Annelerdeki vitamin B12 ve folat düzeylerinin, yenidoğanlardaki vitamin B12 ve folat düzeyleri, antropometrik ölçümler ve metabolik belirteçlerle ilişkisi

Yıl 2020, Cilt: 4 Sayı: 1, 43 - 47, 02.01.2020

Emel Ünsür , Burçin Kınaş , Fatma Kutlusoy Ülkü Aksoy Kıvanç Şahin Tolga Ünsür Huseyin Aksoy Nilgün Tekkeşin

https://doi.org/10.28982/josam.669066

Cited By: 1

Öz

Amaç: Gebelikteki besin dengesizlikleri yenidoğanın gelecek yaşamında obeziteye neden olan metabolik problemlere yol açabilir. Çalışmamızda, gebeliğin sonunda annelerdeki folik asit, B12 vitamini düzeylerini belirlemek, yenidoğanın antropometrik ölçümleri, serum lipit profili, insülin direnci gibi metabolik göstergeleri arasındaki ilişkiyi araştırmak amaçlandı.

Yöntemler: Toplam 102 anne ve bebek prospektif kohort çalışmaya dahil edildi. Demografik, obstetrik özellikler, serum B12 vitamini, folat, glikoz, yüksek yoğunluklu lipoprotein (HDL), düşük yoğunluklu lipoprotein (LDL), trigliseritler, kolesterol, insülin, homosistein ve homeostatik model değerlendirmesi (HOMA-IR ) not edildi. B12 vitamini için, ≥191 ng/L seviyeleri normal olarak kabul edildi. Maternal vitamin B12 ve folat seviyeleri ile yenidoğanların metabolik göstergeleri, antropometrik ölçümleri arasındaki ilişki araştırıldı.

Bulgular: Serum vitamin B12 düzeyi düşük olan annelerden doğan bebeklerde vücut kitle indeksi (P=0,004), serum insülin düzeyleri (P=0,012), HOMA-IR (P=0,001) ve homosistein (P=0,001) düzeyleri artmış olarak saptandı. Maternal B12 vitamini düzeylerinin, yenidoğan B12 vitamini düzeyleri ile kuvvetli korelasyon (r=0,719, P<0,001); serum insülin (r=-0,221, P=0,025), HOMA-IR (r=-0,249, P=0,011), homosistein (r=-0,394, P<0,001) seviyeleri arasında ters zayıf bir korelasyon saptandı. Maternal folat düzeyleri neonatal folat düzeyleri ile kuvvetli pozitif (r=0,735, P<0,001); yenidoğan B12 vitamini düzeyleri ile zayıf pozitif (r=0,327, P=0,001); neonatal homosistein seviyeleri ile orta derecede ters korelasyon gösterdi (r=-0,505, P<0,001).

Sonuç: Gebelik döneminde annelerde vitamin değerlerinin optimal seviyelerde tutulması, bebeklerin gelecek yaşamlarında obeziteye yol açabilecek metabolik dengesizliklerini azaltmak açısından önemlidir.

Anahtar Kelimeler

Gebelik, Vitamin B12, Folat, Yenidoğan, İnsülin direnci, Metabolik belirteçler

Destekleyen Kurum

-

Teşekkür

DR FATMA KUTLUSOY,DR KIVANÇ ŞAHİN,DR ÜLKÜ AKSOY

The relationship between maternal and neonatal vitamin B12 and folate levels, anthropometric measurements, and metabolic indicators

Öz

Aim: The nutritional imbalances in pregnancy may lead to metabolic problems in newborns, which may cause obesity during childhood and later in life. It is aimed to determine the maternal levels of folate, vitamin B12 at birth and to investigate the correlation between neonatal anthropometric measurements, and metabolic indicators such as serum lipid profile and insulin resistance.

Methods: A total of 102 mothers and newborns were enrolled in this prospective cohort study. The demographic, obstetric features, serum levels of vitamin B12, folate, glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, cholesterol, insulin, homocysteine, and homeostatic model assessment (HOMA-IR) were noted. For vitamin B12, levels, ≥191 ng/L were accepted as normal. The correlation between maternal levels of vitamin B12, folate, anthropometric measurements, and metabolic indicators of newborns were evaluated. 

Results: Body mass index (P=0.004), serum insulin levels (P=0.012), HOMA-IR (P=0.001), and homocysteine (P=0.001) were increased in neonates born from mothers with lower serum levels of vitamin B12. The maternal vitamin B12 levels were positively, strongly correlated with neonatal vitamin B12 levels (r=0.719, P<0.001). There was an inverse, weak correlation between maternal vitamin B12 levels and neonatal serum insulin levels (r=-0.221, P=0.025), HOMA-IR (r=-0.249, P=0.011), and homocysteine (r=-0.394, P<0.001). Maternal folate levels were strongly, positively correlated with neonatal folate (r=0.735, P<0.001); weakly, positively correlated with neonatal vitamin B12 (r=0.327, P=0.001); moderately, inversely correlated with neonatal homocysteine (r=-0.505, P<0.001).

Conclusion: Optimizing intake of these vitamins levels during pregnancy is important to reduce the neonatal metabolic abnormalities, which may lead to obesity later in life.

Anahtar Kelimeler

Pregnancy, Vitamin B12, Folate, Neonates, Insulin resistance, Metabolic indicators

Kaynakça

• 1. Raimi TH, Dada SA, Solanke A. Positive association of neck circumference and cardiometabolic risk factors in Ekiti, Nigeria. J Surg Med. 2018;2(3):218-22.
• 2. Adaikalakoteswari A, Vatish M, Lawson A, Wood C, Sivakumar K, McTernan PG, et al. Low maternal vitamin B12 status is associated with lower cord blood HDL cholesterol in white Caucasians living in the UK. Nutrients. 2015;7:2401-14.
• 3. Roseboom TJ, Painter RC, van Abeelen AF, Veenendaal MV, de Rooij SR. Hungry in the womb: What are the consequences? Lessons from the dutch famine. Maturitas. 2011;70:141–5.
• 4. Saravanan P, Yajnik CS. Role of maternal vitamin B12 on the metabolic health of the offspring: A contributor to the diabetes epidemic? Br J Diabetes Vasc Disease. 2010;10:109–14.
• 5. Yajnik CS, Deshpande SS, Jackson AA, Refsum H, Rao S, Fisher DJ, et al. Vitamin B12 and folate concentrations during pregnancy and insulin resistance in the offspring: The pune maternal nutrition study. Diabetologia. 2008;51:29–38.
• 6. 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;141:1912–7.
• 7. Krishnaveni GV, Veena SR, Karat SC, Yajnik CS, Fall CH. Association between maternal folate concentrations during pregnancy and insulin resistance in Indian children. Diabetologia. 2014;57:110–21.
• 8. Sinclair KD, Allegrucci C, Singh R, Gardner DS, Sebastian S, Bispham J, et al. DNA methylation, insulin resistance, and blood pressure in offspring determined by maternal periconceptional B vitamin and methionine status. Proc Natl Acad Sci USA. 2007;104:19351–6.
• 9. Garcia MM, Gueant-Rodriguez RM, Pooya S, Brachet P, Alberto JM, Jeannesson E, et al. Methyl donor deficiency induces cardiomyopathy through altered methylation/acetylation of PGC-1alpha by PRMT1 and SIRT1. J Pathol. 2011;225:324–35.
• 10. Kumar KA, Lalitha A, Pavithra D, Padmavathi IJ, Ganeshan M, Rao KR, et al. Maternal dietary folate and/or vitamin B12 restrictions alter body composition (adiposity) and lipid metabolism in Wistar rat offspring. J Nutr Biochem. 2013;24:25–31.
• 11. Ba Y, Yu H, Liu F, Geng X, Zhu C, Zhu Q, et al. Relationship of folate, vitamin B12 and methylation of insulin-like growth factor-II in maternal and cord blood. Eur J Clin Nutr. 2011;65:480–5.
• 12. Adaikalakoteswari A, Finer S, Voyias PD, McCarthy CM, Vatish M, Moore J, et al. Vitamin B12 insufficiency induces cholesterol biosynthesis by limiting s-adenosylmethionine and modulating the methylation of SREBF1 and LDLR genes. Clin Epigenetics. 2015;7:14.
• 13. 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;25:1618-1621
• 14. 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;103:1232-51. Erratum in: Am J Clin Nutr. 2017;105:241.
• 15. Johnson R, McNutt P, MacMahon S, Robson R. Use of the Friedewald formula to estimate LDL-cholesterol in patients with chronic renal failure on dialysis. Clin Chem. 1997;43:2183-4.
• 16. Hermans MP, Levy JC, Morris RJ, Turner RC. Comparison of tests of beta-cell function across a range of glucose tolerance from normal to diabetes. Diabetes. 1999;48:1779-86.
• 17. Hermans MP, Levy JC, Morris RJ, Turner RC. Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes. Diabetologia. 1999;42:678-87.
• 18. Wallace JM, Bonham MP, Strain J, Duffy EM, Robson PJ, Ward M, et al. Homocysteine concentration, related B vitamins, and betaine in pregnant women recruited to the Seychelles child development study. Am J Clin Nutr. 2008;87:391–7.
• 19. Kumar KA, Lalitha A, Pavithra D, Padmavathi IJ, Ganeshan M, Rao KR. Maternal dietary folate and/or vitamin B12 restrictions alter body composition (adiposity) and lipid metabolism in Wistar rat offspring. J Nutr Biochem. 2013;24:25–31.
• 20. Molloy AM, Mills JL, Cox C, Daly SF, Conley M, Brody LC, et al. Choline and homocysteine interrelations in umbilical cord and maternal plasma at delivery. Am J Clin Nutr. 2005;82:836–42.
• 21. Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: Evidence on causality from a meta-analysis. BMJ. 2002;325:1202.
• 22. Schaefer-Graf UM, Meitzner K, Ortega-Senovilla H, Graf K, Vetter K, Abou-Dakn M, et al. Differences in the implications of maternal lipids on fetal metabolism and growth between gestational diabetes mellitus and control pregnancies. Diabet Med. 2011;28:1053–9.
• 23. 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;103:1232-51.
• 24. Ly A, Ishiguro L, Kim D, Im D, Kim SE, Sohn KJ, et al. Maternal folic acid supplementation modulates DNA methylation and gene expression in the rat offspring in a gestation period-dependent and organ-specific manner. J Nutr Biochem. 2016;33:103-10.
• 25. Fekete K, Berti C, Cetin I, Hermoso M, Koletzko BV, Decsi T. Perinatal folate supply: relevance in health outcome parameters. Matern Child Nutr. 2010;2:23-38.
• 26. MacFarlane AJ, Greene-Finestone LS, Shi Y. Vitamin B-12 and homocysteine status in a folate-replete population: results from the Canadian Health Measures Survey. Am J Clin Nutr. 2011;94:1079-87 .