Folate deficiency in an unselected population in Calgary, Alberta and its relationship with red blood cell macrocytosis

BMC Research Notes

Christopher Naugler¹  Matthew Budd² 

[1] Department of Family Medicine, University of Calgary, C410, Diagnostic and Scientific Centre, 3535 Research Road NW, Calgary T2L 2K8, AB, Canada;Calgary Laboratory Services, Calgary, Canada

关键词: Canada;    Demographics;    Receiver operator characteristic curve;    Macrocytosis;    Folate;   

Others  :  1230940
DOI  :  10.1186/s13104-015-1273-y

 received in 2014-04-25, accepted in 2015-07-08,  发布年份 2015

【 摘 要 】

Background

Folate deficiency is rare in western countries and therefore blood tests for folate level have limited indications. One such indication is red cell macrocytosis, however it is unclear if the association of macrocytosis with folate deficiency is robust enough to serve as a risk marker. Our objective is to determine whether macrocytosis is a useful marker for folate deficiency.

Findings

Paired data from the Calgary Laboratory Services Information System was analyzed using receiver operating characteristic (ROC) curves to determine strength of association between mean corpuscular volume and serum folate. Strength of association was analyzed for serum folate cut-off values of 12, 10, 8, and 6 nmol/L. Overall, 0.2% of individuals were folate deficient (<6 nmol/L serum folate). Based on ROC curves, at each cut-off level, mean corpuscular volume was a poor predictive marker for serum folate level.

Conclusions

Folate deficiency is rare in Calgary, Alberta. Macrocytosis is not a strong predictor for folate deficiency.

【 授权许可】

   
2015 Budd and Naugler.

【 图 表 】

Fig.1.

Fig.1.

【 参考文献 】

• [1]Ganji V, Kafai MR: Trends in serum folate, RBC folate, and circulating total homocysteine concentrations in the United States: analysis of data from National Health and Nutrition Examination Surveys, 1988–1994, 1999–2000, and 2001–2002. J Nutr 2006, 136(1):153-158.
• [2]Ray JG: Folic acid food fortification in Canada. Nutr Rev 2004, 62(1):S35-S39.
• [3]Pfeiffer CM, Johnson CL, Jain RB, Yetley EA, Picciano MF, Rader JI, et al.: Trends in blood folate and vitamin B-12 concentrations in the United States, 1988–2004. Am J Clin Nutr 2007, 86(3):718-727.
• [4]Pfeiffer CM, Caudill SP, Gunter EW, Osterloh J, Sampson EJ: Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999–2000. Am J Clin Nutr 2005, 82(2):442-450.
• [5]Dowd JB, Aiello AE: Did national folic acid fortification reduce socioeconomic and racial disparities in folate status in the US? Int J Epidemiol 2008, 37(5):1059-1066.
• [6]Maxwell SJ, Brameld KJ, Bower C, D’Antoine H, Hickling S, Marley J, et al.: Baseline investigations of folate status in Aboriginal and non-Aboriginal West Australians prior to the introduction of mandatory fortification. Aust NZ J Obstet Gynaecol 2013, 53(1):26-31.
• [7]Colapinto CK, O’Connor DL, Tremblay MS: Folate status of the population in the Canadian Health Measures Survey. Can Med Assoc J 2011, 183(2):E100-E106.
• [8]Bor MV, Wullf AM, Nexo E, Krarup H: Infrequency of low red blood cell (RBC) folate levels despite no folate fortification program: a study based on results from routine requests for RBC folate. Clin Chem Lab Med 2008, 46(3):401-404.
• [9]Kaferle J, Strzoda CE: Evaluation of macrocytosis. Am Fam Physician 2009, 79(3):203-208.
• [10]Köpcke F, Lubgan D, Fietkau R, Scholler A, Nau C, Stürzl M, et al.: Evaluating predictive modeling algorithms to assess patient eligibility for clinical trials from routine data. BMC Med Inform Decis Mak 2013, 13(1):134. BioMed Central Full Text