·   What is folate deficiency?


    Folate deficiency is a kind of clinical syndrome characterized by megaloblastic anemia.

    ·   Will folate deficiency be harmful?


    Absolutely, the answer is Yes!

    ·   What's the harm of folate deficiency?

    Leucopenia

    Folate deficiency can cause a decrease in white blood cells, which in turn reduces body resistance.

    Megaloblastic Anemia

    Either B12 deficiency or Folate deficiency will lead to megaloblastic anemia.

    Interferes with DNA synthesis and repair

    As we know, folate plays an important role in DNA synthesis and repair. Folate deficiency will interfere with DNA synthesis and further increase the risky of canceration.

    Affective cognitive impairment

    Some research shows folate can prevent Alzheimer's disease and depression, etc.

    HHcy

    Genetic and environmental nutrition are the two factors cause elevated Hcy. Environmental nutritional factors are the deficiency of  metabolic cofactors such as folate, vitamin B6, and B12. These factors are essential in the metabolic reaction of homocysteine, which all can lead to hyperhomocysteinemia.
    Research shows: Hcy per increase 5umol/L, the risky of cerebral apoplexy increase 59%, ischemic heart disease increase 32%; Hcy per decrease 5umol/L, the risky of cerebral apoplexy decrease 24%, ischemic heart disease decrease 16%.[1]

    Headache, Migraine

    Abnormal Pregnancy

    Pregnancy is a time when the folate requirement is greatly increased to sustain the demand for rapid cell replication and growth of fetal, placental, and maternal tissue. The folate deficiency will lead to abnormal pregnancy, such as neural tube defects, miscarriage, Down syndrome, cleft lip and palate, etc.

    ·   What will cause the folate deficiency?


    Generally speaking, there are four main reasons will lead to the folate deficiency.

    Dietary insufficiency

    Folate deficiency is most often caused by a dietary insufficiency;Meanwhile, folate deficiency can also occur in a number of other situations. For example, chronic and heavy alcohol consumption is associated with diminished absorption of folate (in addition to low dietary intake), which can lead to folate deficiency [2]

    MTHFR677 TT genotype

    The MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. This enzyme plays a role in processing amino acids, the building blocks of proteins. Methylenetetrahydrofolate reductase is important for a chemical reaction involving forms of the vitamin folate. Specifically, this enzyme converts 5,10-methylenetetrahydrofolate to a molecule called 5-methyltetrahydrofolate.

    However, various studies show that the utilization capacity of glutamate is different by race and region, especially MTHFR677 TT genotype, which called folate metabolism obstacle, who can absorb few pteroylglutamic acid (folic acid). Global variation in MTHFR 677 Genotypes is in Figure1[3];Prevalence of homozygous TT Genotype (two 677C＞ T alleles) is in Figure 2[4].

    Figure 1: Global variation in MTHFR 677 Genotypes
    Figure 2: Prevalence of homozygous TT Genotype (two 677C＞ T alleles)

    Disease patients

    Some disease patients, like Hypertension, diabetes mellitus or hyperlipidemia will affect the metabolism of folate.

    The stages with special physiological

    The people like gravid and the aged who will have much higher demand for folate. Some women have a higher risk of having a baby with a neural tube defect. For these women dietary folate alone is not sufficient. Hence folate deficiency will always be caused in above such special physiological stages.

    Reference

    [1].  https://baike.baidu.com/item/HCY/7616802?fr=aladdin
    [2].  Halsted CH, Villanueva JA, Devlin AM, Chandler CJ. Metabolic interactions of alcohol and folate. J Nutr. 2002;132(8 Suppl):2367S-2372S.  (PubMed)
    [3].  BottoandYang2000;Gueant-Rodriguezetal.2006;McNultyetal.2002
    [4].  WilckenBetal.JMedGenet2003;40:619-625

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