Association between obesity and risk of folate insufficiency among non-pregnant women of reproductive age in the United States Público

Abstract

Background: Folate insufficiency in the mother during the periconceptional period is associated with an increased risk of neural tube defects (NTD) in the offspring. Limited studies have examined the effect of obesity on low red blood cell (RBC) folate concentrations in non-pregnant women of reproductive-age, and the results have been inconsistent.

Objective: The purpose of this study was to examine the association between obesity, further stratified by different classes of obesity, and folate insufficiency in non-pregnant women of childbearing age (20-44 years) in the United States.

Methods: We used data from the U.S National Health and Nutrition Examination Survey (NHANES) (2007-2010). Folate insufficiency in our study was defined as RBC folate concentration (<748 nmol/l) where a woman is at risk for having NTD-affected pregnancy. High risk NTD category was defined based on RBC folate concentration of ≤585 nmol/l and elevated risk was defined by 586-747 nmol/l. We examined the association between obesity and folate insufficiency using multivariable logistic regression. We estimated crude and adjusted prevalence odds ratios (aPOR) and 95% confidence intervals accounting for the complex survey design.

Results: Overall, among the 30,878 eligible women, 32.69% were obese and 25.58% were overweight. We noted that 32.30 % of all women examined had folate insufficiency. Obesity was a significant determinant of overall RBC folate status, based on log-transformed RBC folate concentration (P = 0.0245). However, after adjusting for potential confounders, there was no association between obesity and folate insufficiency (aPOR:0. 79; 95% CI:0. 50, 1.23 for high risk NTD category and aPOR:0. 67; 95% CI:0. 45,1.00 for elevated NTD risk category). The association also did not persist when examined by obesity strata.

Conclusion: Our analyses show that obesity is not associated with folate insufficiency among women of reproductive age in the United States. Future studies should examine the association to better understand the relation between body weight and its impact on folate metabolism pathways, especially among obese women of reproductive age. 

Table of Contents

Introduction………………………………………………………………..1

Materials and Methods……………………………………………………13

Results………………………………………………………..…………….19

Discussion………………………………………………………………….22

References..………………………………………………………………..26

Tables and Figures………………………………………………………..31

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Women's Studies Health Sciences, Epidemiology
Palavra-chave	Folic acid Neural tube defect Folat insufficiency Reproductive age women Folate Body mass index Obesity NHANES
Committee Chair / Thesis Advisor	Vijaya Kancherla, PhD, Emory University Hind Beydoun, PhD, Johns Hopkins University

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