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Hemoglobin concentration is inversely associated with erythrocyte folate concentrations in Colombian school-age children, especially among children with low vitamin B12 status.
Eur J Clin Nutr. 2009 Jul; 63(7):842-9.EJ

Abstract

BACKGROUND

While the majority of cases of nutritional anemia in developing countries are caused by iron deficiency, other micronutrient deficiencies may also be involved. In Colombia, it was recently reported that 38% of school children were anemic; yet, the rate of iron deficiency was only 3.6%.

OBJECTIVE

To determine if micronutrients other than iron were responsible for low hemoglobin concentrations in Colombian school children.

METHODS

We examined hemoglobin concentrations in relation to plasma ferritin, vitamin A, vitamin B12, and erythrocyte folate levels in a representative sample of 2812 low- and middle-income children (5-12 years) from Bogotá, Colombia.

RESULTS

In multivariate analysis, hemoglobin concentration was positively associated with child's age, mother's age, household's socioeconomic stratum, and family income. Low ferritin was related to 3.6 g/l lower hemoglobin concentration (95% confidence interval=-6.0, -1.3). Unexpectedly, we found an inverse trend in hemoglobin concentration by quartiles of erythrocyte folate; the adjusted hemoglobin concentration difference between the highest and lowest folate quartiles was -6.0 g/l (95% confidence interval=-7.2, -4.9; P for trend <0.0001). This difference was greatest among children with vitamin B12 concentration <148 pmol/l (-11.5 g/l), followed by children with vitamin B12 concentration 148-221 pmol/l (-7.7 g/l), and smallest in children with vitamin B12 concentration >221 pmol/l (-5.7 g/l); P for interaction=0.04.

CONCLUSIONS

Hemoglobin concentration is inversely related to erythrocyte folate concentrations in a setting where folate fortification was adopted more than a decade ago. The impact of improving vitamin B12 status on this inverse relationship should be examined.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18957973

Citation

Arsenault, J E., et al. "Hemoglobin Concentration Is Inversely Associated With Erythrocyte Folate Concentrations in Colombian School-age Children, Especially Among Children With Low Vitamin B12 Status." European Journal of Clinical Nutrition, vol. 63, no. 7, 2009, pp. 842-9.
Arsenault JE, Mora-Plazas M, Forero Y, et al. Hemoglobin concentration is inversely associated with erythrocyte folate concentrations in Colombian school-age children, especially among children with low vitamin B12 status. Eur J Clin Nutr. 2009;63(7):842-9.
Arsenault, J. E., Mora-Plazas, M., Forero, Y., Lopez-Arana, S., Baylin, A., & Villamor, E. (2009). Hemoglobin concentration is inversely associated with erythrocyte folate concentrations in Colombian school-age children, especially among children with low vitamin B12 status. European Journal of Clinical Nutrition, 63(7), 842-9. https://doi.org/10.1038/ejcn.2008.50
Arsenault JE, et al. Hemoglobin Concentration Is Inversely Associated With Erythrocyte Folate Concentrations in Colombian School-age Children, Especially Among Children With Low Vitamin B12 Status. Eur J Clin Nutr. 2009;63(7):842-9. PubMed PMID: 18957973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemoglobin concentration is inversely associated with erythrocyte folate concentrations in Colombian school-age children, especially among children with low vitamin B12 status. AU - Arsenault,J E, AU - Mora-Plazas,M, AU - Forero,Y, AU - Lopez-Arana,S, AU - Baylin,A, AU - Villamor,E, Y1 - 2008/10/29/ PY - 2008/10/30/pubmed PY - 2009/8/7/medline PY - 2008/10/30/entrez SP - 842 EP - 9 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 63 IS - 7 N2 - BACKGROUND: While the majority of cases of nutritional anemia in developing countries are caused by iron deficiency, other micronutrient deficiencies may also be involved. In Colombia, it was recently reported that 38% of school children were anemic; yet, the rate of iron deficiency was only 3.6%. OBJECTIVE: To determine if micronutrients other than iron were responsible for low hemoglobin concentrations in Colombian school children. METHODS: We examined hemoglobin concentrations in relation to plasma ferritin, vitamin A, vitamin B12, and erythrocyte folate levels in a representative sample of 2812 low- and middle-income children (5-12 years) from Bogotá, Colombia. RESULTS: In multivariate analysis, hemoglobin concentration was positively associated with child's age, mother's age, household's socioeconomic stratum, and family income. Low ferritin was related to 3.6 g/l lower hemoglobin concentration (95% confidence interval=-6.0, -1.3). Unexpectedly, we found an inverse trend in hemoglobin concentration by quartiles of erythrocyte folate; the adjusted hemoglobin concentration difference between the highest and lowest folate quartiles was -6.0 g/l (95% confidence interval=-7.2, -4.9; P for trend <0.0001). This difference was greatest among children with vitamin B12 concentration <148 pmol/l (-11.5 g/l), followed by children with vitamin B12 concentration 148-221 pmol/l (-7.7 g/l), and smallest in children with vitamin B12 concentration >221 pmol/l (-5.7 g/l); P for interaction=0.04. CONCLUSIONS: Hemoglobin concentration is inversely related to erythrocyte folate concentrations in a setting where folate fortification was adopted more than a decade ago. The impact of improving vitamin B12 status on this inverse relationship should be examined. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/18957973/Hemoglobin_concentration_is_inversely_associated_with_erythrocyte_folate_concentrations_in_Colombian_school_age_children_especially_among_children_with_low_vitamin_B12_status_ L2 - http://dx.doi.org/10.1038/ejcn.2008.50 DB - PRIME DP - Unbound Medicine ER -