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Homocysteine and methylmalonic acid levels in pregnant Nepali women. Should cobalamin supplementation be considered?
Eur J Clin Nutr 2001; 55(10):856-64EJ

Abstract

OBJECTIVE

The aim of this study was to investigate homocysteine and methylmalonic acid levels as markers of functional cobalamin and folate status in pregnant Nepali women.

DESIGN

Cross-sectional study.

SETTING

Patan Hospital, Kathmandu, Nepal.

SUBJECTS

A sub-sample (n=382) of all pregnant women (n=2856) coming for their first antenatal visit in a 12 month period, 1994-1995. The selection of the sub-sample was based on maternal haematocrit values, categorised into three groups: severely, moderately and non-anaemic women. As serum levels of total homocysteine (s-tHcy) and methylmalonic acid (s-MMA) were similar in the three groups, pooled data are presented. Women who had already received micronutrient supplementation (n=54) were excluded. The remaining women (n=328) were included in the statistical analysis.

RESULTS

Overall mean values (+/-s.d.) of s-tHcy and s-MMA were 9.5 (+/-4.2) micromol/l and 0.39 (+/-0.32) micromol/l, respectively. Elevated s-tHcy (>7.5 micromol/l) was found in 68% of the women, while 61% had elevated s-MMA (>0.26 micromol/l). Low s-cobalamin values (<150 pmol/l) were observed in 49% of the women, while only 7% had low s-folate values (< or =4.5 nmol/l). s-tHcy was significantly correlated with s-MMA (r=0.28, P<0.001), s-cobalamin (r=-0.30, P<0.001) and s-folate (r=-0.24, P<0.001). s-MMA was significantly associated with s-cobalamin (r=-0.40, P<0.001), but not with s-folate.

CONCLUSIONS

Functional cobalamin deficiency was very common in the study population, while functional folate deficiency was rather uncommon. We suggest considering cobalamin supplementation to pregnant Nepali women.

SPONSORSHIP

The Norwegian Research Council and the Norwegian Universities Committee for Development, Research and Education.

Authors+Show Affiliations

Centre for International Health, University of Bergen, Bergen, Norway. gunnar.bondevik@cih.uib.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11593347

Citation

Bondevik, G T., et al. "Homocysteine and Methylmalonic Acid Levels in Pregnant Nepali Women. Should Cobalamin Supplementation Be Considered?" European Journal of Clinical Nutrition, vol. 55, no. 10, 2001, pp. 856-64.
Bondevik GT, Schneede J, Refsum H, et al. Homocysteine and methylmalonic acid levels in pregnant Nepali women. Should cobalamin supplementation be considered? Eur J Clin Nutr. 2001;55(10):856-64.
Bondevik, G. T., Schneede, J., Refsum, H., Lie, R. T., Ulstein, M., & Kvåle, G. (2001). Homocysteine and methylmalonic acid levels in pregnant Nepali women. Should cobalamin supplementation be considered? European Journal of Clinical Nutrition, 55(10), pp. 856-64.
Bondevik GT, et al. Homocysteine and Methylmalonic Acid Levels in Pregnant Nepali Women. Should Cobalamin Supplementation Be Considered. Eur J Clin Nutr. 2001;55(10):856-64. PubMed PMID: 11593347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine and methylmalonic acid levels in pregnant Nepali women. Should cobalamin supplementation be considered? AU - Bondevik,G T, AU - Schneede,J, AU - Refsum,H, AU - Lie,R T, AU - Ulstein,M, AU - Kvåle,G, PY - 2000/09/07/received PY - 2001/03/08/revised PY - 2001/03/19/accepted PY - 2001/10/11/pubmed PY - 2001/11/3/medline PY - 2001/10/11/entrez SP - 856 EP - 64 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 55 IS - 10 N2 - OBJECTIVE: The aim of this study was to investigate homocysteine and methylmalonic acid levels as markers of functional cobalamin and folate status in pregnant Nepali women. DESIGN: Cross-sectional study. SETTING: Patan Hospital, Kathmandu, Nepal. SUBJECTS: A sub-sample (n=382) of all pregnant women (n=2856) coming for their first antenatal visit in a 12 month period, 1994-1995. The selection of the sub-sample was based on maternal haematocrit values, categorised into three groups: severely, moderately and non-anaemic women. As serum levels of total homocysteine (s-tHcy) and methylmalonic acid (s-MMA) were similar in the three groups, pooled data are presented. Women who had already received micronutrient supplementation (n=54) were excluded. The remaining women (n=328) were included in the statistical analysis. RESULTS: Overall mean values (+/-s.d.) of s-tHcy and s-MMA were 9.5 (+/-4.2) micromol/l and 0.39 (+/-0.32) micromol/l, respectively. Elevated s-tHcy (>7.5 micromol/l) was found in 68% of the women, while 61% had elevated s-MMA (>0.26 micromol/l). Low s-cobalamin values (<150 pmol/l) were observed in 49% of the women, while only 7% had low s-folate values (< or =4.5 nmol/l). s-tHcy was significantly correlated with s-MMA (r=0.28, P<0.001), s-cobalamin (r=-0.30, P<0.001) and s-folate (r=-0.24, P<0.001). s-MMA was significantly associated with s-cobalamin (r=-0.40, P<0.001), but not with s-folate. CONCLUSIONS: Functional cobalamin deficiency was very common in the study population, while functional folate deficiency was rather uncommon. We suggest considering cobalamin supplementation to pregnant Nepali women. SPONSORSHIP: The Norwegian Research Council and the Norwegian Universities Committee for Development, Research and Education. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/11593347/Homocysteine_and_methylmalonic_acid_levels_in_pregnant_Nepali_women__Should_cobalamin_supplementation_be_considered L2 - http://dx.doi.org/10.1038/sj.ejcn.1601236 DB - PRIME DP - Unbound Medicine ER -