- Kelly P, "Unmetabolized folic acid in serum : acute studies in subjects consuming fortified food and supplements", Am J Clin Nutr, 65, pp.1790~1795 (1997)
- Bailey SW, "The extremely slow and variable activity of dihydrofolate reductase in human liver and its implications for high folic acid intake", Proc Natl Acad Sci U S A, 106, pp.15424~15429 (2009)
- Pietrzik K, "Folic acid and L-5-methyltetrahydrofolate : comparison of clinical pharmacokinetics and pharmacodynamics", Clin Pharmacokinet, 49, pp.535~548 (2010)
- Kalmbach RD, "A 19-base pair deletion polymorphism in dihydrofolate reductase is associated with increased unmetabolized folic acid in plasma and decreased red blood cell folate", J Nutr, 138, pp.2323~2327 (2008)
- Mahabir S, "Measures of adiposity and body fat distribution in relation to serum folate levels in postmenopausal women in a feeding study", Eur J Clin Nutr, 62, pp.644~650 (2008)
- Tungtrongchitr R, "Serum homocysteine, B12 and folic acid concentration in Thai overweight and obese subjects", Int J Vitam Nutr Res, 73, pp.8~14 (2003)
- Mierzecki A, "Association between low-dose folic acid supplementation and blood lipids concentrations in male and female subjects with atherosclerosis risk factors", Med Sci Monit, 19, pp.733~739 (2013)
