vitamin-b-12 and Obesity

The present review focuses on the side effects that ex-obese patients face following bariatric surgery. We searched through the principal medical indexes (SCOPUS, Web of Science, PubMed, MEDLINE) using the following words, both alone and in combinations: bariatrics; bariatric surgery; anemia; vitamin B12; cobalamin; folate; folic acid; iron; iron supplements; gut microbiota; lactalbumin; α-lactalbumin. To perform exhaustive research, we considered articles published since 1985. Bariatric surgery induces states of nutritional deficiencies. In particular, the surgery results in a drastic fall in the levels of iron, cobalamin, and folate. Despite the dietary supplements which can counteract such decrease, some limitations exist in the nutraceutical approach. Indeed, the gastrointestinal side effects of supplements, the alterations in the microbiota, and the reduced absorption induced by the surgery may impair the effect of dietary supplements, exposing the patients to the risk of developing nutritional deficiencies. Recent literature reports the effect of promising molecules to counteract such limitations, which include α-lactalbumin, a whey protein with prebiotic activities, and new pharmaceutical forms of iron supplements, namely micronized ferric pyrophosphate. If on the one hand, α-lactalbumin enhances intestinal absorption and helps in restoring a physiological microbiota, micronized ferric pyrophosphate has a high tolerability and low or null risk of gastrointestinal side effects. Bariatric surgery represents a valid solution to obesity and obesity-related disease. However, the procedure may induce deficiencies in micronutrients. Data exists on the promising activities of α-lactalbumin and micronized ferric pyrophosphate, which may help in preventing bariatric-induced anemia.

Topics: Anemia; Bariatric Surgery; Dietary Supplements; Folic Acid; Humans; Iron; Lactalbumin; Malnutrition; Obesity; Obesity, Morbid; Vitamin B 12

Although Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most prevalent bariatric surgical procedures, high-level evidence is scarce regarding the assessment of postoperative nutritional risk in RYGB versus SG. Therefore, we performed a systematic review and meta-analysis to compare the risk of anemia and related micronutrient deficiencies after RYGB and SG. We analyzed 10 randomized controlled trials that compared RYGB and SG with reported incidence of postoperative anemia and/or anemia-related micronutrient deficiencies (iron, vitamin B

Topics: Anemia; Folic Acid; Gastrectomy; Gastric Bypass; Humans; Malnutrition; Micronutrients; Obesity; Obesity, Morbid; Randomized Controlled Trials as Topic; Retrospective Studies; Vitamin B 12; Vitamins

COVID-19 exacts a disproportionate toll on both the elderly and those with diabetes; these patients are more likely to require costly intensive care, longer hospitalisation, and die from complications. Nations would thus find it extremely difficult to either lift or sustain socially, economically, and politically damaging restrictions that keep this group of people safe. Without a vaccine, there is thus an urgent need to identify potential modifiable risk factors which can help manage overall fatality or recovery rates. Case fatality rates are highly variable between (and even within) nations; nutritional differences have been proposed to account significantly for this disparity. Indeed, vitamin B12 deficiency is a common denominator between the elderly and those with diabetes. The question on hand thus lies on whether managing B12 deficiencies will impact COVID-19 fatality outcome or recovery rates. Herein, we review the latest evidence that shows that B12 deficiency associates in multiple areas very similar to where COVID-19 exerts its damaging effects: immunologically; microbiologically; haematologically; and through endothelial cell signalling-supporting the hypothesis that B12 deficiency is a potential modifiable risk factor in our fight against COVID-19.

Topics: Aged; Comorbidity; COVID-19; Critical Care; Diabetes Complications; Folic Acid Deficiency; Gastrointestinal Microbiome; Homocysteine; Humans; Models, Biological; Obesity; Pandemics; Risk Factors; SARS-CoV-2; Severity of Illness Index; Vitamin B 12; Vitamin B 12 Deficiency

Hidradenitis suppurativa (HS) is a systemic recalcitrant inflammatory condition characterized by debilitating lesions with high morbidity. Its known association with obesity and smoking indicate correlation with other environmental factors, such as diet, suggesting a larger role for lifestyle modifications in disease treatment. This study seeks to assess the contribution of weight loss and dietary intake in HS management. A primary literature search was conducted using PubMed, Web of Science, and CINAHL in November 2018 to include association and intervention studies on the influence of diet and weight on HS. Twenty-five articles were included. Meta-analysis of nine case-control studies across Asia, Europe, and the United States showed that HS patients are four times more likely to be obese compared to the general population; random effects pooled odds ratio 4.022 (2.667-6.065), P < 0.001. Five articles assessed weight-loss interventions and revealed mixed findings. The remaining articles included three association studies on micronutrient levels, eight dietary intervention studies, and one article analyzing both micronutrient association and dietary intervention. Included articles in this systematic review reveal that low serum zinc and vitamin D levels are associated with increased lesion count in HS. Supplementation of zinc, vitamin D, vitamin B12, or exclusion of dairy or brewer's yeast can be effective in partial or complete lesion resolution. Reviewed data show that weight loss from bariatric surgery may lead to HS improvement but often results in more severe malnutrition that worsens or even leads to new onset HS post bariatric surgery. Future reporting is needed to conclusively determine the role of diet in HS.

Topics: Diet; Diet, Reducing; Hidradenitis Suppurativa; Humans; Micronutrients; Obesity; Vitamin B 12; Vitamin D; Weight Loss; Zinc

Obesity is a worldwide epidemic responsible for 5% of global mortality. The risks of developing other key metabolic disorders like diabetes, hypertension and cardiovascular diseases (CVDs) are increased by obesity, causing a great public health concern. A series of epidemiological studies and animal models have demonstrated a relationship between the importance of vitamin B12 (B12) and various components of metabolic syndrome. High prevalence of low B12 levels has been shown in European (27%) and South Indian (32%) patients with type 2 diabetes (T2D). A longitudinal prospective study in pregnant women has shown that low B12 status could independently predict the development of T2D five years after delivery. Likewise, children born to mothers with low B12 levels may have excess fat accumulation which in turn can result in higher insulin resistance and risk of T2D and/or CVD in adulthood. However, the independent role of B12 on lipid metabolism, a key risk factor for cardiometabolic disorders, has not been explored to a larger extent. In this review, we provide evidence from pre-clinical and clinical studies on the role of low B12 status on lipid metabolism and insights on the possible epigenetic mechanisms including DNA methylation, micro-RNA and histone modifications. Although, there are only a few association studies of B12 on epigenetic mechanisms, novel approaches to understand the functional changes caused by these epigenetic markers are warranted.

Topics: Adult; Animals; Biomarkers; Cardiometabolic Risk Factors; Child; DNA Methylation; Epigenesis, Genetic; Female; Histones; Humans; Lipid Metabolism; Male; Metabolic Syndrome; MicroRNAs; Obesity; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency

Sirtuin1 (Sirt1) has a NAD (+) binding domain and modulates the acetylation status of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α) and Fork Head Box O1 transcription factor (Foxo1) according to the nutritional status. Sirt1 is decreased in obese patients and increased in weight loss. Its decreased expression explains part of the pathomechanisms of the metabolic syndrome, diabetes mellitus type 2 (DT2), cardiovascular diseases and nonalcoholic liver disease. Sirt1 plays an important role in the differentiation of adipocytes and in insulin signaling regulated by Foxo1 and phosphatidylinositol 3'-kinase (PI3K) signaling. Its overexpression attenuates inflammation and macrophage infiltration induced by a high fat diet. Its decreased expression plays a prominent role in the heart, liver and brain of rat as manifestations of fetal programming produced by deficit in vitamin B12 and folate during pregnancy and lactation through imbalanced methylation/acetylation of PGC1α and altered expression and methylation of nuclear receptors. The decreased expression of Sirt1 produced by impaired cellular availability of vitamin B12 results from endoplasmic reticulum stress through subcellular mislocalization of ELAVL1/HuR protein that shuttles Sirt1 mRNA between the nucleus and cytoplasm. Preclinical and clinical studies of Sirt1 agonists have produced contrasted results in the treatment of the metabolic syndrome. A preclinical study has produced promising results in the treatment of inherited disorders of vitamin B12 metabolism.

Topics: Animals; ELAV-Like Protein 1; Humans; Metabolic Syndrome; Obesity; Peroxisome Proliferator-Activated Receptors; Sirtuin 1; Vitamin B 12

The purpose of this study was to conduct a literature review to examine micronutrient deficiencies in laparoscopic sleeve gastrectomy. We conducted a literature review using PubMed and Cochrane databases to examine micronutrient deficiencies in SG patients in order to identify trends and find consistency in recommendations. Seventeen articles were identified that met the defined criteria. Iron, vitamin B12 and vitamin D were the primary micronutrients evaluated. Results demonstrate the need for consistent iron and B12 supplementation, in addition to a multivitamin, while vitamin D supplementation may not be necessary. Additional prospective studies to establish a clearer picture of micronutrient deficiencies post-SG are needed.

Topics: Calcium; Dietary Supplements; Ferritins; Folic Acid; Gastrectomy; Humans; Iron; Iron Deficiencies; Laparoscopy; Micronutrients; Obesity; Prospective Studies; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Homocysteine (Hcy) is methylated by methionine synthase to form methionine with methyl-cobalamin as a cofactor. The reaction demethylates 5-methyltetrahydrofolate to tetrahydrofolate, which is required for DNA and RNA synthesis. Deficiency of either of the cobalamin (Cbl) and/or folate cofactors results in elevated Hcy and megaloblastic anemia. Elevated Hcy is a sensitive biomarker of Cbl and/or folate status and more specific than serum vitamin assays. Elevated Hcy normalizes when the correct vitamin is given. Elevated Hcy is associated with alcohol use disorder and drugs that target folate or Cbl metabolism, and is a risk factor for thrombotic vascular disease. Elevated methionine and cystathionine are associated with liver disease. Elevated Hcy, cystathionine, and cysteine, but not methionine, are common in patients with chronic renal failure. Higher cysteine predicts obesity and future weight gain. Serum S-adenosylhomocysteine (AdoHcy) is elevated in Cbl deficiency and chronic renal failure. Drugs that require methylation for catabolism may deplete liver S-adenosylmethionine and raise AdoHcy and Hcy. Deficiency of Cbl or folate or perturbations of their metabolism cause major changes in sulfur amino acids.

Topics: Alcoholism; Amino Acids, Sulfur; Anemia, Megaloblastic; Biomarkers; Cardiovascular Diseases; Folic Acid; Folic Acid Deficiency; Humans; Hyperhomocysteinemia; Kidney Failure, Chronic; Liver Diseases; Nutritional Status; Obesity; S-Adenosylhomocysteine; Vitamin B 12; Vitamin B 12 Deficiency

Each year 6,800 bariatric operations are performed in Sweden. Bariatric surgery involves both a reduced intake and a reduced absorption of vitamins and minerals. There has been debate about whose responsibility long-term follow-up is, particularly regarding monitoring vitamin and mineral status. The Swedish Society for Bariatric Surgery and the Norwegian Association for Bariatric Surgery, who oversee their respective national quality registers, have appointed an expert group to develop guidelines for postoperative supplementation and nutritional monitoring of vitamins and minerals, along with a schedule for routine follow-up. Several existing international guidelines have served as the basis for the development of this guidance. The Finnish Association for Metabolic Surgery and The Danish Association for the Study of Obesity have also decided to adopt the recommendations. The care of the patient group with severe obesity is a common responsibility of primary care and hospitals, as patients are heavily affected by obesity-related morbidity, which, even without surgery, requires major health care efforts, not least from primary care. After surgery, a large proportion of these efforts can be reduced, but focus changes.

Topics: Aftercare; Bariatric Surgery; Calcium; Dietary Supplements; Folic Acid; Humans; Iron; Monitoring, Physiologic; Nutrition Policy; Nutritional Support; Obesity; Postoperative Care; Postoperative Complications; Practice Guidelines as Topic; Scandinavian and Nordic Countries; Thiamine; Vitamin B 12; Vitamin D; Zinc

Multiple studies have explored the association between serum or plasma vitamin B12 status and obesity, in part because of the relationship between elevated homocysteine concentrations and atherosclerosis. This review will address the inconsistent finding of these studies with the objective of determining whether vitamin B12 concentrations are lower in people with higher body mass indices.. MEDLINE and EMBASE were searched to February 2017. Observational studies in general and clinical populations comparing serum/plasma B12 concentrations across groups of different body mass indices were selected. We did network and pairwise meta-analyses of serum/plasma B12, folate and homocysteine using frequentist techniques. Evidence-based items potentially indicating risk of bias were assessed.. Of 844 citations, we identified 19 eligible observational studies with 7,055 participants. The overall network, while showing no significant inconsistency between indirect and direct comparisons (P = 0.34), was qualitatively inconsistent. Based on the results of the meta-regression, in an exploratory sub-network meta-analysis where obesity groups were combined, we excluded disease-specific populations and studies with inadequate description of populations. The direction of the indirect and direct evidence was consistent. The pairwise results from this sub-network showed lower levels of B12 in people with higher body mass indices: obesity versus control difference in means (MD) -56 pmol L. This review did not establish an inverse association (or J-curve) between serum or plasma B12 concentrations and body mass index, but the direct pairwise evidence is consistent with an inverse association and supports further investigation.

Topics: Body Mass Index; Folic Acid; Homocysteine; Humans; Obesity; Vitamin B 12

Inappropriate food behavior contributes to obesity and leads to vitamin deficiency. This review discusses the nutritional status of water- and fat-soluble vitamins in obese subjects. We verified that most vitamins are deficient in obese individuals, especially the fat-soluble vitamins, folic acid, vitamin B

Topics: Avitaminosis; Comorbidity; Folic Acid; Humans; Metabolic Diseases; Nutritional Status; Obesity; Vitamin A; Vitamin B 12; Vitamins

Vitamin B12 deficiency is common in certain populations, such as in India, where there is also a rising prevalence of Type 2 diabetes, obesity and their complications. Human cohorts and animal models provide compelling data suggesting the role of the one-carbon cycle in modulating the risk of diabetes and adiposity via developmental programming. Early mechanistic studies in animals suggest that alterations to the cellular provision of methyl groups (via the one-carbon cycle) in early developmental life may disrupt DNA methylation and induce future adverse phenotypic changes. Furthermore, replacement of micronutrient deficits at suitable developmental stages may modulate this risk. Current human studies are limited by a range of factors, including the accuracy and availability of methods to measure nutritional components in the one-carbon cycle, and whether its disruptions exert tissue-specific effects. A greater understanding of the causal and mechanistic role of the one-carbon cycle is hoped to generate substantial insights into its role in the developmental origins of complex metabolic diseases and the potential of targeted and population-wide prevention strategies.

Topics: Adiposity; Carbon Cycle; Diabetes Mellitus, Type 2; Environmental Exposure; Female; Fetal Development; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Infant, Newborn; Insulin Resistance; Male; Maternal Nutritional Physiological Phenomena; Methylmalonic Acid; Obesity; Pregnancy; Prenatal Exposure Delayed Effects; Vitamin B 12; Vitamin B 12 Deficiency

Chronic vitamin D deficiency, inadequate calcium intake, and secondary hyperparathyroidism are common in obese individuals, placing them at risk for low bone mass and metabolic bone disease. After bariatric surgery, they are at even higher risk, owing to malabsorption and decreased oral intake. Meticulous preoperative screening, judicious use of vitamin and mineral supplements, addressing modifiable risk factors, and monitoring the absorption of key nutrients postoperatively are essential in preventing metabolic bone disease in bariatric surgery patients.

Topics: Absorptiometry, Photon; Bariatric Surgery; Bone Diseases, Metabolic; Calcium Compounds; Dietary Proteins; Health Status Indicators; Humans; Magnesium Compounds; Nutritional Status; Obesity; Perioperative Care; Risk Factors; Vitamin B 12; Vitamin D

Neural tube defects (NTDs) are serious malformations affecting approximately 1 per 1000 births, yet the mechanisms by which they arise are unknown. There have been consistent efforts in many fields of research to elucidate the etiology of this multifactorial condition. While no single gene has been identified as a major independent risk factor for NTDs, candidate genes have been proposed that may modify the effects of maternal and/or embryonic exposures. Folate supplementation effectively reduces the occurrence of NTDs and, consequently, has focused much research on metabolism of folate-related pathways during pregnancy and development. Further understanding of normal development and how teratogens can perturb these orchestrated processes also remains at the fore of modern scientific endeavors. The composite of these factors remains fragmented; the aim of this review is to provide the reader with a summary of sentinel and current works in the body of literature addressing NTD disease etiology.

Topics: Central Nervous System; Diabetes Complications; Drug-Related Side Effects and Adverse Reactions; Female; Fever; Folic Acid; Fumonisins; Humans; Neural Tube Defects; Obesity; Pregnancy; Risk Factors; Teratogens; Vitamin B 12

Topics: Bile Acids and Salts; Diarrhea; Dietary Proteins; Humans; Ileum; Intestinal Absorption; Jejunum; Methods; Obesity; Time Factors; Vitamin B 12

Obesity is a major public health problem and great risk for not only cardiovascular diseases but also cancer, musculoskeletal, and gynecological diseases. This study was aimed to investigate the association between serum Vitamin B12 (vitB12), body mass index (BMI), and nutritional status among obese women.. This cross-sectional study enrolled consecutive female subjects. The consumptions of red meat, fish, bovine liver, egg, and mushroom were recorded. According to the Dietary Reference Intakes, the patients were categorized as insufficiency and sufficiency. Three cutoff points were defined for vitB12 status: (1) Deficiency if vitB12 is <200 pg/mL; (2) insufficiency if vitB12 is 250-350 pg/mL, and (3) sufficient if vitB12 is ≥350 pg/mL. According to BMI, the patients were assigned to nonobese and obese groups. BMI, serum vitB12 level, consumptions of red meat, fish, bovine liver, egg, and mushroom were evaluated and compared between two groups.. Mean level of vitB12 was 247.8 ± 10.4 pg/mL and significantly associated with consumption of egg (P = 0.031), bovine liver (P = 0.004), mushroom (P = 0.040), and red meat (P = 0.003). VitB12 was significantly higher in nonobese than obese group (282.5 ± 106.8 vs. 242.5 ± 107.5 pg/mL, P = 0.001). The ratio of vitB12 deficiency was significantly higher in obese than nonobese group (37.6% vs. 24.7%; P = 0.019). VitB12 level was negatively correlated with BMI (r = -0.155; P< 0.001), but not insulin resistance (r = -0.172; P = 0.062).. Obesity was associated with low level of vitB12 in obese women, and more likely to be vitB12 deficient. Consumption of certain types of food contributes to increase vitB12 level.

Topics: Adult; Animals; Body Mass Index; Cardiovascular Diseases; Cattle; Cross-Sectional Studies; Female; Humans; Insulin Resistance; Middle Aged; Nutritional Status; Obesity; Turkey; Vitamin B 12

Obese subjects are commonly deficient in several micronutrients. Weight loss, although beneficial, may also lead to adverse changes in micronutrient status and body composition. The objective of the study is to assess changes in micronutrient status and body composition in obese individuals after a dietary weight loss program.. As part of a dietary weight loss trial, enrolling 192 obese patients (body mass index >30 kg/m2) with knee osteoarthritis (>50 years of age), vitamin D, ferritin, vitamin B12 and body composition were measured at baseline and after 16 weeks. All followed an 8-week formula weight-loss diet 415-810 kcal per day, followed by 8 weeks on a hypo-energetic 1200 kcal per day diet with a combination of normal food and formula products. Statistical analyses were based on paired samples in the completer population.. A total of 175 patients (142 women), 91%, completed the 16-week program and had a body weight loss of 14.0 kg (95% confidence interval: 13.3-14.7; P<0.0001), consisting of 1.8 kg (1.3-2.3; P<0.0001) lean body mass (LBM) and 11.0 kg (10.4-11.6; P<0.0001) fat mass. Bone mineral content (BMC) did not change (-13.5 g; P=0.18), whereas bone mineral density (BMD) increased by 0.004 g/cm2 (0.001-0.008 g/cm2; P=0.025). Plasma vitamin D and B(12) increased by 15.3 nmol/l (13.2-17.3; P<0.0001) and 43.7 pmol/l (32.1-55.4; P<0.0001), respectively. There was no change in plasma ferritin.. This intensive program with formula diet resulted in increased BMD and improved vitamin D and B12 levels. Ferritin and BMC were unchanged and loss of LBM was only 13% of the total weight loss. This observational evidence supports use of formula diet-induced weight loss therapy in obese osteoarthritis patients.

Topics: Aged; Body Composition; Body Mass Index; Bone and Bones; Bone Density; Energy Intake; Female; Ferritins; Humans; Male; Middle Aged; Nutritional Status; Obesity; Osteoarthritis, Knee; Prospective Studies; Vitamin B 12; Vitamin D; Weight Loss; Weight Reduction Programs

To compare the effects of an energy reduced very low carbohydrate, high saturated fat diet (LC) and an isocaloric high carbohydrate, low fat diet (LF) on endothelial function after 12 months.. Forty-nine overweight or obese patients (age 50.0 +/- 1.1 years, BMI 33.7 +/- 0.6 kg m(-2)) were randomized to either an energy restricted ( approximately 6-7 MJ), planned isocaloric LC or LF for 52 weeks. Body weight, endothelium-derived factors, flow-mediated dilatation (FMD), adiponectin, augmentation index (AIx) and pulse wave velocity (PWV) were assessed. All data are mean +/- SEM.. Weight loss was similar in both groups (LC -14.9 +/- 2.1 kg, LF -11.5 +/- 1.5 kg; P = 0.20). There was a significant time x diet effect for FMD (P = 0.045); FMD decreased in LC (5.7 +/- 0.7% to 3.7 +/- 0.5%) but remained unchanged in LF (5.9 +/- 0.5% to 5.5 +/- 0.7%). PWV improved in both groups (LC -1.4 +/- 0.6 m s(-1), LF -1.5 +/- 0.6 m s(-1); P = 0.001 for time) with no diet effect (P = 0.80). AIx and VCAM-1 did not change in either group. Adiponectin, eSelectin, tPA and PAI-1 improved similarly in both groups (P < 0.01 for time).. Both LC and LF hypoenergetic diets achieved similar reductions in body weight and were associated with improvements in PWV and a number of endothelium-derived factors. However, the LC diet impaired FMD suggesting chronic consumption of a LC diet may have detrimental effects on endothelial function.

Topics: Blood Flow Velocity; Blood Pressure; Brachial Artery; Diet, Carbohydrate-Restricted; Diet, Fat-Restricted; Endothelium, Vascular; Female; Folic Acid; Homocysteine; Humans; Lipids; Male; Middle Aged; Obesity; Overweight; Vitamin B 12; Weight Loss

To assess the associations between serum folate concentration and measures of adiposity in postmenopausal women.. This study was conducted as a cross-sectional analysis within the control segment of a randomized, crossover trial in which postmenopausal women (n=51) consumed 0 g (control), 15 g (one drink) and 30 g (two drinks) alcohol (ethanol)/day for 8 weeks as part of a controlled diet. Subjects in one treatment arm were crossed-over to another arm after a 2- to 5-week washout period. Body mass index (BMI) was measured, and dual energy X-ray absorptiometry (DEXA) scan administered to the women during the control (0 g alcohol) treatment, and a blood sample from this group was collected at baseline and week 8 of each diet period and analyzed for folate, B12, homocysteine and methylmalonic acid.. This study was conducted at the Beltsville Human Nutrition Research Center, MD, USA.. In multivariate analysis, women who were overweight had a 12% lower, and obese women had a 22% lower serum folate concentrations compared to normal weight women (P-trend=0.02). Vitamin B12 also decreased with increasing BMI (P-trend=0.08). Increased BMI, percent body fat, and absolute amounts of central and peripheral fat were all significantly associated with decreased serum folate, but were unrelated to serum B12, homocysteine or methylmalonic acid.. Our data show that adiposity is associated with lower serum folate levels in postmenopausal women. With obesity at epidemic proportions, these data, if confirmed by prospective or randomized controlled studies, have important public health implications.

Topics: Absorptiometry, Photon; Adipose Tissue; Adiposity; Aged; Alcohol Drinking; Body Composition; Body Mass Index; Cross-Over Studies; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Methylmalonic Acid; Middle Aged; Multivariate Analysis; Obesity; Overweight; Postmenopause; Vitamin B 12

A high plasma homocysteine concentration is an independent risk factor for cardiovascular disease. Homocysteine concentrations are thought to be raised by high protein and methionine intakes.. Our goal was to investigate the effects of high and low protein and methionine intakes on homocysteine in overweight subjects.. Sixty-five overweight subjects were randomly assigned to a 6-mo intervention with a low-protein, low-methionine diet (LP: 12% of total energy, 1.4 g methionine/d; n = 25); a high-protein, high-methionine diet (HP: 22% of total energy, 2.7 g methionine/d; n = 25), both of which had similar fat contents (30% of total energy); or a control diet with an intermediate protein content (n = 15). All food was self-selected at a shop at the department. Protein intake was increased in the HP group mainly through lean meat and low-fat dairy products. Dietary compliance was evaluated by urinary nitrogen excretion.. Homocysteine concentrations did not change significantly in the LP or control groups but were 25% lower in the HP group (NS). Homocysteine concentrations after the 3-mo intervention were inversely associated with vitamin B-12 intake and with weight change (by multivariate analysis performed for all subjects), but not with methionine or protein intake. Sixty-nine percent of the variation could be explained by baseline homocysteine (P < 0.001), 2% by vitamin B-12 (P = 0.02), and another 2% by weight change (P = 0.06). The plasma homocysteine concentration after 6 mo was associated only with baseline homocysteine (P < 0.001).. A high-protein, high-methionine diet does not raise homocysteine concentrations compared with a low-protein, low-methionine diet in overweight subjects.

Topics: Adolescent; Adult; Analysis of Variance; Body Weight; Diet; Diet, Protein-Restricted; Dietary Proteins; Female; Folic Acid; Homocysteine; Humans; Male; Methionine; Middle Aged; Obesity; Vitamin B 12

Sulfonylurea drugs have been the only oral therapy available for patients with non-insulin-dependent diabetes mellitus (NIDDM) in the United States. Recently, however, metformin has been approved for the treatment of NIDDM.. We performed two large, randomized, parallel-group, double-blind, controlled studies in which metformin or another treatment was given for 29 weeks to moderately obese patients with NIDDM whose diabetes was inadequately controlled by diet (protocol 1: metformin vs. placebo; 289 patients), or diet plus glyburide (protocol 2: metformin and glyburide vs. metformin vs. glyburide; 632 patients). To determine efficacy we measured plasma glucose (while the patients were fasting and after the oral administration of glucose), lactate, lipids, insulin, and glycosylated hemoglobin before, during, and at the end of the study.. In protocol 1, at the end of the study the 143 patients in the metformin group, as compared with the 146 patients in the placebo group, had lower mean (+/- SE) fasting plasma glucose concentrations (189 +/- 5 vs. 244 +/- 6 mg per deciliter [10.6 +/- 0.3 vs. 13.7 +/- 0.3 mmol per liter], P < 0.001) and glycosylated hemoglobin values (7.1 +/- 0.1 percent vs. 8.6 +/- 0.2 percent, P < 0.001). In protocol 2, the 213 patients given metformin and glyburide, as compared with the 210 patients treated with glyburide alone, had lower mean fasting plasma glucose concentrations (187 +/- 4 vs. 261 +/- 4 mg per deciliter [10.5 +/- 0.2 vs. 14.6 +/- 0.2 mmol per liter], P < 0.001) and glycosylated hemoglobin values (7.1 +/- 0.1 percent vs. 8.7 +/- 0.1 percent, P < 0.001). The effect of metformin alone was similar to that of glyburide alone. Eighteen percent of the patients given metformin and glyburide had symptoms compatible with hypoglycemia, as compared with 3 percent in the glyburide group and 2 percent in the metformin group. In both protocols the patients given metformin had statistically significant decreases in plasma total and low-density lipoprotein cholesterol and triglyceride concentrations, whereas the values in the respective control groups did not change. There were no significant changes in fasting plasma lactate concentrations in any of the groups.. Metformin monotherapy and combination therapy with metformin and sulfonylurea are well tolerated and improve glycemic control and lipid concentrations in patients with NIDDM whose diabetes is poorly controlled with diet or sulfonylurea therapy alone.

Topics: Blood Glucose; Body Weight; Cholesterol; Diabetes Mellitus; Diabetes Mellitus, Type 2; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Fasting; Female; Folic Acid; Glucose Tolerance Test; Glyburide; Glycated Hemoglobin; Humans; Insulin; Lactates; Lactic Acid; Male; Metformin; Middle Aged; Obesity; Treatment Failure; Vitamin B 12

This study was conducted to assess serum levels of folate and vitamin B12 in overweight and obese pregnant women.. A cross-sectional study was conducted at Saad Abualila Hospital, Sudan. Clinical data were collected through questionnaires and body mass index (BMI) was computed from weight and height. The serum folate and vitamin B12 levels were analyzed by immunofluorescence.. Of 300 enrolled women, 44.7% were of normal weight, 32.3% were overweight and 3.0% were obese. The folate level was significantly lower in overweight women (median 4.79 ng/ml [IQR 2.70‒7.70]) than in normal-weight women (median 6.650 ng/ml [IQR 3.30‒10.55]; p=0.022). There was no significant difference in the prevalence of marginal and severe folate deficiencies in women in different BMI groups. Compared with normal-weight women (median 197.5 pg/ml [IQR 150.0‒263.0]), obese women (median 173.0 pg/ml [IQR 150.0‒213.0]; p=0.038) had significantly lower vitamin B12 levels and had a higher prevalence of vitamin B12 insufficiency. Fair negative correlations (p<0.01) were observed between folate and BMI (r = -0.157) and between vitamin B12 and BMI (r = -0.173).. Overweight and obese pregnant Sudanese women had lower levels of serum folate and vitamin B12.

Topics: Cross-Sectional Studies; Female; Folic Acid; Humans; Obesity; Overweight; Pregnancy; Sudan; Vitamin B 12

Homocysteine is a possible risk marker in hematological complications of COVID-19 infection. This study aimed to elucidate the significance of homocysteine as a biomarker for COVID-19 infection, and the relation of homocysteine with COVID-19 severity in obese people and diabetic patients.  The study groups were 1- COVID-19 patients + Diabetic + Obese (CDO), 2- COVID-19 patients + Diabetic (CD), 3- COVID-19 patients + Obese (CO), 4- Healthy Group (HG). Serum levels of homocysteine, IL-6, D-dimer, vitamin B12, and folate were measured by a fully automated biochemistry device Cobas 6000 analyzer series. The mean serum concentration of homocysteine in the COD, CD, CO and H groups were 32.0114, 23.604, 19.4154, and 9.3206 umol/l respectively. The mean concentration of homocysteine levels between every two groups was statistically significant differences (P<0.05) except for the CD and the CO group (P=0.957). In the CDO group, the males have higher mean concentrations than females (P<0.05). The means of homocysteine concentrations in the CDO group among different age groups were different (P <0.001). The serum homocysteine level in the CDO group has a strong positive correlation (R=0.748) with D-dimer and a strong negative correlation (R= - 0.788) with serum folate, while its correlation with serum vitamin B12 is moderate negative (-0.499) and its correlation with serum IL-6 is weakly positive (R=0.376). The AUC value for homocysteine in predicting COVID-19 in the CDO group was 0.843, while 0.714 for the CD group, and 0.728 for the CO group. The serum homocysteine concentration test for all study groups was compared to the serum IL-6 test and the sensitivity was equal to 95% and its specificity was 67.5%. Serum homocysteine has potential predictive power in COVID-19 patients, and the severity of COVID-19 infection and the type of comorbidity is associated with higher sensitivity and specificity of homocysteine serological tests.

Topics: Biomarkers; COVID-19; Diabetes Mellitus; Female; Folic Acid; Homocysteine; Humans; Interleukin-6; Male; Obesity; Vitamin B 12

Fetal growth and development are influenced by maternal nutrition and gestational weight gain. Adequate intake of nutrients such as folate, vitamin B12, and docosahexaenoic acid (DHA) is essential for healthy fetal and placental development. Many countries have a national flour fortification program with folic acid (FA), together with pre-pregnancy supplementation of FA (400 μg/day) during the first trimester of pregnancy. The latter has been recommended by the WHO and adapted to local requirements by perinatal guidelines. On the other hand, in population studies, many women of childbearing age have vitamin B12 deficiency (<148 pmol/L), which can be additionally masked by high FA intake and maternal pregestational obesity. Under these conditions, these patients could be having pregnancies in a folate/vitamin B12 imbalance, which is associated with higher adiposity, insulin resistance, altered lipid metabolism, and low DHA levels in their offspring. However, if these neonatal consequences of maternal pregestational obesity and folate/vitamin B12 imbalance can be reverted by DHA supplementation during pregnancy has not been addressed. This chapter reviews the literature and exposes the current gaps in knowledge and challenges in maternal nutrition with a life-course perspective.

Topics: Fatty Acids, Unsaturated; Female; Folic Acid; Humans; Infant, Newborn; Obesity; Placenta; Pregnancy; Vitamin B 12

We aimed to evaluate the association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness (CIMT) among children with obesity in whom vitamin deficiencies are more frequent.. Herein, 100 children with obesity (58 girls) were included (age, 5-18 years). Height, weight, body mass index (BMI), waist circumference (WC), puberty stage, blood pressure, and biochemical values were collected from medical records; standard deviations (SDS) and percentiles were calculated. Obesity was defined as BMI SDS of >+2SDS. Vitamin B12 and folate levels of <300 pg/mL and <4.8 ng/mL, respectively, were considered deficient. A radiologist quantified measurements from the carotid artery.. Mean patient age was 12.52 ± 3.63 years. The mean weight SDS, BMI SDS, and WC/height were +3.37 ± 0.93, +2.93 ± 0.55, and 0.65 ± 0.05, respectively. In pubertal cases, insulin (p<0.001), the homeostatic model assessment for insulin resistance (HOMA-IR) (p=0.001) and homocysteine (p=0.002) levels were higher; vitamin B12 (p<0.001) and folate (p<0.001) levels were lower than those in prepubertal ones. WC and HOMA-IR correlated with CIMT; however, homocysteine levels were not correlated with CIMT.. In our study, pubertal cases had lower vitamin B12 and folate levels as well as higher homocysteine levels. Although no correlation was identified between homocysteine levels and CIMT, this condition may be related to our study group comprising children, who had a shorter duration of obesity than those in adults. As CIMT was higher in children/adolescents with increased WC, it is proposed that they need central obesity more frequently and carefully follow-up.

Topics: Adolescent; Adult; Carotid Intima-Media Thickness; Child; Child, Preschool; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Insulin Resistance; Obesity; Risk Factors; Vitamin B 12

Topics: Adult; Dietary Supplements; Female; Folic Acid; Gastrectomy; Humans; Obesity; Vitamin B 12; Vitamin D; Vitamins

The goal of this study was to assess the anthropometric and biochemical parameters of children and adolescents with phenylketonuria (PKU).. The participants in this cross-sectional study ranged in age from four to 18 years old. Biochemical markers such as vitamin B12, folic acid, iron, ferritin, calcium, 25-hydroxy vitamin D3, zinc, plasma phenylalanine (Phe) and tyrosine (Tyr) levels in blood were evaluated, as well as demographics and anthropometric measurements. A three-day dietary recall questionnaire was completed by all individuals.. 80% (64) of the 80 patients (42 females, 52.5%) had typical PKU. Consanguineous marriages were found in 57.5% (46) of the patients' parents. According to the height for age index, 17.5% of the study group (n = 14) were short or very short. According to age-related weight and body mass index (BMI), 37.5% (n = 30) and 43.8% (n = 35) of people are obese or overweight, respectively. Biochemical tests revealed increased vitamin B12 levels and 25-hydroxy vitamin D3 deficiency in 35% (n = 28) of the patients, insufficient folic acid in 12.5% (n = 10), and elevated phenylalanine levels in 70.3% (n = 45) of children under 12 years old, and adolescents 62.5% (n = 10). A high Phe intake (OR = 4.44, CI %95 = 1.27-15.57) is a risk factor for obesity and overweight.. Patients with PKU had a high rate of overweight and obesity. PKU patients who are overweight or obese do not differ from normal-weight patients in terms of dietary intake or laboratory findings (except for serum iron levels). One-third of patients with phenylketonuria were vitamin D deficient and had a BMI/A index of overweight/obese. It is recommended to use special medical food to help solve energy and nutrient deficiencies.

Topics: Adolescent; Child; Child, Preschool; Cholecalciferol; Cross-Sectional Studies; Female; Folic Acid; Humans; Iron; Nutritional Status; Obesity; Overweight; Phenylalanine; Phenylketonurias; Vitamin B 12; Vitamin D Deficiency

Recent studies implicate maternal gestational diabetes mellitus (GDM) in differential methylation of infant DNA. Folate and vitamin B12 play a role in DNA methylation, and these vitamins may also influence GDM risk. The aims of this study were to determine folate and vitamin B12 status in obese pregnant women and investigate associations between folate and vitamin B12 status, maternal dysglycaemia and neonatal DNA methylation at cytosine-phosphate-guanine sites previously observed to be associated with dysglycaemia. Obese pregnant women who participated in the UK Pregnancies Better Eating and Activity Trial were included. Serum folate and vitamin B12 were measured at the oral glucose tolerance test (OGTT) visit. Cord blood DNA methylation was assessed using the Infinium MethylationEPIC BeadChip. Regression models with adjustment for confounders were used to examine associations. Of the 951 women included, 356 (37.4%) were vitamin B12 deficient, and 44 (4.6%) were folate deficient. Two-hundred and seventy-one women (28%) developed GDM. Folate and vitamin B12 concentrations were not associated with neonatal DNA methylation. Higher folate was positively associated with 1-h plasma glucose after OGTT (β = 0.031, 95% CI 0.001-0.061, p = 0.045). There was no relationship between vitamin B12 and glucose concentrations post OGTT or between folate or vitamin B12 and GDM. In summary, we found no evidence to link folate and vitamin B12 status with the differential methylation of neonatal DNA previously observed in association with dysglycaemia. We add to the evidence that folate status may be related to maternal glucose homoeostasis although replication in other maternal cohorts is required for validation.

Topics: Diabetes, Gestational; DNA Methylation; Female; Folic Acid; Glucose; Homocysteine; Humans; Infant, Newborn; Obesity; Pregnancy; Pregnant Women; Vitamin B 12

Few studies have reported an increase in vitamin B12 (VitB12) levels after bariatric surgery. This study reports the phenomenon and adverse reactions of serum VitB12 elevation 1 month after surgery and explores the possible etiologies.Retrospective analysis was performed on VitB12 data for 112 patients from January 2018 to October 2019. Then, 87 patients were included between November 2019 and August 2020. They were divided into 2 groups according to the level of VitB12 after surgery, and the demographic and clinical data were analyzed. Then, LASSO regression model analysis and multiple logistic regression analysis were performed to explore the risk factors for VitB12 elevation after surgery.Retrospective data showed that the VitB12 level was significantly increased 1 month after surgery. Comparison of data between the 2 groups found that more patients also had diabetes in the nonelevated group. The postoperative folic acid and VitB12 levels of the elevated group were significantly higher than those of the nonelevated group. More patients had concurrent constipation in the elevated group than in the nonelevated group. Two meaningful variables in LASSO regression analysis were incorporated into the multivariate logistic regression analysis, and constipation was found to be an independent risk factor for the increase in VitB12 after surgery. Of the 199 patients in this study, 111 patients had elevated VitB12 levels after surgery. Among them, 7 patients had peripheral nerve symptoms.Constipation is an independent risk factor for increased VitB12 levels after surgery. High levels of VitB12 may cause some peripheral nerve symptoms. Therefore, it is necessary to pay attention to patients with postoperative constipation, monitor their VitB12 level as soon as possible, and take measures to improve constipation to avoid some adverse reactions caused by elevated VitB12 levels.

Topics: Adult; Bariatric Surgery; Case-Control Studies; Constipation; Female; Folic Acid; Humans; Male; Obesity; Postoperative Complications; Retrospective Studies; Vitamin B 12

Topics: Aged; Aged, 80 and over; Calcium; Chile; Diet Surveys; Dietary Supplements; Female; Humans; Male; Micronutrients; Middle Aged; Nutrition Assessment; Nutritional Status; Obesity; Overweight; Thinness; Vitamin B 12; Vitamin D

Metabolic syndrome (MetS) is prevalent not only among the overweight and obese but also normal weight individuals, and the phenotype is referred to as a metabolically unhealthy phenotype (MUHP). Besides normal weight individuals, overweight/obese individuals are also protected from MetS, and the phenotype is known as a metabolically healthy phenotype (MHP). Epidemiological studies indicate that coffee and micronutrients such as plasma folate or vitamin B12 (vit. B12) are inversely associated with MetS. However, correlations among coffee consumption metabolic phenotypes, plasma folate, and vit. B12 remain unknown. Our objective was to investigate the correlation between coffee consumption, metabolic phenotypes, plasma folate, and vit. B12 as well as to understand associations between plasma folate, vit. B12, and metabolic phenotypes. Associations among coffee consumption metabolic phenotypes, plasma folate, and vit. B12 were assessed in a cross-sectional study of 2201 participants, 18 years or older, from 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys (NHANES). MUHP was classified as having > three metabolic abnormalities. Coffee consumption was not associated with metabolic phenotypes, but negatively correlated with several metabolic variables, including BMI (

Topics: Adolescent; Adult; Body Mass Index; Cardiometabolic Risk Factors; Coffee; Cross-Sectional Studies; Drinking; Female; Folic Acid; Humans; Male; Metabolic Syndrome; Middle Aged; Nutrition Surveys; Obesity; Overweight; Phenotype; Protective Factors; Vitamin B 12; Young Adult

To determine the 10-year incidence of hearing impairment (HI) and associated risk factors in the Beaver Dam Offspring Study (BOSS; 2004-present), a large middle-aged cohort followed for 10 years.. Prospective cohort study.. Hearing thresholds were measured at baseline (2005-2008) and 5- (2010-2013) and 10-year (2015-2017) follow-up examinations. HI was defined as a pure-tone average >25 dB HL in either ear. BOSS participants free of HI at baseline with at least one follow-up examination (N = 2,065) were included. Potential risk factors evaluated included cardiovascular measures, health history, lifestyle factors, inflammatory markers, vitamins D and B12, lead, and cadmium.. Participants were 21 to 79 years (mean age = 47.9 years) at baseline. The 10-year cumulative HI incidence was 17.4% (95% confidence interval [CI]: 15.7-19.2) and was twice as likely in men (24.4%, 95% CI: 21.5-27.7) than in women (12.2%, 95% CI: 10.3-14.3). In a multivariable adjusted model, age (hazard ratio [HR] = 1.48, 95% CI: 1.38-1.59, per 5 years), male sex (HR = 2.47, 95% CI: 1.91-3.18), less than a college education (HR = 1.35, 95% CI: 1.02-1.79), body mass index (HR = 1.03, 95% CI: 1.01-1.05, per kg/m. In addition to age and sex, obesity, education, and blood cadmium levels were associated with increased incidence of HI. These prospective results add to evidence that age-related HI is a multifactorial preventable disorder.. 2b Laryngoscope, 130:1396-1401, 2020.

Topics: Adult; Aged; Aged, 80 and over; Audiometry, Pure-Tone; Cadmium; Female; Hearing Loss; Humans; Incidence; Lead; Longitudinal Studies; Male; Middle Aged; Obesity; Proportional Hazards Models; Prospective Studies; Risk Factors; Vitamin B 12; Vitamin D; Young Adult

Research in humans and mice suggests that obesity influences the abundance and diversity of gastrointestinal (GI) microbiota, and that an "obese microbiome" influences energy metabolism and fat storage in the host. Microbiota membership and composition have been previously assessed in healthy cats. However, research investigating the effects of obesity and weight loss on the cat's fecal microbiota is limited. Therefore, this study's objective was to evaluate differences in fecal microbial abundance and biodiversity, as well as serum cobalamin and folate concentrations in obese cats, before and after weight loss, and compare to lean cats. Fourteen lean and 17 obese healthy client-owned cats were fed a veterinary therapeutic weight loss food at maintenance energy requirement for 4 weeks. At the end of week 4, lean cats finished the study, whereas obese cats continued with a 10-week weight loss period on the same food, fed at individually-tailored weight loss energy requirements. Body weight and body condition score were recorded every 2 weeks throughout the study. At the end of each period, a fecal sample and food-consumption records were obtained from the owners, and serum cobalamin and folate concentrations were analysed. DNA was extracted from fecal samples, polymerase chain reaction (PCR) was performed, and products were sequenced using next-generation sequencing (Illumina MiSeq).. No significant differences in the relative abundance of taxa and in biodiversity indices were observed between cats in either group (P > 0.05 for all tests). Nevertheless, some significantly enriched taxa, mainly belonging to Firmicutes, were noted in linear discriminant analysis effect size test in obese cats before weight loss compared to lean cats. Serum cobalamin concentrations were significantly higher in lean compared to obese cats both before and after weight loss. Serum folate concentrations were higher in obese cats before weight loss compared to after.. The association between feline obesity and the fecal bacterial microbiota was demonstrated in enriched taxa in obese cats compared to lean cats, which may be related to enhanced efficiency of energy-harvesting. However, in obese cats, the fecal microbial abundance and biodiversity were only minimally affected during the early phase of a standardized weight loss plan.

Topics: Animal Feed; Animals; Biodiversity; Cats; Diet Therapy; Feces; Folic Acid; Gastrointestinal Microbiome; Obesity; Vitamin B 12; Weight Loss

(1) Background: Aspects of the Mongolian food supply, including high availability of animal-source foods and few plant foods, are plausibly associated with disease in the population. Data on Mongolian diets are lacking, and these risks are poorly quantified. The purpose of this study was to provide a multifaceted nutritional analysis of the modern Mongolian diet. (2) Methods: The study population consisted of 167 male and 167 female healthy non-pregnant urban and nomadic adults (22-55 years) randomly selected from lists of residents in 8 regions. From 2011-2016, 3-day weighed diet records and serum were collected twice from each participant in summer and winter; anthropometry was collected once from each participant. Serum was analyzed for biomarkers, and nutrient intake computed using purpose-built food composition data and adjusted for within-person variation. Exploratory dietary patterns were derived and analyzed for associations with diet and nutrition measurements. (3) Results: We collected 1838 of an expected 1986 diet records (92.5%), 610/658 serum samples (92.7%), and 315/334 height and weight measurements (94.3%). Sixty-one percent of men and 51% of women were overweight or obese. Consumption of red meat, refined grains, and whole-fat dairy was high, while that of fruits, non-tuberous vegetables, eggs, nuts and seeds, fish and poultry, and whole grains was low. Dairy and red meat were more consumed in summer and winter, respectively. Dietary inadequacy of 10 of 21 assessed nutrients, including fiber, folate, and vitamin D were >50% prevalent, while protein, zinc, and vitamin B12 inadequacy were low. Biochemical evidence of iron and vitamin A deficiency was also low. Three dietary patterns (Urban, Transitional, Nomadic) explained 41% of variation in food consumption. The Urban pattern was positively associated with BMI in multivariate analysis. (4) Conclusions: Results indicate a high prevalence of key dietary inadequacies and overweight among Mongolian adults. Prior studies by our group have suggested that expanded supplementation and food fortification would be effective in addressing micronutrient inadequacies; these strategies should be coupled with measures to mitigate the growing burden of chronic disease.

Topics: Adult; Biomarkers; Diet; Diet Records; Diet Surveys; Dietary Fats; Dietary Fiber; Energy Intake; Female; Folic Acid; Food Supply; Food, Fortified; Fruit; Humans; Male; Micronutrients; Middle Aged; Mongolia; Nutritional Status; Obesity; Vegetables; Vitamin B 12; Vitamins; Young Adult

An abnormal lipid profile is an independent risk factor for cardiovascular diseases. The relationship between vitamin B12 deficiency and lipid profile is inconclusive, with most studies conducted in unhealthy populations. In this study, we aimed to assess the relationship between serum vitamin B12 levels and lipid profiles in a cross-sectional study that included 341 apparently healthy Saudi women, aged 19-30 years, from different colleges at King Saud University, Saudi Arabia. Sociodemographic, anthropometric, biochemical, and lifestyle data were collected, including diet and physical activity. Serum vitamin B12 deficiency was defined as serum B12 level of <148 pmol/L. The prevalence of vitamin B12 deficiency was approximately 0.6%. Using multivariable linear regression models, serum vitamin B12 levels were found to be inversely associated with total cholesterol (B = -0.26;

Topics: Adult; Age Factors; Body Mass Index; Cardiovascular Diseases; Cross-Sectional Studies; Female; Healthy Volunteers; Humans; Lipid Metabolism; Obesity; Risk Factors; Saudi Arabia; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

: Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period.. To investigate nutritional status in 10 years follow-up.. : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records.. : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake.. : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.

Topics: Adult; Body Mass Index; Female; Folic Acid; Follow-Up Studies; Gastric Bypass; Humans; Iron; Longitudinal Studies; Male; Middle Aged; Nutrition Disorders; Nutritional Status; Obesity; Phenotype; Postoperative Period; Retrospective Studies; Treatment Outcome; Vitamin B 12; Weight Loss

To investigate the correlation of seminal plasma homocysteine (Hcy) and its metabolic factors folate (FA) and cobalamin (VB12) with semen quality in obese men.. We randomly selected 83 male patients with idiopathic infertility for this study and, according to the body mass index (BMI), divided them into a normal BMI (n = 28), an overweight (n = 28) and an obesity group (n = 27). We determined the levels of Hcy, FA and VB12 in the seminal plasma by ELISA and analyzed their correlation with the semen parameters of the patients in different groups.. Compared with the normal BMI group, the obese males showed significant decreases in the semen volume (［3.23 ± 0.86］ vs ［2.58 ± 0.77］ ml, P < 0.05), total sperm count (［191.35 ± 103.00］ vs ［121.55 ± 88.08］ ×106, P < 0.05), percentage of progressively motile sperm (［52.88 ± 15.58］ % vs ［38.97 ± 16.52］ %, P < 0.05), seminal plasma Hcy (［7.41 ± 1.29］ vs ［6.62 ± 0.85］ μmol/L, P < 0.05), and VB12 (［282.41 ± 30.38］ vs ［230.07 ± 37.75］ pmol/L, P < 0.05). There were no statistically significant differences in the semen parameters between the overweight group and the normal BMI or the obese group (P > 0.05), or in sperm concentration or the FA level among the three groups of patients (P > 0.05). The levels of seminal plasma Hcy and VB12 were correlated positively with the semen volume (r = 0.281 and 0.242, P < 0.05) and total sperm count (r = 0.229 and 0.258, P < 0.05) but negatively with BMI (r = －0.293 and －0.238, P < 0.05). No correlation, however, was found either between sperm concentration and the percentage of progressively motile sperm (P > 0.05) or between the FA level and BMI or semen parameters (P > 0.05).. The levels of seminal plasma Hcy and VB12 are correlated with BMI, semen volume and total sperm count, which suggests that the concentrations of seminal plasma Hcy and VB12 may be associated with the fertility of obese men.

Topics: Folic Acid; Homocysteine; Humans; Infertility, Male; Male; Obesity; Semen; Semen Analysis; Sperm Count; Sperm Motility; Spermatozoa; Vitamin B 12

Many surgeons believe mini gastric bypass (MGB) is more likely to cause micronutrient malabsorption compared to Roux-en-Y gastric bypass (RYGB). Till date, there is no published study evaluating haematological indices and haematinic levels in patients undergoing MGB and comparing these with a matched cohort of RYGB. Two hundred patients who underwent MGB between October 2012 and October 2015 were matched to 200 patients who underwent RYGB for age, sex, body mass index and time of surgery. We then compared haemoglobin, mean corpuscular volume, iron, ferritin, vitamin B12 and folic acid levels preoperatively and at 6 monthly intervals after surgery until 2 years. The percentage total weight loss was significantly higher in the MGB group compared to the RYGB group at all time points. At 2 years, MGB and RYGB both led to an increase in anaemia rates but the difference was only significant for MGB group. Compared to RYGB, MGB patients were more likely to be anaemic at 2 years, although the difference was not significant statistically (16.6% vs. 12.7%; P value = 0.55). There was a trend for lower iron and folate levels in MGB group compared to RYGB group but the difference was statistically significant at some of the time periods only (significantly lower folate at 6 and 12 months and lower iron at 6 months in the MGB group). MGB leads to a significant increase in anaemia rates in a supplemented cohort. There is a trend towards lower iron and folate levels and higher anaemia rates in MGB group in comparison with RYGB. Larger studies with longer follow-up should evaluate results of MGB with a shorter biliopancreatic limb.

Topics: Adult; Anemia; Biomarkers; Databases, Factual; England; Erythrocyte Indices; Female; Ferritins; Folic Acid; Gastric Bypass; Hemoglobins; Humans; Incidence; Iron; Male; Middle Aged; Nutritional Status; Obesity; Prevalence; Time Factors; Treatment Outcome; Vitamin B 12

In obesity, low levels of vitamin D (VD) and vitamin B12 (VB12) may be the result of different pathophysiological mechanisms, but the possible association between them has not been defined yet. The aim of this cross-sectional analysis was to investigate the possible relationship between serum 25-hydroxyvitamin D (25(OH)D) and VB12 levels in middle aged women.. In 80 women, we indirectly evaluated body composition and body volumes [extracellular fluid volume (ECV) and total body water (TBW)] by anthropometric and bioelectrical impedance analysis. Vitamin D and VB12 status was assessed by laboratory measurement [serum 25(OH)D levels by electrochemiluminescent immunoassay; VB12 by chemiluminescent microparticle immunoassay].. Obese women were mostly VD deficient [25(OH)D below 50 nmol/L; 40/50, 80%]. Also, among obese we observed presence of VB12 deficiency [VB12 below 148 pmol/L; 13/50, 26%) and marginal depletion of VB12 level (marginal VB12 status 148-221 pmol/L; 20/50, 40%). All anthropometric indicators of obesity, ECV and TBW were significantly associated with both, 25(OH)D and VB12 (P<0.001) levels. In univariate regression analysis serum level of 25(OH)D was significantly associated with VB12 levels (R2=0.170, P<0.001). In regression models, 25(OH)D was significantly associated with VB12 level, independently of fat mass and extracellular fluid volume.. Obesity may negatively affect VB12 level, indirectly, by reducing 25(OH)D level in middle aged women.

Topics: Adult; Cross-Sectional Studies; Female; Humans; Middle Aged; Obesity; Vitamin B 12; Vitamin D

Anxiety and depression levels are higher in obese compared to those in normal weight pregnant women. The aims of this study are to examine anxiety and depression in pregnancy following bariatric surgery and to compare with obese pregnant controls considering the dietary intake of polyunsaturated fatty acids (PUFA), folate, and vitamin B. Anxiety (State-Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale) were examined in the first (T1) and third (T3) pregnancy trimester in 54 women with bariatric surgery and 25 obese. T1 and T3 dietary intake of PUFA, folate, and vitamin B. About half of the women with surgery had high state and trait anxiety scores (≥ 40), which did not significantly change during pregnancy. Every 10-kg postoperative weight loss was associated with an increase in T1 state and trait anxiety with respectively 2.7 and 2.3 points. A smoking woman had a 8.6-point higher state anxiety score than a non-smoking woman in T1. In T3, every additional hour of sleep was associated with a decrease in trait anxiety score with 1.59 points. Anxiety and depression scores were not associated with and could not be explained by inadequate PUFAs, folate, and vitamin B. Pregnancy following bariatric surgery induces high levels of anxiety that are not associated with an inadequate maternal diet.

Topics: Anxiety; Bariatric Surgery; Depression; Diet; Fatty Acids, Unsaturated; Female; Folic Acid; Humans; Obesity; Pregnancy; Pregnancy Complications; Prospective Studies; Vitamin B 12

Endobarrier® is a minimally invasive, reversible endoscopic treatment for obesity. It provokes malabsorption along 60 cm of the small intestine, which can contribute to the development of vitamin deficiencies and to changes in bone mineral density (BMD). To determine the prevalence of nutrient deficiencies, changes in body composition and BMD during the first year after Endobarrier® placement. Twenty-one patients with type 2 diabetes met inclusion criteria. Levels of vitamins, micro and macronutrients were assessed prior and at 1, 3 and 12 months post-operatively. DEXA was performed before and 12 months after implant. Nineteen patients completed the 12 months follow-up. Vitamin D deficiency was the most prevalent finding before Endobarrier® implant. The percentage of patients with severe deficiency decreased from 19 to 5% at 12 months after supplementation. Microcytic anaemia was initially present in 9.5% of patients and increased to 26.3% at 12 months. Low ferritin and vitamin B12 levels were observed in 14.2 and 4.8% of patients before the implant and worsened to 42 and 10.5%. Low concentrations of magnesium and phosphorus were also common but improved along the study. A significant but not clinically relevant decrease in BMD of 4.14 ± 4.0% at the femoral neck was observed at 12 months without changes in osteocalcin levels. Vitamin deficiencies are common after Endobarrier® implant. It is therefore important to screen patients prior to and at regular intervals after the implant, and to encourage adherence to diet counselling and supplementation.

Topics: Anemia; Avitaminosis; Bone Density; Deficiency Diseases; Diabetes Mellitus, Type 2; Female; Femur Neck; Ferritins; Humans; Intestinal Absorption; Intestine, Small; Magnesium; Male; Middle Aged; Obesity; Phosphorus; Prostheses and Implants; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

Micronutrient deficiency is a global health burden, especially among developing countries. The present cross-sectional study aimed to determine the prevalence of vitamin B. A total of 2403 school-going adolescents (11-17 years) from National Capital Region and rural areas of Haryana, India were selected. Serum B. The prevalence of vitamin B. Vitamin B

Topics: Adolescent; Adolescent Health; Age Factors; Body Mass Index; Child; Female; Humans; India; Male; Obesity; Overweight; Rural Population; Sex Factors; Students; Urban Population; Vitamin B 12; Vitamin B 12 Deficiency

Dyslipidemia and hyper-homocysteinemia are the major independent risk factors of cardio vascular disease. Deficiency of folate and vitamin B-12 are associated with both hyper-homocysteinemia and dyslipidemia. The aim of the study is to evaluate the relationship of homocysteine and its associated dietary determinant levels (Folate and Vitamin B-12) with lipids and obesity parameters (WC, BMI, WHR) in North Indian population.. The participants were recruited under a major government funded project through household survey covering 15 villages of Haryana, India. Participants were both males and females, between age group 30-65 years, from a north Indian community. Initially 1634 individuals were recruited, of which 1374 were considered for analysis as they were not found to be on any kind of medication for high blood pressure, CAD, diabetes or any other disorder, and had no missing data. 5 mL of intravenous blood sample was collected after obtaining written informed consent from the participants. Homocysteine, folate and vitamin B12 levels were estimated through Immulite 1000 by chemi-luminescence technique. Triglyceride, total cholesterol and HDL-C were estimated by spectrophotometry technique using commercial kits. The values for LDL and VLDL were calculated using Friedwald's equation. Height, weight, waist circumference (WC), hip circumference (HC) was measured over light clothing. Statistical analysis for data was performed using SPSS 16.0 version.. All the lipid indices, except HDL, showed a trend of negative correlation with homocysteine after controlling for confounders, though not significant. No association was found between obesity (WC, BMI, WHR) and homocysteine in the present study. Vitamin B-12 deficiency was significantly associated with both hyper-homocysteinemia and low HDL. Folate was found to have significantly reduced risk for high TC & LDL.. The "hcy-lipid" hypothesis does not seem to be complementing in the present studied population. The population is vulnerable to severe under-nutrition due to the association of vitamin B-12 with HDL, leading to metabolic disturbance in both the pathways; lipid and one carbon metabolic pathway. Co-factors such as ethnicity, cultural practices, and lifestyle & dietary habits must be considered while making public health policies to control diseases.

Topics: Adult; Body Mass Index; Cholesterol, HDL; Cholesterol, LDL; Cholesterol, VLDL; Cross-Sectional Studies; Dyslipidemias; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; India; Male; Middle Aged; Obesity; Triglycerides; Vitamin B 12; Vitamin B 12 Deficiency; Waist Circumference

Adequate vitamin A is essential for healthy pregnancy, but high levels may be teratogenic. We present a patient who underwent bariatric surgery, prior to child bearing, and suffered maternal and foetal complications during eleven pregnancies, possibly associated with vitamin A deficiency, amongst multiple micronutrient deficiencies and risk factors including smoking and obesity. Maternal complications included visual disturbance, night blindness and recurrent infections. Recurrent foetal pulmonary hypoplasia and microphthalmia led to foetal and neonatal loss, not previously described in the medical literature. Current guidance on vitamin A deficiency in pregnancy is focused on developing countries where aetiology of vitamin A deficiency is different to that of women in developed countries. We describe nutritional management of the micronutritient deficiencies, focusing on vitamin A, during her last pregnancy. The need for specific antenatal nutritional guidance for pregnant women post-bariatric surgery is becoming more urgent as more mothers and offspring will be affected.

Topics: Abortion, Spontaneous; Adult; Anemia, Iron-Deficiency; Biliopancreatic Diversion; Diet; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Iron; Micronutrients; Obesity; Perinatal Death; Pregnancy; Pregnancy Complications; Premature Birth; Smoking; Vitamin A; Vitamin A Deficiency; Vitamin B 12

Iron (Fe) status of neonates born to women carrying multiple fetuses might be compromised as a consequence of the high prevalence of maternal Fe deficiency and anemia coupled with an increased risk of preterm birth. This study aimed to characterize and identify determinants of anemia in this neonatal population.. Umbilical cord blood obtained from 183 neonates was utilized to assess hemoglobin (Hb), ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, serum Fe, erythropoietin, folate, vitamin B-12, C-reactive protein, and interleukin-6. Associations with maternal Fe status were explored.. Cord Hb or SF did not change significantly as a function of gestational age at birth (25-38 wks). Neonates born to women who were obese prior to pregnancy or smoked cigarettes during pregnancy had a 4-5-fold greater odds of anemia at birth. Cord sTfR was the strongest indicator of cord Hb (P < 0.0001), and it was significantly associated with maternal sTfR at mid-gestation (P = 0.01) and delivery (P = 0.002). Cord Fe indicators were significantly associated with cord hepcidin, but not maternal hepcidin.. Screening for Fe status in neonates born to women carrying multiple fetuses is warranted, especially for those born to smokers or to women who are obese at entry into pregnancy.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; C-Reactive Protein; Cohort Studies; Erythropoietin; Female; Ferritins; Fetal Blood; Folic Acid; Hemoglobins; Hepcidins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Interleukin-6; Iron; Obesity; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Premature Birth; Receptors, Transferrin; Smoking; Tobacco Use Disorder; Vitamin B 12; Young Adult

Phellinus linteus polysaccharide (PLP) has hypoglycemic effects, but mechanisms remain unclear. Male C57BL/6 J mice were either fed a normal diet (CON) or a high-fat high-fructose diet (HFD) for 16 weeks, and starting from week 12, HFD-fed animals in PLP group were orally given PLP. PLP administration significantly reduced fasting blood glucose level and ameliorated glucose intolerance. Differentially expressed genes involved in FOXO signaling pathway and in vitamin B12 (VB12) transport were identified between HFD and PLP group. HFD decreased the phosphatidylcholine (PC) to phosphatidylethanolamine (PE) ratio and S-adenosyl methionine to S-adenosyl homocysteine ratio, which were recovered by PLP treatment. Plasma VB12 levels in HFD group was lower than CON or PLP group, and PLP stimulated the proliferation of gut bacteria in genus Porphyromonas with capability of VB12 synthesis. In conclusion, PLP administration improved insulin resistance via modifying hepatic phospholipids metabolism and rescuing insulin signaling transduction.

Topics: Animals; Basidiomycota; Diet, High-Fat; Fructose; Fungal Polysaccharides; Hypoglycemic Agents; Insulin Resistance; Intestinal Mucosa; Intestines; Liver; Male; Mice; Mice, Inbred C57BL; Microbiota; Obesity; Phosphatidylcholines; S-Adenosylmethionine; Sucrose; Vitamin B 12

There is good evidence that periconceptual Folic Acid (FA) supplementation can prevent two thirds of Neural Tube Defects (NTDs). A two-fold increase in NTD rates have been associated with maternal obesity and, based on limited evidence, national guidelines have recommended prescribing high dose FA for women with a Body Mass Index (BMI) >29.9 kg/m. Women were recruited at their convenience during their first antenatal visit to the hospital following sonographic confirmation of an ongoing pregnancy. Clinical, sociodemographic, dietary and supplementation details were collected and computerised. At the time of routine phlebotomy, samples were collected for serum folate, red blood cell (RBC) folate and plasma B12.. Our findings support existing recommendations that obese women should be prescribed higher doses of FA periconceptually. However, to prevent NTDs successfully they may also require B12 supplementation.

Topics: Adult; Body Mass Index; Dietary Supplements; Erythrocytes; Female; Folic Acid; Humans; Neural Tube Defects; Obesity; Preconception Care; Pregnancy; Pregnancy Complications; Prenatal Care; Vitamin B 12

Elevated homocysteine (Hcy) is a known cardiovascular risk factor. However, its role in intergenerational cardiometabolic risk is unknown. We hypothesized that maternal elevated Hcy can act alone or in combination with maternal prepregnancy obesity to increase child systolic blood pressure (SBP).. This study included 1279 mother-child pairs who were enrolled at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Child SBP percentile was calculated according to US reference data and elevated SBP was defined as SBP⩾75th percentile.. A U-shaped relationship between maternal Hcy and her child SBP was observed. The risk for child elevated SBP was higher among those in the lowest quartile (Q1, odds ratio (OR): 1.27; 95% confidence interval (CI): 0.94-1.72), and highest quartile (Q4, OR: 1.34; 95% CI: 1.00-1.81) as compared with those in quartiles 2 and 3. The highest risk of child elevated SBP was found among children born to obese mothers with Hcy in Q4 (OR: 2.22; 95%CI: 1.35-3.64), compared with children of non-obese mothers with Hcy in Q2-Q3. This association was independent from maternal folate and vitamin B12 status, and was not mediated by gestational age or size at birth.. In this prospective birth cohort, we observed a U-shaped association between maternal Hcy levels and child elevated SBP. Maternal high Hcy (Q4) and prepregnancy obesity jointly increased the risk of child elevated SBP by more than two-fold.

Topics: Adult; Biomarkers; Blood Pressure; Body Mass Index; Boston; Child; Child, Preschool; Female; Folic Acid; Homocysteine; Humans; Male; Mothers; Obesity; Oxidative Stress; Preconception Care; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Risk Factors; Time Factors; Vitamin B 12

Gastric bypass has been thought to be associated with a risk of gastric cancer, particularly in Asia. Sleeve gastrectomy with duodenojejunal end-to-side anastomosis (SG-DJESA) was suggested to be a better-designed procedure to avoid this risk, and it also has other advantages.. We aimed to evaluate the clinical efficacy and feasibility of SG-DJESA in the treatment of nonobese patients with type 2 diabetes (T2D).. University Hospital, China.. We present prospective data from 7 consecutive T2D patients with gastric precancerosis who underwent SG-DJESA from December 15, 2011 to June 8, 2013. The group had a mean body mass index of 27.7 kg/m. Along with a decrease in antidiabetic medication requirements, body mass index, fasting plasma glucose, 2-hour postprandial plasma glucose, and glycated hemoglobin decreased significantly at each postoperative time point, compared with the preoperative baseline (P<.05, respectively). Four patients (4/7, 57.1%) achieved a complete remission of T2D at 12 months and maintained remission at the 4-year follow-up time; 1 patient (1/7, 14.3%) achieved a partial remission at 6 months but had recurrence at 12 months postoperatively; and the other 2 patients (2/7, 28.6%) achieved improvement during the follow-up time. There were no deaths during the follow-up period. One patient had a postoperative anastomotic bleed and recovered under conservative treatment. Another patient had iron deficiency anemia 8 weeks after surgery and recovered after taking an oral iron supplement for 1 month. No other serious perioperative complications or postoperative malnutrition occurred.. SG-DJESA is an effective and safe procedure for nonobese patients with T2D and could be recommended as a treatment option for T2D patients with gastric precancerosis. A larger sample size may be required for better evaluation.

Topics: Adolescent; Adult; Aged; Anastomosis, Surgical; Bariatric Surgery; Blood Glucose; China; Diabetes Mellitus, Type 2; Duodenum; Fasting; Feasibility Studies; Female; Folic Acid; Gastrectomy; Hemoglobins; Humans; Hypertension; Jejunum; Laparoscopy; Lipid Metabolism; Male; Middle Aged; Obesity; Postoperative Complications; Prospective Studies; Transferrin; Vitamin B 12; Young Adult

Low vitamin B12 during pregnancy is associated with higher maternal obesity, insulin resistance (IR), and gestational diabetes mellitus. B12 is a key cofactor in one-carbon metabolism.. We hypothesize that B12 plays a role in epigenetic regulation by altering circulating microRNAs (miRs) during adipocyte differentiation and results in an adverse metabolic phenotype.. Human preadipocyte cell line (Chub-S7) was differentiated in various B12 concentrations: control (500 nM), low B12 (0.15 nM), and no B12 (0 nM). Maternal blood samples (n = 91) and subcutaneous adipose tissue (SAT) (n = 42) were collected at delivery. Serum B12, folate, lipids, plasma one-carbon metabolites, miR profiling, miR expression, and gene expression were measured.. Our in vitro model demonstrated that adipocytes in B12-deficient conditions accumulated more lipids, had higher triglyceride levels, and increased gene expression of adipogenesis and lipogenesis. MiR array screening revealed differential expression of 133 miRs involving several metabolic pathways (adjusted P < 0.05). Altered miR expressions were observed in 12 miRs related to adipocyte differentiation and function in adipocytes. Validation of these data in pregnant women with low B12 confirmed increased expression of adipogenic and lipogenic genes and altered miRs in SAT and altered levels of 11 of the 12 miRs in circulation. After adjustment for other possible confounders, multiple regression analysis revealed an independent association of B12 with body mass index (β: -0.264; 95% confidence interval, -0.469 to -0.058; P = 0.013) and was mediated by four circulating miRs targeting peroxisome proliferator-activated receptor γ and IR.. Low B12 levels in pregnancy alter adipose-derived circulating miRs, which may mediate an adipogenic and IR phenotype, leading to obesity.

Topics: 3T3 Cells; Adipocytes; Adipogenesis; Animals; Cells, Cultured; Circulating MicroRNA; Cross-Sectional Studies; Diabetes, Gestational; Female; Gene Expression Regulation; Humans; Insulin Resistance; Mice; Obesity; PPAR gamma; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B 12 Deficiency

The aim of this study was to explore factors affecting cardiorespiratory fitness in males and females with different body mass index (BMI).. The National Health and Nutrition Examination Survey 1999-2004 data were used for this retrospective study. Estimated maximal oxygen uptake (VO. A total of 3292 subjects 20-49 years of age were included in the analysis. CRF significantly decreased as BMI increased in both females and males. Ethnic difference was found in normal BMI in both genders and obese females; homocysteine was significantly negatively associated with estimated VO. There are different predictors of CRF in males and females, and in individuals with different BMI. Key messages Different BMI classes are associated with different predictors of cardiorespiratory fitness. Indicators of cardiorespiratory fitness differ between sexes.

Topics: Adult; Body Mass Index; C-Reactive Protein; Cardiorespiratory Fitness; Female; Folic Acid; Humans; Male; Middle Aged; Nutrition Surveys; Obesity; Oxygen; Physical Fitness; Retrospective Studies; Vitamin B 12

We have demonstrated previously that severe but not moderate vitamin B12 deficiency altered body composition and induced adiposity in female C57BL/6 mice. This study aims to elucidate the effects of chronic transgenerational dietary vitamin B12 restriction on body composition and various biochemical parameters in the F1 generation offspring of our mouse models of severe and moderate vitamin B12 deficiency established earlier. Female weanling C57BL/6 mice received, ad libitum, for 4 weeks a (i) control diet, (ii) vitamin B12-restricted diet with pectin as dietary fiber (severely deficient diet), or (iii) vitamin B12-restricted diet with cellulose as dietary fiber (moderately deficient diet) and then mated with control males. The offspring of control and severely deficient dams continued on the respective diets of their mothers. Few moderately deficient dams were rehabilitated to control diet from parturition and their pups were weaned to control diet. Also, some offspring born to moderately B12 deficient dams were weaned to control diet, while others continued on the same diet as their mothers. Various parameters were determined in the F1 offspring after 12 and 36 weeks of feeding. The results indicate that both severe and moderate maternal vitamin B12 restrictions were associated with accelerated catch-up growth, increased body fat percentage, visceral adiposity, dyslipidemia, fasting hyperglycemia and insulin resistance in the F1 offspring. Inflammation, increased glucocorticoid and oxidative stress and poor antioxidant defence probably underlie these adverse effects. Rehabilitation from parturition but not weaning was beneficial in delaying the onset of the adverse outcomes in the offspring. © 2016 BioFactors, 43(3):400-414, 2017.

Topics: Adipose Tissue; Animals; Blood Glucose; Body Composition; Diet; Dietary Fiber; Dyslipidemias; Female; Hyperglycemia; Inheritance Patterns; Insulin; Insulin Resistance; Male; Mice; Mice, Inbred C57BL; Obesity; Oxidative Stress; Pregnancy; Prenatal Exposure Delayed Effects; Severity of Illness Index; Vitamin B 12; Vitamin B 12 Deficiency

Adipose tissue plays important roles in regulating carbohydrate and lipid homeostasis, but less is known about the regulation of amino acid metabolism in adipocytes. Here we applied isotope tracing to pre-adipocytes and differentiated adipocytes to quantify the contributions of different substrates to tricarboxylic acid (TCA) metabolism and lipogenesis. In contrast to proliferating cells, which use glucose and glutamine for acetyl-coenzyme A (AcCoA) generation, differentiated adipocytes showed increased branched-chain amino acid (BCAA) catabolic flux such that leucine and isoleucine from medium and/or from protein catabolism accounted for as much as 30% of lipogenic AcCoA pools. Medium cobalamin deficiency caused methylmalonic acid accumulation and odd-chain fatty acid synthesis. Vitamin B12 supplementation reduced these metabolites and altered the balance of substrates entering mitochondria. Finally, inhibition of BCAA catabolism compromised adipogenesis. These results quantitatively highlight the contribution of BCAAs to adipocyte metabolism and suggest that BCAA catabolism has a functional role in adipocyte differentiation.

Topics: 3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide); 3T3-L1 Cells; Acetyl Coenzyme A; Adipocytes; Adipogenesis; Adipose Tissue; Amino Acids, Branched-Chain; Animals; Base Sequence; Cell Differentiation; Humans; Lipogenesis; Mice; Molecular Sequence Data; Obesity; Tricarboxylic Acids; Vitamin B 12

Topics: Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Aldehyde Dehydrogenase; AMP-Activated Protein Kinases; Anastomosis, Surgical; Animals; Bariatric Surgery; Betaine-Homocysteine S-Methyltransferase; Blood Glucose; Cystathionine; Cystathionine beta-Synthase; Cysteine; Duodenum; Fatty Acids; Gastric Bypass; Glucose; Glutathione; Glutathione Transferase; Guanine Deaminase; Hypoxanthine; Inosine Monophosphate; Jejunum; Liver; Male; Metabolomics; Obesity; Oxidation-Reduction; Phosphorylation; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Serine; Vitamin B 12

Previous reports have linked maternal prepregnancy obesity with low folate concentrations and child overweight or obesity (OWO) in separate studies. To our knowledge, the role of maternal folate concentrations, alone or in combination with maternal OWO, in child metabolic health has not been examined in a prospective birth cohort.. To test the hypotheses that maternal folate concentrations can significantly affect child metabolic health and that sufficient maternal folate concentrations can mitigate prepregnancy obesity-induced child metabolic risk.. This prospective birth cohort study was conducted at the Boston Medical Center, Boston, Massachusetts. It included 1517 mother-child dyads recruited at birth from 1998 to 2012 and followed up prospectively up to 9 years from 2003 to 2014.. Child body mass index z score calculated according to US reference data, OWO defined as a body mass index in the 85th percentile or greater for age and sex, and metabolic biomarkers (leptin, insulin, and adiponectin).. The mean (SD) age was 28.6 (6.5) years for mothers and 6.2 (2.4) years for the children. An L-shaped association between maternal folate concentrations and child OWO was observed: the risk for OWO was higher among those in the lowest quartile (Q1) as compared with those in Q2 through Q4, with an odds ratio of 1.45 (95% CI, 1.13-1.87). The highest risk for child OWO was found among children of obese mothers with low folate concentrations (odds ratio, 3.05; 95% CI, 1.91-4.86) compared with children of normal-weight mothers with folate concentrations in Q2 through Q4 after accounting for multiple covariables. Among children of obese mothers, their risk for OWO was associated with a 43% reduction (odds ratio, 0.57; 95% CI, 0.34-0.95) if their mothers had folate concentrations in Q2 through Q4 compared with Q1. Similar patterns were observed for child metabolic biomarkers.. In this urban low-income prospective birth cohort, we demonstrated an L-shaped association between maternal plasma folate concentrations and child OWO and the benefit of sufficient folate concentrations, especially among obese mothers. The threshold concentration identified in this study exceeded the clinical definition of folate deficiency, which was primarily based on the hematological effect of folate. Our findings underscore the need to establish optimal rather than minimal folate concentrations for preventing adverse metabolic outcomes in the offspring.

Topics: Adult; Biomarkers; Body Mass Index; Boston; Child; Child, Preschool; Female; Folic Acid; Humans; Insulin; Leptin; Male; Metabolic Diseases; Obesity; Overweight; Pediatric Obesity; Preconception Care; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Prospective Studies; Vitamin B 12

To evaluate vitamin B12 and folate status in pregnancy and their relationship with maternal obesity, gestational diabetes mellitus (GDM), and offspring birthweight.. A retrospective case-control study of 344 women (143 GDM, 201 no-GDM) attending a district general hospital and that had B12 and folate levels measured in the early 3rd trimester was performed. Maternal history including early pregnancy body mass index (BMI) and neonatal data (birthweight, sex, and gestational age) was recorded for all subjects.. 26% of the cohort had B12 levels <150 pmol/L (32% vs. 22% in the two groups respectively,. This is the first study from the UK to show that maternal B12 levels are associated with BMI, risk of GDM, and additionally may have an independent effect on macrosomia. Due to the increasing burden of maternal obesity and GDM, longitudinal studies with B12 measurements in early pregnancy are needed to explore this link.

Topics: Adult; Body Mass Index; Case-Control Studies; Cohort Studies; Diabetes Complications; Diabetes, Gestational; Female; Fetal Macrosomia; Hospitals, District; Hospitals, General; Humans; Maternal Nutritional Physiological Phenomena; Nutritional Status; Obesity; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Retrospective Studies; Risk; United Kingdom; Vitamin B 12; Vitamin B 12 Deficiency

High multivitamin (HV, tenfold AIN-93G) gestational diets fed to Wistar rats increase food intake, obesity, and characteristics of metabolic syndrome in the offspring. We hypothesized that methyl vitamins, and specifically folate, in the HV gestational diet contribute to the obesogenic phenotypes consistent with their epigenetic effects on hypothalamic food intake regulatory mechanisms.. Male offspring of dams fed the AIN-93G diet with high methyl vitamins (HMethyl; tenfold folate, vitamins B12, and B6) (Study 1) and HV with recommended folate (HVRF) (Study 2) were compared with those from HV and recommended vitamin (RV) fed dams. All offspring were weaned to a high fat diet for 8 wks. HMethyl diet, similar to HV, and compared to RV, resulted in higher food intake, body weight, and metabolic disturbances. Removing folate additions to the HV diet in HVRF offspring normalized the obesogenic phenotype. Methyl vitamins, and folate in HV diets, altered hypothalamic gene expression toward increased food intake concurrent with DNA methylation and leptin and insulin receptor signaling dysfunction.. Methyl vitamins in HV gestational diets contribute to obesogenic phenotypes and epigenetic alterations in the hypothalamic feeding pathways in the offspring. Folate alone accounts for many of these effects.

Topics: Adipose Tissue; Animals; Diet; Diet, High-Fat; DNA Methylation; Eating; Epigenesis, Genetic; Female; Folic Acid; Gene Expression Regulation; Hypothalamus; Leptin; Male; Maternal Nutritional Physiological Phenomena; Obesity; Pregnancy; Prenatal Exposure Delayed Effects; Rats, Wistar; Vitamin B 12; Vitamins; Weaning

The first epigenome-wide association study of BMI identified DNA methylation at an HIF3A locus associated with BMI. We tested the hypothesis that DNA methylation variants are associated with BMI according to intake of B vitamins. In two large cohorts, we found significant interactions between the DNA methylation-associated HIF3A single nucleotide polymorphism (SNP) rs3826795 and intake of B vitamins on 10-year changes in BMI. The association between rs3826795 and BMI changes consistently increased across the tertiles of total vitamin B2 and B12 intake (all P for interaction <0.01). The differences in the BMI changes per increment of minor allele were -0.10 (SE 0.06), -0.01 (SE 0.06), and 0.12 (SE 0.07) within subgroups defined by increasing tertiles of total vitamin B2 intake and -0.10 (SE 0.06), -0.01 (SE 0.06), and 0.10 (SE 0.07) within subgroups defined by increasing tertiles of total vitamin B12 intake. In two independent cohorts, a DNA methylation variant in HIF3A was associated with BMI changes through interactions with total or supplemental vitamin B2, vitamin B12, and folate. These findings suggest a potential causal relation between DNA methylation and adiposity.

Topics: Adult; Aged; Apoptosis Regulatory Proteins; Basic Helix-Loop-Helix Transcription Factors; Body Mass Index; Cohort Studies; Diet; DNA Methylation; Female; Folic Acid; Gene-Environment Interaction; Humans; Longitudinal Studies; Male; Middle Aged; Obesity; Overweight; Polymorphism, Single Nucleotide; Prospective Studies; Repressor Proteins; Riboflavin; United Kingdom; United States; Vitamin B 12; Vitamin B 6; Vitamin B Complex; Weight Gain

Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and folate at 28 weeks' gestation with maternal adiposity and related biochemical markers in a white non diabetic UK obstetric cohort.. Anthropometry and biochemistry data was available on 995 women recruited at 28 weeks gestation to the Exeter Family Study of Childhood Health. Associations between B12 and folate with maternal BMI and other obesity-related biochemical factors (HOMA-R, fasting glucose, triglycerides, HDL and AST) were explored using regression analysis, adjusting for potential confounders (socioeconomic status, vegetarian diet, vitamin supplementation, parity, haemodilution (haematocrit)).. Higher 28 week BMI was associated with lower circulating vitamin B12 (r = -0.25; P<0.001) and folate (r = -0.15; P<0.001). In multiple regression analysis higher 28 week BMI remained an independent predictor of lower circulating B12 (β (95% CI) = -0.59 (-0.74, -0.44) i.e. for every 1% increase in BMI there was a 0.6% decrease in circulating B12). Other markers of adiposity/body fat metabolism (HOMA-R, triglycerides and AST) were also independently associated with circulating B12. In a similar multiple regression AST was the only independent obesity-related marker associated with serum folate (β (95% CI) = 0.16 (0.21, 0.51)).. In conclusion, our study has replicated the previous Indian findings of associations between lower serum B12 and higher obesity and insulin resistance during pregnancy in a non-diabetic White British population. These findings may have important implications for fetal and maternal health in obese pregnancies.

Topics: Adiposity; Cross-Sectional Studies; Diet; Diet, Vegetarian; Dietary Supplements; Female; Folic Acid; Humans; Insulin Resistance; Life Style; Lipoproteins, HDL; Obesity; Pregnancy; Pregnancy Complications; Triglycerides; United Kingdom; Vitamin B 12; Vitamin B 12 Deficiency; White People

Methyl donor supplementation has been reported to prevent obesity-induced liver fat accumulation in adult rats. We hypothesized that this protection could be mediated by perinatal nutrition. For this purpose, we assessed the response to an obesogenic diet (high-fat-sucrose, HFS) during adulthood depending on maternal diet during lactation. Female Wistar rats fed control diet during pregnancy were assigned to four postpartum dietary groups: control, control supplemented with methyl donors (choline, betaine, folic acid, vitamin B12), HFS and HFS supplemented with methyl donors. At weaning, the male offspring was transferred to a chow diet and at week 12th assigned to a control or a HFS diet during 8 weeks. The offspring whose mothers were fed HFS during lactation showed increased adiposity (19%, P<0.001). When fed the HFS diet as adults, offspring whose mothers were HFS supplemented had more body fat (23%, P<0.001) than those from HFS non-supplemented. However, they showed lower liver fat accumulation (-18%, P<0.001). Srebf1, Dnmt1 and Lepr liver mRNA levels increased after adulthood HFS feeding. In those animals HFS fed during adulthood, previous maternal HFS decreased Lepr and Dnmt1 expression levels when compared with c-HFS offspring, while the supplementation of control and HFS-fed dams, respectively, induced higher hepatic Mme and Lepr mRNA levels after adult HFS intake compared with hfs-HFS offspring. In conclusion, maternal HFS diet during lactation influenced the response to an obesogenic diet in the adult progeny. Interestingly, dietary methyl donor supplementation in lactating mothers fed an obesogenic diet reduced liver fat accumulation, but increased adipose tissue storage in adult HFS-fed offspring.

Topics: Adipose Tissue; Animals; Betaine; Body Composition; Choline; Diet; Diet, High-Fat; Dietary Sucrose; Dietary Supplements; DNA (Cytosine-5-)-Methyltransferase 1; DNA Methylation; Female; Folic Acid; Gene Expression; Lactation; Liver; Male; Maternal Nutritional Physiological Phenomena; Obesity; Pregnancy; Rats; Rats, Wistar; Receptors, Leptin; RNA, Messenger; Vitamin B 12

This study aimed to describe the nutritional status of elderly people living in a rural area of North China.. Community-based, cross-sectional prevalence survey.. 3 rural towns of Lvliang City, Shanxi Province, China.. A sample of 1845 community residents (29.1% of those eligible) 55 years or older (birth before 1958-01-01).. The participants were assessed regarding demographic characteristics, height, weight, as well as having a physical examination and blood sampling for serum cholesterol, total homocysteine (tHcy), folate, and vitamin B12 levels.. 991 (53.7%) were female and 139 (7.5%) did not complete the anthropometric measurement. Prevalence of underweight and obesity was 3.5% and 24.9% in men and 6.7% and 31.0% in women (P = 0.003, P = 0.005, respectively). Prevalence of hypercholesterolemia and hypocholesterolemia was 13.5% and 52.6% in men and 25.0% and 34.3% in women (P < 0.001, P < 0.001, respectively). Prevalence of high LDL-c concentrations was 8.8% in men and 16.8% in women (P < 0.001). The mean serum tHcy in men (28.8 ± 20.1 μmmol/l) was significantly higher than in women (21.0 ± 15.1 μmmol/L, P < 0.001). Prevalence of hyperhomocysteinemia (defined as > 15μmmol/L) was 79.7% in men and 65.5% in women (P < 0.001). Prevalence of low folate (defined as < 11 nmol/L) and vitamin B12 levels (defiend as < 185 pmol/L) was 70.8 % and 76.8% in men and 56.5% and 72.6% in women (P < 0.001, P = 0.036, respectively). Correlation coefficients between tHcy, folate, and vitamin B12 indicated an inverse linear correlation (r = -0.21, P < 0.001, r = -0.35, P < 0.001, respectively).. As China's economic climate has developed, the nutritional status of elderly people in the rural parts of the country has improved in some aspects. However, the trend toward obesity will lead to a shift in the burden of obesity-related chronic diseases. In addition, rurally-located elderly people are at high risk of death that may be associated with abnormal serum cholesterol. The data also suggest that severe deficiencies in folate and vitamin B12 levels exist, as well as there being a high prevalence of hyperhomocysteinemia. Folate and vitamin B12 supplementation are necessary to prevent related diseases.

Topics: Aged; Aged, 80 and over; Body Mass Index; China; Cholesterol; Cross-Sectional Studies; Dietary Supplements; Female; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Nutrition Surveys; Nutritional Status; Obesity; Prevalence; Rural Health; Rural Population; Thinness; Vitamin B 12; Vitamin B 12 Deficiency

Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery.. To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery.. A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy.. The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies.. Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.

Topics: Adolescent; Adult; Anemia; Bariatric Surgery; Cholecalciferol; Cohort Studies; Dietary Supplements; Female; Folic Acid; Humans; Micronutrients; Obesity; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Prospective Studies; Vitamin A; Vitamin B 12; Vitamin D Deficiency; Vitamins; Young Adult

To investigate correlation of vitamin B12 with obesity insulin resistance, metabolic syndrome.. The cross-sectional and primary care-based study was carried out. Anthropometric, blood pressure measurements and bioelectric impedance analysis (BIA) were recorded. Vitamin B12, folic acid, hemogram, insulin, ferritin, iron, total iron binding capacity and other biochemical tests were assayed. The subjects were grouped as obesity, overweight, control, metabolic syndrome (MetS) and insulin resistance (IR). Correlation of vitamin B12 with body mass index (BMI), IR, age, and BIA was evaluated.. The study enrolled 976 patients (obesity: 414, overweight: 212, and control: 351). The mean age in groups of obesity, overweight and control were 35.9 ± 8.7, 28.9 ± 6.3 and 33.1 ± 8.7, respectively (p = 0.142). Vitamin B12 level was significantly lower in patients with obesity and overweight than healthy individuals (178.9 ± 25.2; 219.8 ± 78.5, and 328.5 ± 120.5, p less than 0.001, respectively). Vitamin B12 level was lower in patients with MetS (+/-) and IR (+/-), but insignificant (p = 0.075 and 0.058, respectively). Significant and negative correlation was observed between vitamin B12 and BMI (r =-0.221, p=0.001). No significant difference was observed between obese male and female patients (247.8 ± 89.1 versus 235.5 ± 89.3 pg/mL, respectively, p=0.090).. Low Vitamin B12 level was associated with obesity and overweight, but not with insulin resistance, metabolic syndrome and gender. Vitamin B12 was negatively correlated only with body mass index.

Topics: Adipose Tissue; Body Mass Index; Cross-Sectional Studies; Humans; Insulin Resistance; Metabolic Syndrome; Obesity; Overweight; Primary Health Care; Vitamin B 12

Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD). This study aimed to assess the nutritional and vitamin/mineral status of current "early diagnosed" untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± 15.1 years) and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations. Nutritional status and serum concentrations of folic acid, vitamin A, B₆, B₁₂, and (25-hydroxy) D, zinc, haemoglobin (Hb) and ferritin were determined (before prescribing gluten free diet). Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B₆ 14.5%, folic acid 20%, and vitamin B₁₂ 19%. Likewise, zinc deficiency was observed in 67% of the CD-patients, 46% had decreased iron storage, and 32% had anaemia. Overall, 17% were malnourished (>10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients were overweight (BMI > 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B₁₂. Vitamin/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. In conclusion, vitamin/mineral deficiencies are still common in newly "early diagnosed" CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.

Topics: Adolescent; Adult; Aged; Body Mass Index; Case-Control Studies; Celiac Disease; Cohort Studies; Diet, Gluten-Free; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Male; Micronutrients; Middle Aged; Netherlands; Nutritional Status; Obesity; Prevalence; Vitamin A; Vitamin B 12; Vitamin B 6; Vitamin D; Weight Loss; Young Adult; Zinc

Oxidative stress is a key factor in the development of the principal comorbidities of obesity. Methylenetetrahydrofolate reductase enzyme (MTHFR) participates in the metabolism of folate with the action of vitamins B6 and B12. The gene of MTHFR may present a single nucleotide polymorphism (SNP) at position 677 (C677T), which can promote homocysteinemia associated to the production of free radicals.. To determine the frequency of SNP C677T of the MTHFR, evaluate the consumption of vitamins B6, B9, B12 and determine the concentration of plasma lipid hydroperoxides (LOOH) in obese and control groups.. 128 Mexican mestizo according to their body mass index were classified as normal weight (Nw; n=75) and obesity (ObeI-III; n=53). Identification of SNP C677T of MTHFR was performed by PCR-RFLP technic. The consumption of vitamins B6, B9 and B12 was assessed by a validate survey. LOOH was determined as an indicator of peripheral oxidative stress.. There was no statistical difference in the frequency of the C677T polymorphism between the TT homozygous genotype in Nw (0.19) and ObeI-III (0.25). The frequency of T allele in Nw was 0.45 and 0.51 in ObI-III group. There were no statistical differences in the consumption of vitamins B6, B9 and B12 between Nw and ObI-III groups. The LOOH showed statistical difference (p < 0.05) between Nw and ObI–III group.. Oxidative stress is present in all grades of obesity although there were no differences in the vitamin consumption and the SNP C677T between Nw and ObeI–III groups.. Introducción. El estrés oxidativo es un factor clave en el inicio y el desarrollo de las comorbilidades de la obesidad. La enzima metiltetrahidrofolato reductasa (MTHFR) participa en el metabolismo del folato con la acción de las vitaminas B9 y B12. El gen MTHFR puede presentar un polimorfismo de un solo nucleótido (SNP) en la posición 677 (C677T), que puede promover homocisteinemia asociada a la producción de radicales libres. Objetivo. Determinar la frecuencia del SNP C677T de la MTHFR, evaluar el consumo de vitaminas B6, B9, B12 y determinar la concentración de hidroperóxidos lipídicos (LOOH) en plasma en un grupo de obesos y testigo. Métodos. Se clasificaron 128 mexicanos mestizos de acuerdo a su índice de masa corporal en normopeso (Nw; n=75) y obesidad (ObeI-III; n=53). Se identificó el SNP C677T de la MTHFR mediante la técnica de PCR-RFLP. El consumo de vitaminas B6, B9 y B12 se evaluó mediante una encuesta validada. Se determinaron LOOH como un indicador de estrés oxidativo periférico. Resultados. No hubo diferencia estadística significativa en la frecuencia del polimorfismo C677T entre homocigotos TT en Nw (0.19) y ObeI-III (0.25). La frecuencia del alelo T en Nw fue de 0.45, y 0.51 en el grupo ObeI-III. Los LOOH mostraron diferencia estadística significativa (p.

Topics: Adolescent; Adult; Female; Folic Acid; Gene Frequency; Humans; Lipid Peroxides; Male; Methylenetetrahydrofolate Reductase (NADPH2); Mexico; Middle Aged; Obesity; Polymorphism, Genetic; Prevalence; Vitamin B 12; Vitamin B 6; Young Adult

Plasma cobalamin is requested in order to diagnose cobalamin deficiency and low levels confirm a deficient state. Here, we present three family members with unexpected high levels of cobalamin.. We included a patient referred for cobalamin measurement due to neurological symptoms, her son and her daughter. Mother and son both suffered from myotonic dystrophy type II, while the daughter tested negative for this disease. Blood samples were analyzed for cobalamin, haptocorrin, transcobalamin, holoTC, and sCD320. We employed gel filtration and antibody precipitation for further characterization. The protein coding region of the TCN2 gene, encoding transcobalamin, was sequenced.. The patient, her {son} and [daughter] all had cobalamin levels above the measurement range of the routine method employed (>1476 pmol/L). Total transcobalamin and (holoTC) were 5980 (1500), {5260 (2410)} and [5630 (1340)] pmol/L, which is well above the upper reference limits of 1500 (160) pmol/L. The sCD320 concentration was also well above the upper reference limit of 97 arb.u.: 1340, {1510} and [1090] arb.u. Haptocorrin levels were within the reference range and no signs of cobalamin deficiency were found. DNA sequencing of the TCN2 gene revealed several known polymorphisms not associated with highly elevated transcobalamin levels. Upon gel filtration, sCD320 eluted as a larger molecule than previously reported. By incubation with anti-transcobalamin antibodies, we precipitated both transcobalamin and part of sCD320.. The high cobalamin levels were mainly explained by high levels of holoTC, possibly caused by complex formation with its soluble receptor, sCD320. The family occurrence points to a genetic explanation.

Topics: Adult; Antigens, CD; Chromatography, Gel; Diabetes Mellitus, Type 2; Enzyme-Linked Immunosorbent Assay; Female; Heterozygote; Humans; Male; Middle Aged; Myotonic Disorders; Myotonic Dystrophy; Obesity; Promoter Regions, Genetic; Receptors, Cell Surface; Sequence Analysis, DNA; Transcobalamins; Vitamin B 12; Young Adult

Asian Indians are an at-risk group for vitamin B12 deficiency (because of vegetarianism) and insulin resistance (IR). Vegetarianism and consequent vitamin B12 deficiency may be associated with IR. This study aimed to describe the vitamin B12 status of predominantly overweight/obese women of South Asian origin living in Auckland and to correlate serum vitamin B12 and vegetarian status with IR as part of the larger Surya Study looking at health and lifestyle in this population.. This was a cross-sectional study of 135 women at least 20 y of age who were not taking vitamin B supplements or medications that could affect vitamin B12 concentrations (serum vitamin B12 < 800 pmol/L). Data collection included serum vitamin B12, serum folate, measurements of IR (HOMA2-IR), and anthropometry. Vegetarian status was established for 124 subjects (90 non-vegetarians, 34 vegetarians).. Mean serum vitamin B12 was 227 pmol/L (95% confidence interval 210-245), serum folate was 19.1 nmol/L (18.0-20.2), and HOMA2-IR was 1.24 (1.13-1.36). Non-vegetarians had higher serum vitamin B12 levels (257 pmol/L, 235-281) than vegetarians (181 pmol/L, 159-207), P < 0.001. Vitamin B12 deficiency (<150 pmol/L) in vegetarians was 24% versus 9% in non-vegetarians. Non-vegetarians had increased body mass index (25.9 kg/m², 25.0-26.9, versus 23.9 kg/m², 22.6-25.3), waist circumference (81 ± 10.1 versus 75.8 ± 9.88 cm), and HOMA2-IR levels (1.30, 1.17-1.46, versus 1.00, 0.83-1.22). No correlation was found between serum vitamin B12 and HOMA2-IR. A significant positive correlation between non-vegetarian status and IR disappeared after controlling for body mass index.. This study population has a low serum vitamin B12 status, especially if vegetarian. The high rates of observed obesity may have overshadowed any other contributing factor to IR.

Topics: Adult; Body Mass Index; Cross-Sectional Studies; Diet, Vegetarian; Emigrants and Immigrants; Female; Folic Acid; Humans; India; Insulin Resistance; Middle Aged; New Zealand; Obesity; Overweight; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency

Is well known that obesity has increased significantly in recent times and therefore many dietary supplements, synthetic or natural, have been proposed in order to prevent and/or to treat obesity or overweight. Chitosan, a polysaccharide with ability to act as a carrier and to absorb fat, has been used for this purpose. However, interactions with other molecules present in the body may also occur and, therefore, the purpose of this study was to evaluate interactions of chitosan with vitamin B12. Spectroscopic properties of vitamin B12 (acid aqueous solution) were monitored in the absence and the presence of chitosan in order to evaluate possible interactions between the two. Results showed that the rigid micro-environment generated by chitosan solution modifies the photophysical properties of vitamin B12. Thus, chitosan is able to eliminate vitamin B12 and, based on this information, some care must be taken during prolonged treatment with chitosan.

Topics: Anti-Obesity Agents; Avitaminosis; Chitosan; Dietary Supplements; Obesity; Photochemical Processes; Vitamin B 12

The aim of the study was the evaluation of serum vitamin B12 and folate levels in patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and their association with the disease severity. Thirty patients with biopsy-proven NAFLD and 24 healthy controls matched for gender, age, body mass index and waist circumference were recruited. Blood samples for vitamin B12, folate, insulin and standard biochemical tests were obtained after overnight fasting. Homeostatic model of assessment-insulin resistance was calculated. There was no difference in serum vitamin B12 and folate levels between groups. Neither vitamin B12 nor folate levels were significantly different within any histological category, including steatosis grade, fibrosis stage, lobular inflammation, portal inflammation and ballooning. In conclusion, similar vitamin B12 and folate levels were observed in non-alcoholic steatohepatitis and non-alcoholic fatty liver patients, and controls. Furthermore, vitamin B12 and folate levels were not associated with either insulin resistance or the severity of liver disease.

Topics: Cross-Sectional Studies; Fatty Liver; Female; Folic Acid; Humans; Logistic Models; Male; Menopause; Middle Aged; Non-alcoholic Fatty Liver Disease; Obesity; Vitamin B 12

Poor physical fitness is associated with increased health-related risks in children. The association of nutritional status indicators and physical fitness in children residing in developing countries is not well characterised. We conducted a cross-sectional study among 1945 children of age 5-12 years in Bogotá, Colombia, to assess whether anthropometric and micronutrient status indicators were associated with performance in the shuttle run and standing long jump tests. Stunted children scored significantly lower in the run (0·4 s; P = 0·0002) and jump (6 cm; boys only; P = 0·003) tests than non-stunted children, after adjustment for age and other factors. Children who were thin, overweight or obese ran slower than normal-weight children (P < 0·01). Lower jump scores were associated with overweight or obesity and greater arm fat area in boys only (P < 0·0001). Girls with low ferritin concentrations ran 0·6 s slower than girls with normal ferritin concentrations (P = 0·02). Erythrocyte folate concentrations were linearly related to higher run (P < 0·0001) and long jump scores (P = 0·0001). Boys with marginal or low vitamin B12 status had 4 cm lower long jump scores than children with normal status (P = 0·01). Suboptimal anthropometric and micronutrient status are related to poorer performance in fitness tests. The effects of improving nutritional status on physical fitness of children warrant investigation.

Topics: Anthropometry; Body Composition; Child; Child, Preschool; Colombia; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Humans; Linear Models; Male; Micronutrients; Obesity; Overweight; Physical Fitness; Schools; Thinness; Vitamin B 12

Topics: Adenocarcinoma; Adult; Age Distribution; Age Factors; Aged; Aged, 80 and over; Aspirin; Barrett Esophagus; Clopidogrel; Drug Interactions; Drug Prescriptions; Esophageal Neoplasms; Esophagitis; Esophagoscopy; Gastroesophageal Reflux; Gastroscopy; Heartburn; Hip Fractures; Humans; Intestinal Absorption; Middle Aged; Obesity; Odds Ratio; Platelet Aggregation Inhibitors; Population Surveillance; Prevalence; Proton Pump Inhibitors; Ticlopidine; Vitamin B 12

Vitamin B-12 is an important cofactor required for nucleotide and amino acid metabolism. Vitamin B-12 deficiency causes anemia and neurologic abnormalities-a cause for concern for the elderly, who are at increased risk of vitamin B-12 malabsorption. Vitamin B-12 deficiency is also associated with an increased risk of neural tube defects and hyperhomocysteinemia. The metabolism of vitamin B-12 and folate is interdependent, which makes it of public health interest to monitor biomarkers of vitamin B-12, folate, and homocysteine in a folic acid-fortified population.. The objective was to determine the vitamin B-12, folate, and homocysteine status of the Canadian population in the period after folic acid fortification was initiated.. Blood was collected from a nationally representative sample of ∼5600 participants aged 6-79 y in the Canadian Health Measures Survey during 2007-2009 and was analyzed for serum vitamin B-12, red blood cell folate, and plasma total homocysteine (tHcy).. A total of 4.6% of Canadians were vitamin B-12 deficient (<148 pmol/L). Folate deficiency (<320 nmol/L) was essentially nonexistent. Obese individuals were less likely to be vitamin B-12 adequate than were individuals with a normal BMI. A total of 94.9% of Canadians had a normal tHcy status (≤13 μmol/L), and individuals with normal tHcy were more likely to be vitamin B-12 adequate and to have high folate status (>1090 nmol/L).. Approximately 5% of Canadians are vitamin B-12 deficient. One percent of adult Canadians have metabolic vitamin B-12 deficiency, as evidenced by combined vitamin B-12 deficiency and high tHcy status. In a folate-replete population, vitamin B-12 is a major determinant of tHcy.

Topics: Adolescent; Adult; Aged; Biomarkers; Canada; Child; Cross-Sectional Studies; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Food, Fortified; Health Surveys; Homocysteine; Humans; Legislation, Food; Male; Middle Aged; Nutritional Status; Obesity; Prevalence; Severity of Illness Index; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Hyperhomocysteinemia (HH) is an emerging risk factor for ischemic stroke but its role in outcome is controversial. We compare the risk factors, nature of stroke and outcome of patients with and without hyperhomocysteinemia.. CT proven ischemic stroke patients were included. The conventional risk factors such as diabetes, hypertension, hyperlipidemia, obesity, smoking, and family history of stroke were recorded. Dietary history was noted. Fasting serum homocysteine (Hcy), B12 and folic acid were estimated after 1 month of stroke. Severity of stroke was assessed by Canadian Neurological Scale (CNS) and outcome at 3 months by Barthel Index (BI) score into good (BI > or = 12) and poor (BI < 12). Serum Hcy, B12 and folic acid were also estimated in 200 normal healthy volunteers.. There were 198 patients with ischemic stroke whose median age was 56 years and 36 were females. In the study group, 41.4% patients were vegetarian, 55.1% hypertensive, 24.7% diabetic, 30.8% smoker, 61.1% sedentary and 28.8% obese. 23.2% had past history of stroke and 21.7% had stroke in their first degree relative. Serum cholesterol was elevated in 11.7% and LDL in 10.8% patients. Serum Hcy was elevated in 60.6% and serum B12 low in 25.7% and folic acid in 42.1%. Hcy levels correlated with serum B12 and LDL. Patients with hyperhomocysteinemia had significantly better outcome at 3 months. Hcy levels in stroke patients did not significantly differ from controls.. Hyperhomocysteinemia is found in 60.6% stroke patients, which is related to low serum B12 level. Patients with hyperhomocysteinemia had a better 3-month outcome.

Topics: Adult; Aged; Brain Ischemia; Comorbidity; Diabetes Mellitus; Diet, Vegetarian; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Hyperlipidemias; Hypertension; India; Male; Middle Aged; Obesity; Risk Factors; Severity of Illness Index; Smoking; Stroke; Tomography, X-Ray Computed; Vitamin B 12

Topics: Diabetes Mellitus, Type 2; Disease Progression; Folic Acid; Glucose Intolerance; Humans; Obesity; Placebos; Primary Prevention; Randomized Controlled Trials as Topic; Risk Factors; Vitamin B 12; Vitamin B 6

Homocysteine is considered as independent predictor of cardiovascular risk. Patients treated with haemodialysis (HD) exhibit elevated homocysteine levels, even four times higher than the general population does. This study focuses on the determination of the vascular risk in patients treated with conventional HD and haemodiafiltration on-line (HDF). It was also considered important to determine whether there was a relationship between homocysteine and the variables given to the patient such as dialysis dose, obesity and treatment with folic acid, vitamin B6 and vitamin B12. A one-year cross-sectional observational study was conducted on patients initially treated with renal replacement therapy such as HDF on-line and conventional HD. Data collected included patient's age, sex, aetiology, duration of dialysis treatment and association with dialysis session, including data on body mass index, waist circumference, treatment with vitamin B6, B12 and folic acid. The results obtained conclusively indicate that patients treated with renal replacement therapy such as HDF on-line exhibit lower homocysteine levels than those treated with conventional HD. Therefore we can conclude that: homocysteine markers indicate that patients treated with HDF on-line are exposed to lower average vascular risk.

Topics: Biomarkers; Cardiovascular Diseases; Chi-Square Distribution; Cross-Sectional Studies; Female; Folic Acid; Hemodiafiltration; Homocysteine; Humans; Hyperhomocysteinemia; Kidney Failure, Chronic; Male; Middle Aged; Obesity; Online Systems; Renal Dialysis; Risk Assessment; Risk Factors; Treatment Outcome; Vitamin B 12

Polycystic ovary syndrome (PCOS) shares some or most components of metabolic cardiovascular syndrome, manifested by abdominal obesity, insulin resistance, dyslipidaemia and atherosclerosis. It has been previously demonstrated that folate and vitamin B(12) treatment improved insulin resistance in patients with metabolic syndrome. This study first investigated whether PCOS patients have lower or higher vitamin B(12), folate and homocysteine concentrations when compared with healthy, age and body mass index matched controls, and, then examined associations between vitamin B(12), folate, homocysteine and insulin resistance and obesity in PCOS patients. Homocysteine concentrations and homeostasis model assessment index were higher, whereas concentrations of vitamin B(12) were lower in PCOS patients with insulin resistance compared with those without insulin resistance. Serum vitamin B(12) concentrations were significantly lower in obese PCOS women in comparison with obese control women (P < 0.05). Fasting insulin, insulin resistance and homocysteine are independent determinants of serum vitamin B(12) concentrations in PCOS patients. Insulin resistance, obesity, and elevated homocysteine were associated with lower serum vitamin B(12) concentrations in PCOS patients.

Topics: Adult; Case-Control Studies; Female; Folic Acid; Homocysteine; Humans; Insulin Resistance; Obesity; Polycystic Ovary Syndrome; Vitamin B 12

Topics: Adipose Tissue; Cohort Studies; Cytosol; Female; Folic Acid; Humans; Insulin Resistance; Mitochondria; Models, Biological; Mothers; Obesity; Pregnancy; Pregnancy Complications; Vitamin B 12

Obesity and homocysteine are important risk factors for cardiovascular disease. The relation between pattern of obesity and homocysteine is unclear. The objective of this study was to investigate the relation between pattern of obesity and plasma total homocysteine (tHcy) level in male patients with coronary artery disease (CAD).. A total of 63 male patients (mean age 66.2 years) with angiographically documented CAD were enrolled. Overnight fasting blood samples were measured for plasma tHcy, serum folic acid and serum vitamin B12 levels. Anthropometric measurements included waist-to-hip ratio (WHR) and body mass index (BMI).. The mean WHR was 0.90+/-0.05, mean BMI 24.6+/-3.3 kg/m2 and the mean plasma tHcy level 11.6+/-3.2 micromol/L. In univariate analysis, plasma tHcy level correlated significantly with serum vitamin B12 level, serum folic acid level, WHR, estimated creatinine clearance, aspirin use and fibrate use. There was no significant association between plasma tHcy level and BMI. In multivariate analysis, only WHR (beta-value 22.263, p<0.001), serum level of vitamin B12 (beta-value -0.004, p=0.003), estimated creatinine clearance (beta-value -4.154, p=0.003) and use of fibrates (beta-value 2.307, p=0.031) were independent predictors of plasma tHcy level.. WHR, but not BMI, is a strong independent predictor of plasma tHcy level in male patients with CAD.

Topics: Aged; Biomarkers; Body Mass Index; Coronary Artery Disease; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Obesity; Risk Factors; Vitamin B 12; Waist-Hip Ratio

Childhood obesity is a widespread health problem in Australia. Overweight in childhood can lead to adult overweight and the development of risk factors for cardiovascular disease (CVD). Effective strategies for reducing childhood obesity are urgently required. A vegetarian diet has been shown to be an effective prophylactic to many lifestyle diseases in the adult population and may therefore be beneficial in children. However the metabolic demands of adolescents are different to adults and the impact of a vegetarian diet on CVD markers in this demographic is not certain. We compared key physiological and biochemical markers of health against responses to a modified, Schools Physical Activity and Nutrition Survey (SPANS) using one-way and two-way Analysis of Variance. 215 adolescents (14-15 yrs) from 5 Adventist secondary schools in the Sydney and Hunter regions of New South Wales, Australia, participated in this study. Adolescents consuming predominantly vegetarian foods showed significantly better scores on markers of cardiovascular health, including, body mass index (BMI), waist circumference, Cholesterol/High density lipoprotein ratio and low density lipoprotein. Adolescents consuming nuts more than once per week, also showed lower scores for BMI and serum glucose irrespective of their vegetarian status. Markers of general health including haemoglobin and average height were not different between groups; however a lower serum level of vitamin B12 was apparent in the vegetarian cohort. Surprisingly, exercise on its own was not statistically associated with any of the risk factors tested suggesting that diet may be the most significant factor in promoting health in this age group.

Topics: Adolescent; Adolescent Nutritional Physiological Phenomena; Analysis of Variance; Biomarkers; Body Mass Index; Cohort Studies; Diet, Vegetarian; Female; Health Promotion; Health Status; Humans; Lipids; Male; Meat; New South Wales; Nutritional Requirements; Nutritional Status; Obesity; Vegetables; Vitamin B 12

Obesity, hypertension and total serum homocysteine levels are well-known risk factors for cardiovascular disease in adults. However, there is limited data on the relation of these risk factors in children.. Five hundred twenty-four healthy school children aged 6-15 years participated in the study. BMI were used to categorize our subjects in normal overweight and obese groups based on Internationally Obesity Task Force criteria.. The prevalence of overweight and obesity was 21.1% and 8.4% for boys and 17.6% and 7.3% for girls, respectively. Diastolic blood pressure (DBP), systolic blood pressure (SBP) and waist circumference (WC) were significantly higher in overweight and obese group compared to normal ones, whereas for homocysteine levels no difference was observed. Based on the results derived from the multiple regression analysis, BMI was positively related to energy intake (beta=0.247, p<0.001) and WC (beta=0.014, p<0.001). Both SBP and DBP were positively related to age ([beta=0.251, p<0.001] and [beta=0.301, p<0.001, respectively]), and BMI ([beta=0.096, p<0.001] and [beta=0.022, p<0.001], respectively).. The current study revealed an association of blood pressure and WC with overweight and obesity in children, and even though these children may not have increased homocysteine levels, they still have enough reasons to reduce weight in order to avoid cardiovascular disease in their life later on.

Topics: Adolescent; Age Factors; Analysis of Variance; Blood Pressure; Body Mass Index; Child; Energy Intake; Female; Folic Acid; Greece; Homocysteine; Humans; Male; Obesity; Overweight; Regression Analysis; Risk Factors; Vitamin B 12

Elevated plasma homocysteine is widely seen as an independent risk factor of cardiovascular disease in adults. In order to investigate the role of homocysteine in a paediatric population at risk for early atheroclerosis, we studied plasma homocysteine in obese schoolchildren and non-obese peers. Plasma homocysteine, serum vitamin B12 and serum folic acid were determined in 41 obese and 27 control subjects and related to carotid intima-media thickness and flow-mediated dilatation measured on high-resolution ultrasonography. Homocysteine, vitamin B12 and folic acid were all significantly elevated in obese children. In girls, plasma homocysteine correlated significantly with body mass index (r=0.56, p=0.002), increased ICA intima-media thickness (r=0.39, p=0.035) and flow-mediated dilatation (r=-0.40, p=0.031). In boys, none of these associations reached significance (all p>0.234). No independent association of homocysteine with IMT and FMD was seen after adjustment for BMI.. Plasma homocysteine is elevated in obese schoolchildren with hypertension and dyslipidaemia, particularly in girls. This may indicate a high-risk constellation, so that plasma homocysteine should be monitored in these children.

Topics: Atherosclerosis; Body Mass Index; Brachial Artery; Carotid Artery, Internal; Case-Control Studies; Child; Dyslipidemias; Female; Folic Acid; Homocysteine; Humans; Hypertension; Male; Obesity; Regional Blood Flow; Tunica Intima; Tunica Media; Ultrasonography; Vitamin B 12

Serum folic acid, but not the vitamin B(12) concentration, was found to be significantly lower in obese subjects than in the control ones.. The aim of this study was to examine the levels of serum vitamin B(12) and folic acid in obese women before and after weight reduction therapy with Orlistat in comparison to healthy controls with normal body weight.. Twenty obese women participated in a 3-month weight reduction therapy. The control group consisted of 20 healthy women.. Body weight and height were measured and BMI was calculated. Body composition was analyzed with the impedance method using a Bodystat analyzer. In all patients before and after 3-month weight reduction therapy, serum concentrations of folic acid and vitamin B(12) were assessed.. In obese women, serum concentrations of folic acid and vitamin B(12) did not change significantly after 3-month weight reduction therapy with Orlistat.

Topics: Adult; Anti-Obesity Agents; Body Height; Body Mass Index; Body Weight; Case-Control Studies; Female; Folic Acid; Humans; Lactones; Middle Aged; Obesity; Orlistat; Vitamin B 12; Weight Loss

A moderate increase of total homocysteine (tHcy) plasma levels seems to increase cardiovascular disease (CVD) risk in Type 2 diabetic subjects, but its relationship with diabetes and insulin-resistance is still controversial. We examined whether mild hyperhomocysteinemia and its major genetic determinant would cluster with the metabolic syndrome (MS) in Type 2 diabetes. One hundred Type 2 diabetic subjects with and without MS were enrolled in the study. Fasting tHcy, vitamin B12, and folate plasma levels, insulin-resistance [assessed by homeostasis model assessment, (HOMAIR)] and the methylene tetrahydrofolate reductase (MTHFR) C677T genotype were assessed in all the participants. Geometric mean tHcy concentration and the prevalence of mild hyperhomocysteinemia, as commonly defined by tHcy >/=15 micromol/l, were comparable in diabetic subjects with and without MS, even after adjustment for age, sex, vitamin B12, folate and creatinine levels. In both groups, the MTHFR C677T genotype distribution was not significantly different from the Hardy-Weinberg equilibrium, with a TT homozygous frequency of 21% in subjects with and 18% in those without the syndrome (p=ns). tHcy plasma levels and the degree of insulin-resistance did not differ across MTHFR genotypes in both groups, even after multivariable adjustment. Overall, tHcy significantly correlated with creatinine (r=0.25; p=0.009) and trygliceride concentrations (r=0.24; p=0.02), but not with HOMAIR. At multivariate analysis, only creatinine was significantly correlated with tHcy levels (beta=0.42; p=0.001). In conclusion, hyperhomocysteinemia and the common C677T variant of MTHFR gene are not associated with MS in Type 2 diabetic subjects.

Topics: Adult; Blood Glucose; Body Mass Index; Diabetes Mellitus, Type 2; Female; Folic Acid; Genotype; Homocysteine; Humans; Hyperhomocysteinemia; Insulin Resistance; Linear Models; Male; Metabolic Syndrome; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Obesity; Polymorphism, Genetic; Triglycerides; Vitamin B 12

Little is known about the effects of commonly used vitamins on serum inflammatory markers and the hormonal balance in obese postmenopausal women. We studied the effects of an 8-week open-label supplementation with vitamins C (500 mg), B6 (25 mg), B12 (1 mg), and folate (5 mg) on C-reactive protein, interleukin-6, and estradiol levels in 20 obese (body mass index > or = 30) postmenopausal women. Outcomes were assessed in a blinded fashion. Folate and vitamin B12 levels rose significantly, suggesting that the supplement was well absorbed and that participants adhered to the protocol. Weight, blood pressure, and serum lipids remained stable. C-reactive protein, interleukin-6, and leptin levels remained unchanged. Estradiol levels rose from a median of 22.0 pg/mL (IQR = 15.9-25.8) at baseline to a median of 27.8 pg/mL (IQR = 23.1-33.9) at follow-up (p = 0.003). Increments in serum estradiol caused by vitamin supplementation in postmenopausal women have not been previously described and probably merit further investigation.

Topics: Ascorbic Acid; C-Reactive Protein; Dietary Supplements; Estradiol; Folic Acid; Inflammation; Interleukin-6; Leptin; Obesity; Postmenopause; Vitamin B 12; Vitamin B 6; Vitamin B Complex

Previous studies have suggested that hyperhomocysteinaemia (Hcy) could be a strong and independent cardiovascular risk factor. Many factors could influence the serum concentration of Hcy such as vitamin B 12, folic acid, renal failure, hypothyroid status, ovarian failure and cancers. So the aim of our study was to evaluate the prevalence of hyperhomocysteinaemia among 54 type 2 diabetic patients and to study, its relationship with vitamin B12, folic acid and Metformin. Were excluded all patients with an evident cause of hyperhomocysteinaemia. Mean age of patients was 52.8 years. Mean Hcy was 11.7 + 6.9 micromol/l. The prevalence of hyperhomocysteinaemia was 27.8% in our group. There were eight (14%) patients with vitamin B12 deficiency and three among them had hyperhomocysteinaemia. There was no folic acid deficiency and no relationship with Metformin treatment. We suggest a wide screening of hyperhomocysteinaemia in type 2 diabetic patients and folic acid or vitamin B12 supplements if necessary.

Topics: Diabetes Mellitus, Type 2; Female; Folic Acid; Glycated Hemoglobin; Homocysteine; Humans; Hyperhomocysteinemia; Hypoglycemic Agents; Male; Metformin; Middle Aged; Obesity; Prospective Studies; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

Homocysteine is known as an independent risk factor of atherosclerosis. The aim of this study was assessment of serum homocysteine concentrations in obese children and evaluation of possible relationship between homocysteine and risk factors of atherosclerosis. 498 children with simple obesity were included into our study. There was a significant correlation between serum homocysteine levels and both traditional and new risk factors of atherosclerosis. The issues confirm a necessity of evaluation serum homocysteine levels of obese children in estimation of cardiovascular disease risk.

Topics: Adolescent; Atherosclerosis; Biomarkers; Body Mass Index; Child; Comorbidity; Female; Folic Acid; Genetic Predisposition to Disease; Homocysteine; Humans; Hypertension; Male; Obesity; Obesity, Morbid; Poland; Risk Factors; Statistics, Nonparametric; Vitamin B 12

Pakistani people belong to an ethnic group which has the highest rate of coronary artery disease (CAD). We investigated the possible correlation between deficiency of vitamins B6, B12 or folic acid and hyperhomocysteinemia in Pakistani patients with acute myocardial infarction (AMI). A case-control study was carried out involving 224 AMI patients (age 30-70 years; 55 females and 169 males) and 126 normal healthy subjects (age 31-70 years; 35 females and 91 males).. Fasting venous blood was obtained from cases and controls. Serum was analyzed for folic acid and B12 using radioassays. Plasma was analyzed for pyridoxal phosphate (PLP; coenzymic form of B6) using a radioenzymatic assay and for total homocysteine using a fluorescence polarization immunoassay. Mean serum B12 concentration in AMI patients was found to be significantly lower than the mean for controls (241+/-185 pg/ml vs 608+/-341 pg/ml; p < 0.001). Mean serum folate level in patients was also found to be lower than controls (3.35+/-3.78 ng/ml vs 4.93+/-2.93 ng/ml), however, the differences were not statistically significant. Similarly, mean PLP concentration in plasma of cases (19.4+/-24.4 nmol/l) was lower than the concentration in controls (23.2+/-17.6 nmol/l), but the difference was not statistically significant. Mean plasma homocysteine level in AMI cases (18+/-8.36 micromol/l) was higher than the mean level in controls (16.4+/-4.9 micromol/l), but not to a significant extent. However, this mean homocysteine concentration in normal healthy subjects was among the highest reported in the literature and was significantly more than mean values reported in most Eastern and Western studies. Compared to controls, there was significantly greater deficiency of folate (32.5% vs 67.1%), B12 (3.2% vs 63.4%) and PLP (49.2% vs 74.1%) in AMI patients. Deficiencies of folate, B12 and PLP were defined as serum folate levels less than 3.5 ng/ml, serum levels of B12 less than 200 pg/ml and plasma PLP levels less than 20 nmol/l. Mean plasma homocysteine levels in smokers were found to be significantly higher in both cases and controls. Similarly, mean serum folate levels in smokers (compared to nonsmokers) were significantly lower in both cases and controls.. Substantial nutritional deficiencies of these three vitamins along with mild hyperhomocysteinemia, perhaps through an interplay with the classical cardiovascular risk factors (highly prevalent in this population), could be further aggravating the risk of CAD in the Pakistani population.

Topics: Adult; Aged; Aging; Body Mass Index; Case-Control Studies; Female; Fluorescence Polarization Immunoassay; Folic Acid; Folic Acid Deficiency; Humans; Hyperhomocysteinemia; Male; Middle Aged; Myocardial Infarction; Obesity; Pakistan; Pyridoxal Phosphate; Smoking; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6; Vitamin B 6 Deficiency

We analyzed the association between MTHFR (C677T) gene polymorphism with serum concentrations of homocysteine, folate, and vitamin B12 in 37 male and 112 female overweight/ obese Thai volunteers (BMI > or = 25.00 kg/m2), and compared them with 23 male and 90 female control subjects (BMI = 18.5-24.99 kg/m2). Statistically significant higher levels of serum homocysteine were found in the overweight/obese subjects than the control subjects (p < 0.05). Serum folic acid levels in the overweight/obese subjects were significantly lower than the control subjects (p < 0.05). When the data were grouped according to homocysteine concentration and MTHFR gene polymorphism, there were significantly higher homocysteine concentrations in the overweight/obese subjects than the control subjects in wild type gene polymorphism (CC) in the hyperhomocysteine group (homocysteine >10.0 mmol/l) (p < 0.05), but in genotype polymorphism (CC, CT, TT) there were lower folic acid and vitamin B12 concentrations in the overweight/obese subjects than in the control subjects. In the hyperhomocysteine groups, there was no significant difference in the frequencies of MTHFR (C677T) gene polymorphism between the overweight/obese subjects and the control subjects. Folic acid and gene polymorphism were found to be significantly related to the overweight/ obese and control groups in logistic regression analysis (p < 0.05). The results support the supposition that folic acid is more important than vitamin B12.

Topics: Adolescent; Adult; Body Weight; Case-Control Studies; Female; Fluorescence Polarization Immunoassay; Folic Acid; Homocysteine; Humans; Logistic Models; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Obesity; Polymorphism, Genetic; Thailand; Vitamin B 12

The aim of this study was to determine if the metabolic syndrome (MetS) or other risk factors might be common among young women with nonfatal myocardial infarction (MI).. A matched case-control study using a structured interview and questionnaires, plus analysis of conventional and nonconventional risk factors for MI in serum or plasma was carried out at a teaching hospital. Subjects were 40 women with nonfatal MI at or before age 45 and an equal number of age-matched, ethnicity-matched, and smoking-matched female control subjects.. Cases and control subjects were not significantly different with regard to serum or plasma levels of homocysteine, anticardiolipin antibodies, beta(2)-glycoprotein I, prothrombin, folate, vitamin B(12), high-sensitivity C-reactive protein (CPR), fibrinogen, amyloid A, plasminogen activator inhibitor type 1 (PAI-1), or tissue plasminogen activator (tPA) antigen levels. Compared with matched controls, cases had a higher rate of obesity (37% vs. 12%, p = 0.02), a higher proportion of fasting glucose >/=110 mg/dl (9% vs. 1%, p = 0.01), and higher overall insulin resistance (27% vs. 5%, p = 0.007). Type 2 diabetes tended to be more common in cases (17% vs. 5%, p = 0.10). Cases were also more likely to be hypertensive (35% vs. 12%, p = 0.04) and dyslipidemic (80% vs. 42%, p = <0.001) and to have higher triglyceride levels (110 +/- 13 mg/dl vs. 96 +/- 12, p = 0.02). Overall, after controlling for weight, cases were 4.7 times more likely to have three or more diagnostic criteria of the MetS than matched controls: chi-square = 7.2, OR = 4.7, 95% CI (1.3, 25.3), p = 0.008.. Although this study may have been underpowered to recognize the contribution of other risk factors, we found that the dominant predictor of nonfatal MI in young women was the MetS. Screening young women with central obesity for other parameters of the MetS may help reduce the risk of MI at an early age.

Topics: Adult; Antibodies, Anticardiolipin; beta 2-Glycoprotein I; Biomarkers; C-Reactive Protein; Case-Control Studies; Chi-Square Distribution; Female; Glycoproteins; Homocysteine; Humans; Massachusetts; Metabolic Syndrome; Middle Aged; Myocardial Infarction; Obesity; Plasminogen Activator Inhibitor 1; Predictive Value of Tests; Prevalence; Prothrombin; Risk Factors; Serum Amyloid A Protein; Smoking; Surveys and Questionnaires; Vitamin B 12

Hyperhomocysteinemia is one of the newly recognised risk factors of coronary artery disease (CAD). The role of hyperhomocysteinemia in the development of atherosclerosis has been controversial.. To assess homocysteine (Hcy) plasma concentration in patients with CAD and to correlate Hcy level with some cardiovascular risk factors.. The study group consisted of 150 males aged <55 years (mean age 49.5+/-5.7 years) with stable CAD. Lipid and carbohydrate profiles as well as Hcy, folic acid and vitamin B(12) serum concentration were assessed, and correlated with such cardiovascular risk factors as cigarette smoking, hypertension, obesity and a history of myocardial infarction.. Mean Hcy plasma concentration was 11.81+/-3.75 micro mol/L. In patients with Hcy >11.21 micro mol/L (median value) a lower level of folic acid and vitamin B12 as well as reduced ejection fraction and glomerular filtration rate were found when compared to patients with Hcy level <11.21 micro mol/L. In addition, creatinine concentration, mean patient's age, proportion of patients who smoked cigarettes and the number of affected coronary arteries were significantly higher in patients with an increased level of Hcy. The Hcy plasma concentration positively correlated with the progression of hypertension, creatinine level and the number of coronary vessels with stenosis. A significant negative correlation between Hcy and folic acid as well as vitamin B12 concentrations was documented. In patients with a three-vessel CAD, Hcy concentration was 12.46+/-3.85 micro mol/L and was significantly higher (p<0.03) compared with patients with a less advanced CAD. In the group of patients with diabetes the mean Hcy concentration increased with the number of affected coronary vessels (p<0.02) and reached the highest values in patients with a three-vessel CAD (15.38+/-7.28 micro mol/L).. There is a significant relationship between homocysteine plasma concentration and the incidence as well as progression of CAD. This association is particularly evident in patients with diabetes.

Topics: Adult; Blood Glucose; Coronary Artery Disease; Disease Progression; Folic Acid; Homocysteine; Humans; Hypertension; Lipids; Male; Middle Aged; Myocardial Infarction; Obesity; Research Design; Risk Factors; Smoking; Vitamin B 12

The incidence of colon cancer is high in many developed nations, especially New Zealand. Molecular understanding of the nature of colon cancer shows a disease whose well-characterized morphological progression is paralleled at the cellular level by increased numbers of gene or chromosome mutations, loss of heterozygosity, changed methylation patterns, and genomic instability. In the present study, we consider whether an imbalance of factors that affect DNA methylation patterns might explain at least part of the high colon cancer incidence in New Zealand. Folate is the major micronutrient whose intake impacts methylation, particularly through interaction with choline and methionine. Folate is generally somewhat deficient in the New Zealand diet, with the voluntary addition of folate to white flour not producing desired levels. Selenium affects methylation status in several ways and is recognized as being low in New Zealand soils and, therefore, diet. Zinc is also low in the diets of some New Zealand population groups, which can lead to hypomethylation. Several of the components of fruits and vegetables affect methylation patterns, and the average New Zealand intake, at two to three servings per day, is considerably below recommended amounts. Low dietary fiber, high tobacco use, and increasing rates of obesity are also likely New Zealand risk factors that may impact on methylation status. Dietary supplementation is not as common in New Zealand as in countries such as the United States, but may provide a way to raise the levels of nutrients and phytochemicals affecting methylation status, thereby enhancing colon cancer protection.

Topics: Alcohol Drinking; Colonic Neoplasms; Dietary Fiber; DNA Methylation; Folic Acid; Genistein; Humans; Meat; Micronutrients; Models, Biological; New Zealand; Niacin; Obesity; Polymorphism, Genetic; Riboflavin; Risk Factors; Selenium; Smoking; Vitamin B 12; Vitamin B 6; Zinc

Subclinical inflammation has been implicated in the initiation and/or progression of atherosclerosis. Diabetes mellitus and obesity are risk factors for atherosclerosis, and asymptomatic low grade inflammation occurs prior to overt vascular lesions in these patients. In contrast to adults, little information exists concerning low grade inflammation in young type 1 diabetes and juvenile obesity.. To investigate low grade inflammation and immune activation in juvenile diabetes mellitus and obesity.. hs-CRP, soluble interleukin-2 receptor (sIL-2R), C-peptide, insulin, cortisol, vitamin B12, folic acid, leptin, and homocysteine were determined in 148 patients with juvenile type 1 diabetes, 86 obese children and 142 normal weighted age-matched healthy controls. Intima-media thickness (IMT) and lumen diameter of both common carotid arteries (CCA) was measured by ultrasonography in 52 healthy pediatric controls, 10 diabetics, and 34 obese juveniles.. Serum hs-CRP was significantly elevated in patients with type 1 diabetes (p < 0.0001), and obese children (p < 0.0001) as compared to the control group. The obese juveniles (p < 0.0001) and the diabetics (p < 0.0001) showed significantly increased values for IMT of CAAs. Levels of homocysteine, sIL-2R, insulin, cortisol, vitamin B12, and folic acid did not differ from the controls. The elevation of hs-CRP was more pronounced in obesity as compared to type 1 diabetes (p < 0.0001), and the hs-CRP values correlated significantly with body mass index standard deviation score (BMI-SDS) values. Furthermore, the IMT and the luminal diameter of CCAs showed significant correlations with BMI-SDS values.. A low grade inflammation as determined by serum hs-CRP is significantly increased in children with type 1 diabetes, and even more pronounced in apparently healthy juveniles with obesity. The increased IMT of CCAs strongly argues for an association between this low grade inflammation and early atherosclerotic vessel injury.

Topics: Adolescent; Arteriosclerosis; Body Mass Index; C-Peptide; C-Reactive Protein; Carotid Artery, Common; Child; Diabetes Mellitus, Type 1; Female; Folic Acid; Homocysteine; Humans; Inflammation; Leptin; Male; Obesity; Receptors, Interleukin-2; Tunica Intima; Vitamin B 12

This study investigated in prepubertal obese children (POC), compared with prepubertal lean children (PLC), a possible relation among plasma total homocysteine (tHcy)-an independent risk factor for future atherosclerosis-and MCP-1 and RANTES, two circulating chemokines inducing leukocyte transendothelial migration (TEM), implicated in the initial stages of the inflammatory part of the atherosclerotic process. Seventy-two POC were evaluated for circulating tHcy, MCP-1, and RANTES, and compared with 42 healthy PLC. The mean adjusted (for age, sex as well as log10total insulin, vitB12, folate, total cholesterol, HDL cholesterol, log10triglycerides, and log10glucose levels) differences in tHcy, MCP-1, and RANTES levels between PLC and POC were all significant [1.16 nmol/mL (P = 0.03), 26.6 pg/mL (P = 0.02), and 52.9 pg/mL (P = 0.03), respectively]. In PLC, but not in POC, tHcy levels were negatively associated with both circulating MCP-1 (B = -1.68, P = 0.007) and RANTES (B = -1.16, P = 0.01) after adjusting for age, sex, BMI, as well as log10total insulin, vitB12, folate, total cholesterol, HDL cholesterol, log10triglycerides, and log10glucose levels. In conclusion, in POC there is a lack, in contrast to PLC, of a possibly autoregulatory, negative association of elevated tHcy levels to increased MCP-1 and RANTES levels. This could contribute to future, homocysteine-induced atherosclerosis.

Topics: Arteriosclerosis; Blood Glucose; Body Mass Index; Body Weight; Chemokine CCL2; Chemokine CCL5; Chemotaxis, Leukocyte; Child; Cholesterol, HDL; Data Interpretation, Statistical; Endothelium, Vascular; Female; Folic Acid; Homocysteine; Humans; Insulin; Male; Obesity; Puberty; Sex; Thinness; Triglycerides; Vitamin B 12

The effects of modern oral contraceptives (OC) on serum concentrations of folate and cobalamin are controversial.. Case-control study on the cobalamin and folate status of 71 healthy female nulligravidae using "low dose" OC for >or=3 months and 170 controls. Factors interfering with vitamin metabolism were thoroughly controlled. Serum concentrations were measured by commercial assays. The results were evaluated using Mann-Whitney's U-test and chi(2) analysis.. OC-users showed significantly lower concentrations of cobalamin than controls. The rates of women with reduced, normal, and elevated levels differed significantly. Nine users but no control had frank cobalamin deficiency without clinical symptoms. Folate levels did not differ between the groups. Vegetarian diet, smoking or obesity did not have a significant influence.. Routine measurement of cobalamin or folate in women using "low dose" OC is not warranted. Vitamin supplementation or different contraceptive methods should be considered in women with pre-existing cobalamin deficiency or restrictive dietary habits.

Topics: Adolescent; Adult; Contraceptives, Oral; Diet, Vegetarian; Ethinyl Estradiol; Female; Folic Acid; Humans; Obesity; Smoking; Vitamin B 12; Vitamin B 12 Deficiency

This study investigated levels of serum homocysteine, vitamin B12, folic acid, vitamin B6 and vitamin C, in 37 male and 112 female overweight and obese Thai volunteers (body mass index; BMI > or = 25.00), and 23 male and 90 female normal-weight Thai volunteers, who came for a physical check-up at the Out-patient Department, General Practice Section, Rajvithi Hospital, Bangkok from March to October of 2000. Data included anthropometric measurements and waist/hip ratios. All anthropometric variables, except height, were significantly higher for the overweight subjects than for the normal subjects. Statistically significantly higher levels of serum homocysteine were found in the overweight subjects. Serum homocysteine concentrations in overweight and obese males were significantly higher than in overweight and obese females. Serum folic acid and vitamin C in the overweight and obese were found to be statistically significantly lower than in the control subjects. No statistically significant difference in vitamin B12 was found in the overweight and obese subjects compared with the normal control subjects. The medians of serum folic acid and vitamin C concentrations for the overweight and obese males were significantly lower than those of the overweight and obese females. A negative correlation was found between serum folic acid and homocysteine concentrations in all overweight and obese subjects. A significant negative correlation between serum folic acid and vitamin B6 was observed in both male and female overweight and obese subjects. The results of the investigation suggest that homocysteine levels in overweight and obese subjects seem to be caused by insufficient dietary folic acid intake and probably not by B12 deficiency.

Topics: Adolescent; Adult; Antioxidants; Ascorbic Acid; Body Constitution; Case-Control Studies; Female; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Male; Middle Aged; Obesity; Thailand; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6

Obesity is among the well-established risk factors for cardiovascular morbidity and mortality. However, the exact mechanisms are not well understood. Low concentrations of vitamins (fat soluble antioxidants and B vitamins) are linked to accelerated atherosclerosis through increased oxidative stress and homocysteine.. To compare plasma antioxidant vitamins (carotenoids and vitamin E), B vitamins (folic acid and B12) and homocysteine--all linked to increased cardiovascular morbidity--between patients with severe obesity and lean control subjects.. We investigated plasma carotenoids, vitamin E, folic acid, B12, and homocysteine in 25 obese patients and their age-matched controls (body mass index 38 +/- 3 vs. 21 +/- 2 kg/m2), respectively), related to BMI and plasma insulin.. Patients with obesity had normal B vitamins and a non-significant decrease in plasma homocysteine as compared to controls (9.4 +/- 2.6 vs. 11.4 +/- 4.8 mumol/L, P = 0.07). There was a significant decrease in both plasma carotenoids and vitamin E (0.69 +/- 0.32 vs. 1.25 +/- 0.72 and 24 +/- 10 vs. 33 +/- 14 micrograms/ml, respectively; P < 0.01). Both vitamins were inversely related to BMI and plasma insulin, which was significantly increased in patients with obesity (22 +/- 21 vs. 6 +/- 2 microU/ml, P < 0.01).. Obese patients with BMI above 35 kg/m2 show low plasma antioxidants (carotenoids and vitamin E). This may result in increased oxidative stress and consequently enhanced atherosclerosis in these patients.

Topics: Adult; Body Mass Index; Carotenoids; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Obesity; Vitamin B 12; Vitamin E; Vitamins

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Arteriosclerosis; Cardiovascular Diseases; Chlamydia Infections; Controlled Clinical Trials as Topic; Diabetes Mellitus, Type 2; Double-Blind Method; Female; Folic Acid; Humans; Hypercholesterolemia; Hyperhomocysteinemia; Hypertension; Hypolipidemic Agents; Infections; Male; Middle Aged; Multicenter Studies as Topic; Obesity; Randomized Controlled Trials as Topic; Risk Factors; Vitamin B 12; Vitamin B Complex

An adverse coronary risk profile has been reported amongst rural-to-urban migrant population living in urban slums undergoing stressful socio-economic transition. These individuals are likely to have low intakes of folic acid and vitamin B12, which may have an adverse impact on serum levels of homocysteine (Hcy). To test this hypothesis, we studied serum levels of Hcy in subjects living in an urban slum of North India and healthy subjects from urban nonslum area.. Group I consisted of 46 subjects (22 males and 24 females) living in an urban slum, while group II consisted of healthy subjects (n = 26, 13 males and 13 females) living in the adjacent non-slum area. Anthropometric measurements, biochemical profile (fasting blood glucose, total cholesterol, serum triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) and fasting serum levels of Hcy were measured. Dietary intakes of folic acid, vitamin B12, vitamin B1, and iron were calculated by the 24-hour dietary recall method. Serum levels of Hcy were correlated with dietary intakes of nutrients, anthropometry, and metabolic variables.. Sex-adjusted serum levels of Hcy in micromol/L (Mean +/- SD) were high, though statistically comparable, in both the groups (group I: 20.8 +/- 5.9 and group II: 23.2 +/- 5.9). Overall, higher than normal serum levels of Hcy (> 15 micromol/L) were recorded in 84% of the subjects. A substantial proportion of subjects in both groups had daily nutrient intakes below that recommended for the Asian Indian population (folic acid: 93.4% in group I and 96.7% in group II, vitamin B12: 76.1 % in group I and 88.4% in group II). However, between the two groups, average daily dietary intakes of both the nutrients were statistically comparable. As compared to non-vegetarians, vegetarians showed lower intakes of folic acid (p < 0.01) and vitamin B12 (p < 0.01) in both groups. On multivariate linear regression analysis with serum Hcy as the response variable and vegetarian/non-vegetarian status and sex (male/female) as predictor variables, higher serum levels of Hcy were observed in vegetarians vs non-vegetarians (1 = 4.6, p < 0.05) and males vs females (beta = 5.3, p < 0.01).. Low intakes of folic acid and vitamin B12, and hyperhomocysteinemia, in both the healthy population living in urban slums and adjacent urban non-slum areas, are important observations for the prevention of nutritional and cardiovascular diseases in the Indian subcontinent.

Topics: Adult; Anthropometry; Blood Chemical Analysis; Diet, Vegetarian; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; India; Male; Mental Recall; Obesity; Poverty Areas; Seroepidemiologic Studies; Urban Population; Vitamin B 12

The aim of the study was to investigate whether anthropometric and metabolic risk factors for coronary heart disease (CHD) contribute to the variation in homocysteine levels in obese children and adolescents.. A total of 84 children and adolescents were assessed for fasting total homocysteine, methylenetetrahydrofolate reductase polymorphism (C677T mutation), folate and vitamin B12 status, and anthropometric and metabolic risk factors for CHD.. No significant sex differences were found for all available anthropometric and metabolic characteristics except for homocysteine, which was significantly higher in boys than in girls (7.1 vs. 6.3 micromol/l; P<0.05). After adjustment for age and sex, homocysteine correlated significantly with BMI, fat mass, percentage of fat mass, and insulin and showed an inverse correlation with folate levels. Homocysteine did not correlate with vitamin B12; total cholesterol; LDL, HDL, and VLDL; triglycerides; and glucose. BMI and fat mass correlated significantly with insulin and showed a significant inverse correlation with folate. We found no association between homocysteine and the C677T mutation. In multiple regression analyses, insulin was found to be the main correlate of homocysteine.. Our study demonstrates for the first time that insulin is a main correlate of homocysteine in obese children and adolescents and suggests that fat mass-associated hyper-insulinism may contribute to impairment of homocysteine metabolism in childhood obesity

Topics: Adolescent; Blood Pressure; Child; Child, Preschool; Cholesterol; Coronary Disease; Female; Folic Acid; Homocysteine; Humans; Insulin; Lipoproteins; Male; Methylenetetrahydrofolate Reductase (NADPH2); Obesity; Oxidoreductases Acting on CH-NH Group Donors; Polymorphism, Genetic; Regression Analysis; Risk Factors; Triglycerides; Vitamin B 12

Hyperhomocysteinemia has been identified as a potential risk factor for atherosclerosis. This study examined whether a modest elevation of plasma total homocysteine (tHcy) was an independent risk factor for increased carotid artery intimal-medial wall thickness (IMT) and focal plaque formation in a large, randomly selected community population. We also examined whether vitamin cofactors and the C677T genetic mutation of the methylenetetrahydrofolate reductase (MTHFR) enzyme were major contributors to elevated plasma tHcy and carotid vascular disease.. In 1111 subjects (558 men, 553 women) 52+/-13 years old (mean+/-SD; range, 27 to 77 years) recruited from a random electoral roll survey, we measured fasting tHcy and performed bilateral carotid B-mode ultrasound. For the total population, mean tHcy was 12.1+/-4.0 micromol/L. Plasma tHcy levels were correlated with IMT (Spearman rank rs=0.31, P=0.0001). After adjustment for age, sex, and other conventional risk factors, subjects in the highest versus the lowest quartile of tHcy had an odds ratio of 2.60 (95% CI, 1.51 to 4.45) for increased IMT and 1.76 (95% CI, 1.10 to 2.82) for plaque. Serum and dietary folate levels and the C677T mutation in MTHFR were independent determinants of tHcy (all P=0.0001). The mutant homozygotes (10% of the population) had higher mean tHcy than heterozygotes or those without the mutation (14.2 versus 12.3 versus 11.6 micromol/L, respectively, P=0.0001). The inverse association of folate levels with tHcy was steeper in the mutant homozygotes. Despite this, the C677T MTHFR mutation was not independently predictive of increased carotid IMT or plaque formation.. Mild hyperhomocysteinemia is an independent risk factor for increased carotid artery wall thickness and plaque formation in a general population. Lower levels of dietary folate intake and the C677T mutation in MTHFR are important causes of mild hyperhomocysteinemia and may therefore contribute to vascular disease in the community.

Topics: Adult; Aged; Amino Acid Substitution; Arteriosclerosis; Carotid Arteries; Carotid Stenosis; Comorbidity; Diet; Female; Folic Acid; Gene Frequency; Genetic Predisposition to Disease; Genotype; Health Surveys; Homocysteine; Humans; Hyperhomocysteinemia; Hyperlipidemias; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Mutation, Missense; Obesity; Odds Ratio; Oxidoreductases Acting on CH-NH Group Donors; Point Mutation; Pyridoxine; Risk Factors; Smoking; Tunica Intima; Ultrasonography; Vitamin B 12; Western Australia

Moderately elevated homocysteine concentrations, reflecting deficiency of some nutritional factors required for homocysteine metabolism (folate, vitamin B-6, vitamin B-12) and/or less severe genetic defects, are common in the general population. Several studies have indicated the role of homocysteine as an independent risk factor for vascular disease. A pilot study published recently suggested that plasma homocysteine levels increase during weight reduction in slightly overweight, otherwise healthy subjects (group A). We examined a comparable group of 13 overweight subjects (group B) using a standardised caloric intake and defined vitamin supplementation (Medyn: folate 0.2 mg/ vitamin B-68.0 mg/ vitamin B-120.010 mg three times the day orally) to determine the effect of weight reduction on serum homocysteine levels and to compare the results with those of the pilot study. Mean body weight declined from 87.0 +/- 20.2 to 84.2 +/- 20.1 kg (P < 0.05) in group A and 85.7 +/- 11.3 to 82.5 +/- 9.9 kg (P = 0.049) in group B. Serum homocysteine levels rose from 7.9 +/- 2.0 to 8.7 +/- 2.3 mumol/l (P < 0.0001) in group A and decreased from 8.19 +/- 1.73 to 7.35 +/- 0.88 mumol/l (P = 0.0022) in group B. No correlation was found between the changes in body weight and in homocysteine levels (r = 0.02 in group A, r = 0.18 in group B). Additionally, no correlation was found between serum folate levels and changes in homocysteine levels (r = 0.03 in group A, r = 0.09 in group B). The results suggest that an adequate oral vitamin-supplementation protects against increased homocysteine production during weight reduction.

Topics: Adult; Diet, Reducing; Dietary Supplements; Energy Intake; Female; Folic Acid; Homocysteine; Humans; Male; Obesity; Pyridoxine; Statistics, Nonparametric; Vitamin B 12; Weight Loss

Topics: Adolescent; Adult; Aged; Child; Female; Folic Acid; Humans; Iron; Magnesium; Male; Middle Aged; Nutritional Physiological Phenomena; Obesity; Pyridoxic Acid; Riboflavin; Sex Factors; Thiamine; Vitamin B 12

Topics: Fatty Liver; Humans; Obesity; Vitamin B 12

We studied changes in serum levels of carotene, vitamins A, C, B12 and folate and iron in the immediate perioperative period after gastric by-pass surgery in nine morbidly obese patients and in six patients undergoing abdominal surgery. All parameters were measured preoperatively and 48 h postoperatively. Marked decreases occurred for vitamin A (2.04 +/- 0.45 mumol/l to 0.92 +/- 0.39 mumol/l, P less than 0.01), vitamin C (26 +/- 11.2 mumol/l to 4.9 +/- 4.0 mumol/l, P less than 0.01), iron (15 +/- 5.8 mumol/l to 4 +/- 2.7 mumol/l, P less than 0.01). A significant change also occurred for carotene (1.7 +/- 0.42 mumol/l to 1.25 +/- 0.48 mumol/l, P less than 0.05). No significant changes were seen for vitamins B12 and folate. Only changes in vitamins A and C were significantly greater in the morbidly obese patients compared to the control group of six patients. These changes likely represent redistribution of vitamins rather than enhanced urinary excretion.

Topics: Adult; Ascorbic Acid; Carotenoids; Female; Folic Acid; Humans; Iron; Male; Obesity; Postoperative Period; Stomach; Vitamin A; Vitamin B 12

Topics: Erythrocyte Count; Erythrocyte Indices; Humans; Obesity; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

We studied 41 patients who had gastric bypass for obesity from 1974-1979. The procedure was well received by patients and most achieved adequate weight loss, but most subjects consumed inadequate diets and many developed iron and/or vitamin B12 deficiencies. Ten were anemic and 13 had been treated previously for postbypass anemia. Severely vitamin B12-deficient subjects did not respond to 50 micrograms oral vitamin B12 tablets, but those with milder deficiencies usually did. Schilling tests were usually abnormal and corrected when intrinsic factor was given. Many subjects developed manifestations compatible with osteoporosis due to inadequate calcium intake and absorption, and some also developed abnormal laboratory tests suggesting coexisting osteomalacia. Hematopoietic complications of gastric bypass can usually be prevented and are relatively easy to treat, but musculoskeletal complications may be more difficult to prevent and treat.

Topics: Adult; Anemia, Hypochromic; Body Weight; Diet; Female; Follow-Up Studies; Humans; Iron; Jejunum; Male; Middle Aged; Obesity; Osteoporosis; Postoperative Complications; Schilling Test; Stomach; Surveys and Questionnaires; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Eleven morbidly obese patients were studied before and at various time intervals after jejunoileal bypass (JIB). Bile acid deconjugation was assessed with the bile acid breath test and bile acid absorption by analyzing the fecal excretion of both radioactively labeled and unlabeled bile acids. In addition, aerobic and anaerobic cultures of upper small intestinal aspirates, the Schilling vitamin B12 absorption test, and fecal fat analysis were performed. All patients developed marked diarrhea and steatorrhea after JIB. The bile acid breath test was positive in all 11 patients after JIB. In 7 of the 11 patients, this test was already slightly positive before JIB. In every instance, however, the bile acid breath test became significantly more abnormal after the bypass operation. The fecal excretion of labeled bile acids increased significantly. However, the increase in the quantitative excretion of the bile acids did not reach statistical significance. The concentrations of bile acids in fecal water were considerably below the levels required to induce diarrhea. This was mainly the result of a low fecal pH and consequent low aqueous solubility. Jejunoileal bypass effected a major shift in fecal bile acids from the secondary bile acids, lithocholic acid and deoxycholic acid, to the respective primary compounds, chenodeoxycholic acid and cholic acid. There were no significant changes in the small bowel bacteriologic findings after JIB. In 5 out of the 9 patients in whom bacteriologic studies were performed, the cultures were positive before the operation. The Schilling vitamin B12 absorption test showed in all patients a significant drop in the 24-hour urinary 57Co excretion rate after JIB.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Bile Acids and Salts; Breath Tests; Diarrhea; Enterohepatic Circulation; Fats; Feces; Female; Humans; Ileum; Intestinal Absorption; Intestine, Small; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Obesity; Postoperative Complications; Vitamin B 12

Six patients subjected to jejuno-ileal bypass surgery for obesity were studied for vitamin B12 absorption by the use of the Schilling test, together with measurement of the serum B12 level preoperatively and at 2, 6, 12, 18 and 24 months after the operation. During the follow-up period of 2 years, the serum vitamin B12 level gradually declined to abnormally low values. A postoperative fall of the originally normal vitamin B12 absorption to abnormal values was found. Oral administration of tetracycline resulted in a transitory improvement of the results by the Schilling test, but after its discontinuation serve vitamin-B12 malabsorption was again demonstrable. The importance of parenteral vitamin B12 administration after jejuno-ileal bypass surgery is emphasized.

Topics: Humans; Ileum; Jejunum; Kinetics; Malabsorption Syndromes; Obesity; Postoperative Complications; Schilling Test; Short Bowel Syndrome; Tetracycline; Vitamin B 12

Topics: Humans; Ileum; Jejunum; Malabsorption Syndromes; Obesity; Postoperative Complications; Short Bowel Syndrome; Vitamin B 12; Vitamin B 12 Deficiency

Twenty-one female patients studied between six and 12 months following a jejunoileal bypass procedure for obesity were found to have a wide variety of metabolic disturbances. Hepatic histological abnormalities were common and included liver cell necrosis and inflammation in nine patients and hepatic fibrosis in five. Liver function tests were no guide to the degree of hepatic impairment. Vitamin B12 malabsorption occurred in seven patients, in six probably as a result of bacterial intestinal overgrowth; three of these six patients had the most serious hepatic morphological changes. Malabsorption rather than poor oral intake of food appeared to account for continued postoperative weight loss in the majority of patients.

Topics: Adolescent; Adult; Female; Humans; Ileum; Jejunum; Liver; Liver Diseases; Malabsorption Syndromes; Middle Aged; Necrosis; Obesity; Vitamin B 12

Investigations on the vitamin pattern of diabetic neuropathy: thiamine, riboflavin, pyridoxine, cobalamin and tocopherol. The contents of the vitamins mentioned above have been measured in the blood of 119 patients (53 diabetic neuropathies, 66 diabetics without neuropathy). The incidence of neuropathy shows a strong correlation with the duration of the diabetic state, but not with sex, nor with concomitant diseases such as adipositas, hypertension, heart and circulatory diseases, except retinopathia diabetica. Most of the diabetics in our study are well supplied with vitamins B1, B2, and E; B6 and B12 are occasionally low, but there is no statistically relevant difference between diabetic controls and neuropathies. Adipose patients have neither a markedly different vitamin content nor a different calory uptake from non-adipose patients. A general trend towards reduced total calory uptake is seen in old age, men (lower protein intake) and women (lower carbohydrate intake) obviously differing somewhat in their habits. The influence of therapy on the vitamin pattern is not clear cut, except for patients under diet and biguanide-therapy showing a higher proportion of low or subnormal B12 values. The increased frequency of neuropathies in patients treated with sulfonyl-urea approaches only the limits of significance and needs further investigations.

Topics: Diabetes Complications; Diabetes Mellitus; Diabetic Neuropathies; Diabetic Retinopathy; Female; Humans; Hypertension; Male; Middle Aged; Obesity; Pyridoxine; Riboflavin; Sex Factors; Thiamine; Vitamin B 12; Vitamin E

Topics: Adult; Female; Humans; Ileum; Intestinal Absorption; Jejunum; Male; Middle Aged; Obesity; Postoperative Complications; Vitamin B 12

This study was an attempt to compare psychological and biological variables in 43 obese patients after intestinal bypass surgery. The difficulties in expressing the psychological variables quantitatively are discussed on the basis of the concept of transferability. By use of an expanded version of the Beck Depression Inventory and the Marke-Nyman Temperament Scale we could demonstrate that items concerning asthenia (self-dislike, irritability, work retardation, insomnia, fatigability, somatic preoccupation about aches and pains, loss of libido, headache, vertigo, palpitations, dryness of the mouth, thirst or increased liquid intake) had, when summed up, a score distribution indicating bimodality. The asthenic group of patients (n = 19) when compared with the non-asthenic patients (n = 24) showed metabolic deficiencies related to the vitamin D complex with no response to oral vitamin D3 administration measured by plasma levels of 25-hydroxyvitamin D3. The lack of response was associated with low calcium excretion in the urine, higher plasma alkaline phosphatase, and a tendency to higher blood levels of parathyroid hormone.

Topics: Adult; Alkaline Phosphatase; Bone and Bones; Calcium; Depression; Female; Folic Acid; Humans; Hydroxycholecalciferols; Intestine, Small; Magnesium; Male; Middle Aged; Neurasthenia; Obesity; Parathyroid Hormone; Personality Inventory; Phosphates; Postoperative Complications; Potassium; Vitamin B 12; Zinc

Report on a case of severe megaloblastic anemia in a vegetarian, associated with marked erythroleukemic blood findings probably caused by infections (bronchopneumonia, asthmatic bronchitis, urinary tract infection) and severe heart failure. Successful treatment of the above mentioned complications resulted in almost complete disappearance of pathologic cells from the blood even before vitamin B12 treatment was started. With this therapy complete recovery was achieved and the signs suspect for erythroleukemia in blood and bone marrow disappeared definitively. The case also fulfilled all the criteria of pernicious anemia (Schilling's test and determination of intrinsic factor were not done).

Topics: Aged; Anemia, Macrocytic; Anemia, Megaloblastic; Bone Marrow Examination; Digitalis Glycosides; Diuretics; Female; Folic Acid; Heart Failure; Humans; Leukemia, Erythroblastic, Acute; Obesity; Vitamin B 12; Vitamin B 12 Deficiency

Gastrointestinal anatomy and function has been studied prospectively in 12 patients undergoing jejunoileal bypass surgery in order to investigate the adaptive response of the intestinal mucosa. The total thickness of the jejunal mucosa did not change after surgery, but the crypts became relatively deeper, suggesting a more rapid turnover of gastrointestinal cells. The absorption of oxalate was depressed in the immediate postoperative period but had improved toward preoperative levels by 6 months. Vitamin B12 absorption also declined postoperatively, and increased thereafter in the patients with an end-to-end jejunoileostomy, but showed a much smaller recovery in the group with an end-to-side anastomosis. The cholesterol concentration (lithogenicity) of the duodenal bile rose by 30% in the first 3 weeks after surgery, but had returned to preoperative levels by 6 months. The segmental absorption of glucose across the jejunum declined after surgery. Caloric intake also declined, whether measured as the quantity of food that patients elected to eat over a 24-hr period, or as the quantity of a liquid lunch which they consumed over a 20-min period. The level of basal gastric acid was increased postoperatively but the maximal output after histamine stimulation was not. The gastrin response to a standard liquid meal was also significantly increased after surgery. Enteroglucagon secretion showed an increase in 3 weeks and a further increase by 6 months after intestinal bypass surgery. The significance of these changes to intestinal adaptations is discussed.

Topics: Bile Acids and Salts; Cholesterol; Duodenum; Energy Intake; Gastric Juice; Gastrins; Glucagon; Glucose; Humans; Ileum; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Jejunum; Obesity; Oxalates; Phospholipids; Vitamin B 12

Adaptation of vitamin B12 absorption by small intestine has been suggested by experimental and clinical studies. Five partial ileal bypass patients and ten jejunoileal bypass patients were studied for adaptation of B12 absorption following surgery. Adaptation of vitamin B12 absorption could not be demonstrated in either group. Few of the patients on an individual basis demonstrated adaptation. Parenteral B12 should be given to all patients who undergo bypass surgery unless evidence of persistent normal B12 absorption has been obtained.

Topics: Adaptation, Physiological; Humans; Hypercholesterolemia; Ileum; Intestinal Absorption; Jejunum; Obesity; Vitamin B 12

Food intake was measured in 22 obese patients before and after jejunioleostomy for obesity. Most of the weight loss could be accounted for by the observed reduction of caloric intake. Malabsorption was also present as indicated by increased loss of fat in the stools, and decreased absorption of D-xylose and vitamin B12. A dislike for sweet tastes developed after surgery in most patients. Preferences for concentrated solutions of sucrose and glucose were reduced after patients showed a depression of food intake by a 440-calorie preload which had not been detected before surgery. These studies show a decrease in food intake after intestinal bypass surgery and suggest a role for taste or other gastrointestinal factors in regulating food intake.

Topics: Adult; Diet; Energy Metabolism; Feces; Female; Food Preferences; Glucose; Humans; Ileum; Jejunum; Lipid Metabolism; Malabsorption Syndromes; Male; Obesity; Sucrose; Taste; Vitamin B 12; Xylose

Topics: Adult; Anemia, Hypochromic; Child; Cholelithiasis; Coronary Disease; Diabetes Mellitus; Diet Therapy; Diet, Diabetic; Diet, Reducing; Female; Humans; Hypertension; Male; Middle Aged; Obesity; Osteoporosis; Peptic Ulcer; Pregnancy; Ureteral Calculi; Urinary Bladder Calculi; Vitamin B 12; Vitamin B 6 Deficiency

Topics: Adolescent; Child; Female; Humans; Male; Obesity; Vitamin B 12

Topics: Biopsy; Celiac Disease; Cobalt Radioisotopes; Colitis, Ulcerative; Colostomy; Crohn Disease; Dermatitis Herpetiformis; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Ileostomy; Intestinal Absorption; Jejunum; Obesity; Pentagastrin; Schilling Test; Secretory Rate; Stimulation, Chemical; Vitamin B 12

Topics: Adolescent; Adult; Bacteroides; Bile Acids and Salts; Breath Tests; Carbon Dioxide; Carbon Radioisotopes; Diarrhea; Escherichia coli; Female; Glycine; Glycocholic Acid; Humans; Ileum; Intestinal Absorption; Jejunum; Male; Middle Aged; Obesity; Schilling Test; Taurine; Vitamin B 12

Topics: Antibodies; Bacteriological Techniques; Bile Acids and Salts; Cells, Cultured; Follow-Up Studies; Humans; Hydrochloric Acid; Ileum; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Jejunum; Obesity; Schilling Test; Tetracycline; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Bile Acids and Salts; Duodenum; Escherichia coli; Humans; Ileostomy; Intestinal Absorption; Intestinal Secretions; Jejunum; Obesity; Postoperative Complications; Radioisotope Dilution Technique; Schilling Test; Vitamin B 12

Topics: Adult; Bile Acids and Salts; Biopsy; Blood Glucose; Duodenum; Escherichia coli; Female; Flatulence; Follow-Up Studies; Humans; Ileostomy; Insulin; Intestinal Absorption; Jejunum; Male; Obesity; Postoperative Complications; Tetracycline; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Humans; Intestinal Absorption; Intestine, Small; Obesity; Vitamin B 12

Topics: Administration, Oral; Anemia, Pernicious; Animals; Cobalt Radioisotopes; Duodenal Ulcer; Gastric Juice; Humans; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Intubation, Gastrointestinal; Male; Obesity; Pentagastrin; Protein Binding; Rats; Spinal Diseases; Swine; Vitamin B 12

Topics: Adolescent; Adult; Diarrhea; Diet; Female; Humans; Ileum; Jejunum; Male; Methods; Middle Aged; Obesity; Postoperative Care; Postoperative Complications; Preoperative Care; Vitamin B 12

Topics: Adolescent; Adult; Alkaline Phosphatase; Ascorbic Acid; Aspartate Aminotransferases; Bilirubin; Carotenoids; Cholesterol; Drainage; Female; Folic Acid; Glucose Tolerance Test; Hepatitis; Humans; Ileum; Intestinal Absorption; Intestinal Obstruction; Intestine, Small; Jejunum; Lipids; Male; Middle Aged; Necrosis; Obesity; Postoperative Complications; Surgical Wound Infection; Thrombophlebitis; Triglycerides; Uric Acid; Vitamin A; Vitamin B 12; Vitamin E; Xylose

Topics: Adolescent; Adult; Bile Acids and Salts; Diarrhea; Enzymes; Female; Folic Acid; Humans; Hypothalamic Diseases; Ileum; Intestinal Absorption; Intestine, Small; Jejunum; Kidney Function Tests; Lipids; Liver Function Tests; Male; Methods; Middle Aged; Obesity; Postoperative Complications; Vitamin B 12; Water-Electrolyte Balance

Topics: Bile Acids and Salts; Biotransformation; Celiac Disease; Cholelithiasis; Cholestyramine Resin; Diarrhea; Humans; Hypercholesterolemia; Ileum; Intestinal Diseases; Kidney Calculi; Lipid Metabolism; Malabsorption Syndromes; Obesity; Postoperative Complications; Vitamin B 12; Water-Electrolyte Balance

Topics: Adult; Aged; Arteriosclerosis; Biliary Tract Diseases; Carbohydrate Metabolism; Coronary Disease; Diabetes Mellitus; Diabetic Nephropathies; Female; Humans; Hypertension; Male; Middle Aged; Nucleotides; Obesity; Pyridoxine; Taurine; Vitamin B 12

Topics: Biological Assay; Diet, Reducing; Fasting; Feeding Behavior; Folic Acid; Folic Acid Deficiency; Humans; Imidazoles; Lactobacillus; Male; Obesity; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Biguanides; Cobalt Isotopes; Diabetes Mellitus; Diarrhea; Humans; Intestinal Absorption; Intrinsic Factor; Obesity; Schilling Test; Vitamin B 12

Topics: Body Weight; Carbohydrate Metabolism; Colon; Diarrhea; Digestive System Surgical Procedures; Electrolytes; Female; Humans; Hypertension; Ileum; Jejunum; Lipid Metabolism; Liver Diseases; Malabsorption Syndromes; Male; Methods; Obesity; Postoperative Complications; Preoperative Care; Proteins; Prothrombin; Stomach; Vitamin B 12

Topics: Adult; Ascorbic Acid Deficiency; Celiac Disease; Diarrhea; Employment; Fatty Liver; Female; Humans; Intestinal Absorption; Intestine, Small; Magnesium Deficiency; Male; Middle Aged; Obesity; Vitamin A Deficiency; Vitamin B 12

Topics: Body Weight; Diabetes Mellitus; Humans; Intestinal Absorption; Lipids; Metformin; Obesity; Vitamin B 12; Xylose

Topics: Adult; Anemia; Autoanalysis; Blood Cell Count; Blood Proteins; Blood Urea Nitrogen; Body Weight; Chlorides; Fasting; Female; Headache; Hematocrit; Hemoglobins; Humans; Hypokalemia; Hyponatremia; Ketone Bodies; Malabsorption Syndromes; Male; Nausea; Obesity; Time Factors; Uric Acid; Vitamin B 12; Vitamins; Water-Electrolyte Balance

The effect of oral folic acid on jejunal glycolytic enzyme activity in five fasting obese patients and in three normal male volunteers on a constant 3000 cal diet was studied. The glycolytic enzymes, fructokinase, hexokinase, glucokinase, fructose-1-phosphate aldolase, and fructose diphosphate aldolase, and the disaccharidases, sucrase, maltase, and lactase were measured. In both the fasting patients and the normal volunteers, oral folic acid significantly increased the jejunal glycolytic enzyme activities but had no effect on disaccharidase activity. When oral folic acid was discontinued in the normal volunteers, the glycolytic enzyme activities returned to control values. In the obese patients, refeeding and folic acid caused a further increase in glycolytic enzyme activities above that seen with fasting and folic acid. In contrast to oral folic acid, intramuscular folic acid, oral vitamin B(12), and oral tetracycline had no effect on glycolytic enzyme activities. These studies demonstrate that oral folic acid which is neither a substrate nor a coenzyme of these enzymes, increases human jejunal glycolytic enzyme activity in a specific fashion. This would appear to be an action of oral folic acid which has not been recognized previously.

Topics: Adult; Diet; Fasting; Folic Acid; Fructose; Fructose-Bisphosphate Aldolase; Glucokinase; Glycoside Hydrolases; Hexokinase; Humans; Injections, Intramuscular; Jejunum; Kinetics; Lactose; Male; Maltose; Obesity; Phosphotransferases; Sucrase; Tetracycline; Vitamin B 12

Topics: Achilles Tendon; Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Obesity; Reflex, Stretch; Thyroid Gland; Thyroxine; Vitamin B 12

Topics: Blood Pressure; Cholesterol; Diarrhea; Female; Glucose Tolerance Test; Humans; Jejunum; Lipid Metabolism; Lipids; Middle Aged; Nitrogen; Obesity; Phospholipids; Urine; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Blood Protein Disorders; Brain Neoplasms; Chlormerodrin; Chromium Isotopes; Clinical Laboratory Techniques; Cobalt Isotopes; Diuretics; Erythrocytes; Heart Diseases; Hypoproteinemia; Iodine Isotopes; Kidney Diseases; Liver Diseases; Lung Diseases; Neoplasms; Obesity; Organomercury Compounds; Polycythemia; Protein Deficiency; Pulmonary Embolism; Radiation Protection; Radioisotopes; Radiometry; Radionuclide Imaging; Schilling Test; Spleen; Thinness; Thyroid Diseases; Vitamin B 12

Topics: Animals; Biochemical Phenomena; Corrinoids; Hematinics; Obesity; Rats; Vitamin B 12