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Original Articles
Folate, vitamin B12, and homocysteine status in the Korean population: data from the 2013-2015 Korea National Health and Nutrition Examination Survey
Sihan Song, Bo Mi Song, Hyun-Young Park
Epidemiol Health. 2024;46:e2024007.   Published online December 11, 2023
DOI: https://doi.org/10.4178/epih.e2024007
  • 4,353 View
  • 167 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to assess the serum folate, vitamin B12, and homocysteine status in Korean adolescents and adults using national data.
METHODS
Blood samples were collected from participants aged ≥10 years in the Korea National Health and Nutrition Examination Survey 2013-2015. The stored serum samples were used to measure folate, vitamin B12, and homocysteine concentrations. A total of 8,016 participants were included in this analysis. Unweighted descriptive statistics and adjusted geometric means of the B vitamins and homocysteine concentrations were estimated.
RESULTS
Females had higher serum folate and vitamin B12 concentrations and lower serum homocysteine concentrations than males. Folate deficiency (<6.8 nmol/L) and hyperhomocysteinemia (>15 μmol/L) were found in 8.6% and 11.8% of males, respectively. Approximately 3% of males had low or marginally low vitamin B12 status (≤221 pmol/L). Folate and vitamin B12 deficiencies and hyperhomocysteinemia were found in <2% of females. Suboptimal folate status was prevalent among adolescents and young adults, while suboptimal vitamin B12 status and hyperhomocysteinemia were relatively higher in older adults. Adjusted mean homocysteine concentrations were sharply decreased from the first to second decile of serum folate in males.
CONCLUSIONS
In the Korean population, the proportion of males who achieved desirable folate and homocysteine concentrations were lower than those of females. Although most Koreans have adequate vitamin B12, a suboptimal folate status is common, particularly among adolescents and young adults. These findings could establish a foundation for public health initiatives aimed at improving folate levels in the Korean population.
Summary
Korean summary
엽산과 비타민B12는 전 생애에 걸쳐 건강에 영향을 미치는 필수 비타민이다. 그러나 해당 비타민 상태에 대한 국내 자료는 부족한 실정이다. 본 연구는 국민건강영양조사 참여자로부터 수집된 혈청으로부터 엽산, 비타민B12, 그리고 이들의 기능성 지표인 호모시스테인 농도를 측정하였고 성별과 연령별 분포와 적합 상태를 평가하였다. 엽산 결핍과 고호모시스테인혈증은 남성에서 높은 유병률을 가졌다. 적정 엽산 상태를 충족하지 못하는 비율은 청소년과 젊은 성인에서 흔하게 관찰되었다. 대부분의 한국인은 충분한 비타민B12 수준을 가졌으나, 노인의 경우 정기적인 평가가 필요하다. 본 연구는 한국인이 최적의 엽산과 비타민B12 상태를 유지하기 위한 기반적 근거를 제공한다.
Key Message
Folate and vitamin B12 have significant health impacts throughout the life cycle. However, national-level data on B vitamins in Korea are limited. Serum folate, vitamin B12, and homocysteine concentrations were measured from samples stored during the national survey. In our study, the proportions of folate deficiency and hyperhomocysteinemia were higher in men than in women.Suboptimal folate status was common among adolescents and young adults. Most Koreans had adequate levels of vitamin B12; however, regular monitoring is warranted, especially in the older population. The current data provide a future direction for achieving optimal B vitamin status in the Korean population.
Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
Taiyue Jin, Eun Young Park, Byungmi Kim, Jin-Kyoung Oh
Epidemiol Health. 2022;44:e2022046.   Published online May 15, 2022
DOI: https://doi.org/10.4178/epih.e2022046
  • 8,794 View
  • 324 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.
METHODS
A total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
Elevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.
CONCLUSIONS
Non-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
Summary
Korean summary
본 연구는 국민건강영양조사 자료를 활용하여 한국 성인에서 혈청 엽산 농도와 고콜레스테롤혈증 및 저밀도지단백 (LDL) 콜레스테롤혈증 유병률 간의 비선형 연관성을 확인하였다. 이 결과는 적정 혈청 엽산 농도와 정확한 엽산 권장섭취량을 추정하는데 근거로 활용될수 있을 것이다.
Key Message
1. The prevalence of hypercholesterolemia and hyper-LDL cholesterolemia were non-linearly associated with serum concentrations of folate in the Korean population. 2. An inverse association with a significant linear trend between serum folate concentrations and prevalence of hypo-HDL cholesterolemia was observed. 3. In relation to folate intake and folic acid fortification and supplementation, more accurate recommendations should be provided.

Citations

Citations to this article as recorded by  
  • A Review of Major Secondary Data Resources Used for Research in Traditional Korean Medicine
    Chunhoo Cheon, Bo-Hyoung Jang, Seong-Gyu Ko
    Perspectives on Integrative Medicine.2023; 2(2): 77.     CrossRef
  • The Utilization of Serum Folate and Homocysteine Tests and the Prevalence of Folate Deficiency in Reproductive-Age Korean Women during the COVID-19 Pandemic
    Rihwa Choi, Wonseo Park, Gayoung Chun, Sang Gon Lee, Eun Hee Lee
    Nutrients.2023; 15(14): 3236.     CrossRef
No Association Between Functional Polymorphisms in COMT and MTHFR and Schizophrenia Risk in Korean Population
Ho Jin Kang, Byeong Moo Choe, Seong Hwan Kim, Seung-Rak Son, Kyoung-Mu Lee, Byoung Gwon Kim, Young-Seoub Hong
Epidemiol Health. 2010;32:e2010011.   Published online December 24, 2010
DOI: https://doi.org/10.4178/epih/e2010011
  • 18,278 View
  • 130 Download
  • 13 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Common genetic SNPs in two genes, encoding catechol-O-methyltransferase (COMT) and methylenetetrahydrofolate reductase (MTHFR), which are interconnected with COMT gene regulation, have been reported to contribute to schizophrenia risk. In this study, we evaluated the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk with a case-control study in a Korean population.</p></sec><sec><title>METHODS</title><p>We performed a case-control study by genotyping analysis using 360 cases and 348 controls in Korean subjects to determine the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk.</p></sec><sec><title>RESULTS</title><p>Four functional SNPs in COMT (Val158Met and rs165599) and MTHFR (C677T and A1298C) were genotyped by primer extension assay. None of the genotype distributions for the four SNPs was significantly different between cases and controls. Stratified analysis did not show any significant gender difference for any polymorphism. In addition, we found no evidence of a gene-gene interaction in the analysis of combined genotypes.</p></sec><sec><title>CONCLUSION</title><p>Our results suggest no significant association between the selected functional polymorphisms of COMT or MTHFR in Korean schizophrenia subjects. However, further studies are required to confirm our findings in a larger number of subjects.</p></sec>
Summary

Citations

Citations to this article as recorded by  
  • Molecular Mechanisms Provide a Landscape for Biomarker Selection for Schizophrenia and Schizoaffective Psychosis
    Stephanie Fryar-Williams, Jörg Strobel, Peter Clements
    International Journal of Molecular Sciences.2023; 24(20): 15296.     CrossRef
  • Association between MTHFR (677C>T and 1298A>C) polymorphisms and psychiatric disorder: A meta-analysis
    Xinyao Meng, Ji-long Zheng, Mao-ling Sun, Hai-yun Lai, Bao-jie Wang, Jun Yao, Hongbo Wang, Zezhi Li
    PLOS ONE.2022; 17(7): e0271170.     CrossRef
  • Association between variants of MTHFR genes and psychiatric disorders: A meta-analysis
    Yu-Xin Zhang, Lu-Ping Yang, Cong Gai, Cui-Cui Cheng, Zhen-yu Guo, Hong-Mei Sun, Die Hu
    Frontiers in Psychiatry.2022;[Epub]     CrossRef
  • MTHFR Ala222Val polymorphism and clinical characteristics confer susceptibility to suicide attempt in chronic patients with schizophrenia
    Jia Hong Liu, Cheng Zhu, Ke Zheng, Wei Tang, Li Li Gao, Tammy H. Trihn, Hanjing Emily Wu, Da Chun Chen, Mei Hong Xiu, Xiang Yang Zhang
    Scientific Reports.2020;[Epub]     CrossRef
  • Effort-related decision making in humanized COMT mice: Effects of Val158Met polymorphisms and possible implications for negative symptoms in humans
    Jen-Hau Yang, Rose E. Presby, Suzanne Cayer, Renee A. Rotolo, Peter A. Perrino, R. Holly Fitch, Merce Correa, Elissa J. Chesler, John D. Salamone
    Pharmacology Biochemistry and Behavior.2020; 196: 172975.     CrossRef
  • Association of functional polymorphisms in 3′-untranslated regions of COMT, DISC1, and DTNBP1 with schizophrenia
    Zahra I. Mohamed, Shiau F. Tee, Pek Y. Tang
    Psychiatric Genetics.2018; 28(6): 110.     CrossRef
  • Role of MTHFR C677T gene polymorphism in the susceptibility of schizophrenia: An updated meta-analysis
    Upendra Yadav, Pradeep Kumar, Sanjay Gupta, Vandana Rai
    Asian Journal of Psychiatry.2016; 20: 41.     CrossRef
  • The Role of a Catechol-O-Methyltransferase (COMT) Val158Met Genetic Polymorphism in Schizophrenia: A Systematic Review and Updated Meta-analysis on 32,816 Subjects
    Thelma Beatriz González-Castro, Yazmin Hernández-Díaz, Isela Esther Juárez-Rojop, María Lilia López-Narváez, Carlos Alfonso Tovilla-Zárate, Ana Fresan
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  • Evaluation of an association between plasma total homocysteine and schizophrenia by a Mendelian randomization analysis
    Shusuke Numata, Makoto Kinoshita, Atsushi Tajima, Akira Nishi, Issei Imoto, Tetsuro Ohmori
    BMC Medical Genetics.2015;[Epub]     CrossRef
  • Catechol-O-methyltransferase gene polymorphisms in Saudi cases with schizophrenia
    Ashraf Tantawy, Abduhamid Al-Yahia, Yasser Raya, Abdurrahman Al-Mohaimeed, Ahmad Settin
    Egyptian Journal of Psychiatry.2015; 36(3): 118.     CrossRef
  • Association of MTHFR C677T polymorphism with schizophrenia and its effect on episodic memory and gray matter density in patients
    Yanling Zhang, Hao Yan, Lin Tian, Fang Wang, Tianlan Lu, Lifang Wang, Jun Yan, Qi Liu, Lan Kang, Yanyan Ruan, Dai Zhang, Weihua Yue
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  • Genetic Variation Throughout the Folate Metabolic Pathway Influences Negative Symptom Severity in Schizophrenia
    J. L. Roffman, D. G. Brohawn, A. Z. Nitenson, E. A. Macklin, J. W. Smoller, D. C. Goff
    Schizophrenia Bulletin.2013; 39(2): 330.     CrossRef
  • No Association of Functional Polymorphisms in Methlylenetetrahydrofolate Reductase and the Risk and Minor Physical Anomalies of Schizophrenia in Korean Population
    Su-Gyeong Kim, Joo Yun Song, Eun-Jeong Joo, Seong Hoon Jeong, Se Hyun Kim, Kyu Young Lee, Nam Young Lee, Yong Min Ahn, Yong Sik Kim, Myoung-Sun Roh
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