Araştırma Makalesi
Türk Gebelerdeki Her Trimestere Özel Vitamin B12, Folat ve Homosistein Durumu
Öz
Objective: Vitamin B12 (cobalamin) and folate are
essential micronutrient for cellular growth and differentiation. In current
sequential study, our aim is to determine the mean B12 and folate levels and
prevalence of B12 and folate deficiency at each trimester in Turkish healthy
pregnant women who did not use any supplementation.
Method: A prospective cross-sectional study was
conducted between January-2016 and May-2017. Singleton pregnancies in the first
trimester, not using any vitamin supplementation were included. Blood samples
were collected at 10-14, 20-24 and at last 30-34 gestational weeks and vitamin
B12, folate and homocystein levels were calculated.
Results: In first trimester, we found out that
2.44%, in second trimester 2.41% and in third trimester 2.27% of patients had
vitamin B12 deficiency (B12<126.5 pg/mL). There was statistically
significant decrease in folate and homocystein levels in the second trimester
compare to first trimester (p<0.001).
Conclusion: The homocysteine level was found similar
in the third compared to first trimester with a gradual increase from the
second trimester value, this could be explained with the decrease in the B12
level in the third trimester. By the way, deficiency rates for B12 and folate
were rare in Turkey after new health policy compared to other countries even
without supplementation.
Anahtar Kelimeler
Kaynakça
- Saravanan P YC. Role of maternal vitamin B12 on the metabolic health of the offspring: a contributor to the diabetes epidemic? Br J Diabetes Vasc Dis. 2010;10:109-14.2.
- Smith AD KY-I, Refsum H. Is folic acid good for everyone? Am J Clin Nutr. 2008;87:517-33.3.
- Stabler SP, Allen RH. Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr. 2004;24:299-326. PubMed PMID: 15189123. Epub 2004/06/11. eng.4.
- Clarke R, Smith AD, Jobst KA, Refsum H, Sutton L, Ueland PM. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol. 1998 Nov;55(11):1449-55. PubMed PMID: 9823829. Epub 1998/11/21. eng.5.
- Refsum H, Smith AD. Low vitamin B-12 status in confirmed Alzheimer's disease as revealed by serum holotranscobalamin. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):959-61. PubMed PMID: 12810791. Pubmed Central PMCID: 1738528. Epub 2003/06/18. eng.6.
- George L, Mills JL, Johansson AL, Nordmark A, Olander B, Granath F, et al. Plasma folate levels and risk of spontaneous abortion. JAMA. 2002 Oct 16;288(15):1867-73. PubMed PMID: 12377085. Epub 2002/10/17. eng.7. Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic Acid and vitamin b(12) in patients with preeclampsia. Indian J Clin Biochem. 2011 Jul;26(3):257-60. PubMed PMID: 22754189. Pubmed Central PMCID: 3162959. Epub 2012/07/04. eng.8.
- Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic Acid and vitamin b(12) in patients with preeclampsia. Indian J Clin Biochem. 2011 Jul;26(3):257-60. PubMed PMID: 22754189. Pubmed Central PMCID: 3162959. Epub 2012/07/04. eng.
- Sanchez SE, Zhang C, Rene Malinow M, Ware-Jauregui S, Larrabure G, Williams MA. Plasma folate, vitamin B(12), and homocyst(e)ine concentrations in preeclamptic and normotensive Peruvian women. Am J Epidemiol. 2001 Mar 1;153(5):474-80. PubMed PMID: 11226979. Epub 2001/02/28. eng.
- Ronnenberg AG, Goldman MB, Chen D, Aitken IW, Willett WC, Selhub J, et al. Preconception homocysteine and B vitamin status and birth outcomes in Chinese women. Am J Clin Nutr. 2002 Dec;76(6):1385-91. PubMed PMID: 12450907. Epub 2002/11/27. eng.
- Krishnaveni GV, Hill JC, Veena SR, Bhat DS, Wills AK, Karat CL, et al. Low plasma vitamin B12 in pregnancy is associated with gestational 'diabesity' and later diabetes. Diabetologia. 2009 Nov;52(11):2350-8. PubMed PMID: 19707742. Pubmed Central PMCID: 3541499. Epub 2009/08/27. eng.
- Stewart CP, Christian P, Schulze KJ, Arguello M, LeClerq SC, Khatry SK, et al. Low maternal vitamin B-12 status is associated with offspring insulin resistance regardless of antenatal micronutrient supplementation in rural Nepal. J Nutr. 2011 Oct;141(10):1912-7. PubMed PMID: 21865563. Epub 2011/08/26. eng.
- Koukoura O, Sifakis S, Spandidos DA. DNA methylation in the human placenta and fetal growth (review). Mol Med Rep. 2012 Apr;5(4):883-9. PubMed PMID: 22294146. Pubmed Central PMCID: 3493070. Epub 2012/02/02. eng.
- Gaudet L, Ferraro ZM, Wen SW, Walker M. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. Biomed Res Int. 2014;2014:640291. PubMed PMID: 25544943. Pubmed Central PMCID: 4273542. Epub 2014/12/30. eng.
- He XJ, Qin FY, Hu CL, Zhu M, Tian CQ, Li L. Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis? Arch Gynecol Obstet. 2015 Apr;291(4):729-35. PubMed PMID: 25388922. Epub 2014/11/13. eng.
- Stouten K, Riedl JA, Droogendijk J, Castel R, van Rosmalen J, van Houten RJ, et al. Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice. BMC Fam Pract. 2016 Aug 19;17(1):113. PubMed PMID: 27542607. Pubmed Central PMCID: 4992202. Epub 2016/08/21. eng.
- Sukumar N, Rafnsson SB, Kandala NB, Bhopal R, Yajnik CS, Saravanan P. Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis. Am J Clin Nutr. 2016 May;103(5):1232-51. PubMed PMID: 27076577. Epub 2016/04/15. eng.
- [Nutrition during pregnancy]. Akush Ginekol (Sofiia). 2015;54 Suppl 2:33-7. PubMed PMID: 26817252. Epub 2016/01/29. bul.
- Garcia-Casal MN, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005 Sep;59(9):1064-70. PubMed PMID: 16015269. Epub 2005/07/15. eng.
- Park H, Kim YJ, Ha EH, Kim KN, Chang N. The risk of folate and vitamin B(12) deficiencies associated with hyperhomocysteinemia among pregnant women. Am J Perinatol. 2004 Nov;21(8):469-75. PubMed PMID: 15580543. Epub 2004/12/08. eng.
- Social MdP. Encuesta Nacional de Salud Colombia 2010. Bogota, Colombia. 2010.
- Salud Md. Encuesta Nacional de Nutricio´n y Salud Argentina 2007. Buenos Aires, Argentina: Ministerio de Salud. 2007.
- Sukumar N, Venkataraman H, Wilson S, Goljan I, Selvamoni S, Patel V, et al. Vitamin B12 Status among Pregnant Women in the UK and Its Association with Obesity and Gestational Diabetes. Nutrients. 2016 Dec 1;8(12). PubMed PMID: 27916927. Pubmed Central PMCID: 5188423. Epub 2016/12/06. eng.
- Halicioglu O, Sutcuoglu S, Koc F, Ozturk C, Albudak E, Colak A, et al. Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric measurements in term newborns. J Matern Fetal Neonatal Med. 2012 Sep;25(9):1618-21. PubMed PMID: 22185230. Epub 2011/12/22. eng.
- Balci YI, Ergin A, Karabulut A, Polat A, Dogan M, Kucuktasci K. Serum vitamin B12 and folate concentrations and the effect of the Mediterranean diet on vulnerable populations. Pediatr Hematol Oncol. 2014 Feb;31(1):62-7. PubMed PMID: 24088029. Epub 2013/10/04. eng.
- Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995 Oct 4;274(13):1049-57. PubMed PMID: 7563456. Epub 1995/10/04. eng.
Öz
Kaynakça
- Saravanan P YC. Role of maternal vitamin B12 on the metabolic health of the offspring: a contributor to the diabetes epidemic? Br J Diabetes Vasc Dis. 2010;10:109-14.2.
- Smith AD KY-I, Refsum H. Is folic acid good for everyone? Am J Clin Nutr. 2008;87:517-33.3.
- Stabler SP, Allen RH. Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr. 2004;24:299-326. PubMed PMID: 15189123. Epub 2004/06/11. eng.4.
- Clarke R, Smith AD, Jobst KA, Refsum H, Sutton L, Ueland PM. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol. 1998 Nov;55(11):1449-55. PubMed PMID: 9823829. Epub 1998/11/21. eng.5.
- Refsum H, Smith AD. Low vitamin B-12 status in confirmed Alzheimer's disease as revealed by serum holotranscobalamin. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):959-61. PubMed PMID: 12810791. Pubmed Central PMCID: 1738528. Epub 2003/06/18. eng.6.
- George L, Mills JL, Johansson AL, Nordmark A, Olander B, Granath F, et al. Plasma folate levels and risk of spontaneous abortion. JAMA. 2002 Oct 16;288(15):1867-73. PubMed PMID: 12377085. Epub 2002/10/17. eng.7. Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic Acid and vitamin b(12) in patients with preeclampsia. Indian J Clin Biochem. 2011 Jul;26(3):257-60. PubMed PMID: 22754189. Pubmed Central PMCID: 3162959. Epub 2012/07/04. eng.8.
- Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic Acid and vitamin b(12) in patients with preeclampsia. Indian J Clin Biochem. 2011 Jul;26(3):257-60. PubMed PMID: 22754189. Pubmed Central PMCID: 3162959. Epub 2012/07/04. eng.
- Sanchez SE, Zhang C, Rene Malinow M, Ware-Jauregui S, Larrabure G, Williams MA. Plasma folate, vitamin B(12), and homocyst(e)ine concentrations in preeclamptic and normotensive Peruvian women. Am J Epidemiol. 2001 Mar 1;153(5):474-80. PubMed PMID: 11226979. Epub 2001/02/28. eng.
- Ronnenberg AG, Goldman MB, Chen D, Aitken IW, Willett WC, Selhub J, et al. Preconception homocysteine and B vitamin status and birth outcomes in Chinese women. Am J Clin Nutr. 2002 Dec;76(6):1385-91. PubMed PMID: 12450907. Epub 2002/11/27. eng.
- Krishnaveni GV, Hill JC, Veena SR, Bhat DS, Wills AK, Karat CL, et al. Low plasma vitamin B12 in pregnancy is associated with gestational 'diabesity' and later diabetes. Diabetologia. 2009 Nov;52(11):2350-8. PubMed PMID: 19707742. Pubmed Central PMCID: 3541499. Epub 2009/08/27. eng.
- Stewart CP, Christian P, Schulze KJ, Arguello M, LeClerq SC, Khatry SK, et al. Low maternal vitamin B-12 status is associated with offspring insulin resistance regardless of antenatal micronutrient supplementation in rural Nepal. J Nutr. 2011 Oct;141(10):1912-7. PubMed PMID: 21865563. Epub 2011/08/26. eng.
- Koukoura O, Sifakis S, Spandidos DA. DNA methylation in the human placenta and fetal growth (review). Mol Med Rep. 2012 Apr;5(4):883-9. PubMed PMID: 22294146. Pubmed Central PMCID: 3493070. Epub 2012/02/02. eng.
- Gaudet L, Ferraro ZM, Wen SW, Walker M. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. Biomed Res Int. 2014;2014:640291. PubMed PMID: 25544943. Pubmed Central PMCID: 4273542. Epub 2014/12/30. eng.
- He XJ, Qin FY, Hu CL, Zhu M, Tian CQ, Li L. Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis? Arch Gynecol Obstet. 2015 Apr;291(4):729-35. PubMed PMID: 25388922. Epub 2014/11/13. eng.
- Stouten K, Riedl JA, Droogendijk J, Castel R, van Rosmalen J, van Houten RJ, et al. Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice. BMC Fam Pract. 2016 Aug 19;17(1):113. PubMed PMID: 27542607. Pubmed Central PMCID: 4992202. Epub 2016/08/21. eng.
- Sukumar N, Rafnsson SB, Kandala NB, Bhopal R, Yajnik CS, Saravanan P. Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis. Am J Clin Nutr. 2016 May;103(5):1232-51. PubMed PMID: 27076577. Epub 2016/04/15. eng.
- [Nutrition during pregnancy]. Akush Ginekol (Sofiia). 2015;54 Suppl 2:33-7. PubMed PMID: 26817252. Epub 2016/01/29. bul.
- Garcia-Casal MN, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005 Sep;59(9):1064-70. PubMed PMID: 16015269. Epub 2005/07/15. eng.
- Park H, Kim YJ, Ha EH, Kim KN, Chang N. The risk of folate and vitamin B(12) deficiencies associated with hyperhomocysteinemia among pregnant women. Am J Perinatol. 2004 Nov;21(8):469-75. PubMed PMID: 15580543. Epub 2004/12/08. eng.
- Social MdP. Encuesta Nacional de Salud Colombia 2010. Bogota, Colombia. 2010.
- Salud Md. Encuesta Nacional de Nutricio´n y Salud Argentina 2007. Buenos Aires, Argentina: Ministerio de Salud. 2007.
- Sukumar N, Venkataraman H, Wilson S, Goljan I, Selvamoni S, Patel V, et al. Vitamin B12 Status among Pregnant Women in the UK and Its Association with Obesity and Gestational Diabetes. Nutrients. 2016 Dec 1;8(12). PubMed PMID: 27916927. Pubmed Central PMCID: 5188423. Epub 2016/12/06. eng.
- Halicioglu O, Sutcuoglu S, Koc F, Ozturk C, Albudak E, Colak A, et al. Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric measurements in term newborns. J Matern Fetal Neonatal Med. 2012 Sep;25(9):1618-21. PubMed PMID: 22185230. Epub 2011/12/22. eng.
- Balci YI, Ergin A, Karabulut A, Polat A, Dogan M, Kucuktasci K. Serum vitamin B12 and folate concentrations and the effect of the Mediterranean diet on vulnerable populations. Pediatr Hematol Oncol. 2014 Feb;31(1):62-7. PubMed PMID: 24088029. Epub 2013/10/04. eng.
- Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995 Oct 4;274(13):1049-57. PubMed PMID: 7563456. Epub 1995/10/04. eng.
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