Commenced in January 2007
Paper Count: 31532
Cobalamin, Folate and Metabolic Syndrome Parameters in Pediatric Morbid Obesity and Metabolic Syndrome
Abstract:Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B12 plays essential roles in fat and protein metabolisms and its cooperation with vitamin B9 is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B12 concentrations were measured using electrochemiluminescence immunoassay. Vitamin B9 was analyzed by an immunoassay analyzer. Values for vitamin B12 < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B9 levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B9 and vitamin B12 levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B12 levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B9 and B12 may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B12 metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B12 and vitamin B9 deficiency in MetS associated with the increased vitamin B12 as well as vitamin B9 deficiency metabolites may add to MetS parameters.
Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1317248Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 512
 S. Maffoni, R. De Giuseppe, F. C. Stanford, and H. Cena, “Folate status in women of childbearing age with obesity: a review,” Nutr Res Rev, vol 30, no. 2, pp. 265-271, Dec. 2017.
 V.R. da Silva, D. B. Hausman, G. P. A. Kauwell, A. Sokolow, R. L. Tackett, S. L. Rathbun, and L. B. Bailey, “Obesity affects short-term folate pharmacokinetics in women of childbearing age,” Int J Obes, vol. 37, no. 12, pp. 1608-1610, Dec. 2013.
 N. Sukumar, S. Wilson, H. Venkataraman, and P. Saravanan, “Low vitamin B12 in pregnancy is associated with maternal obesity and gestational diabetes,” Diab Med, vol. 32, no. SI, pp. 79-80, Mar. 2015.
 N. Sukumar, N. Bawazeer, V. Patel, and P. Saravanan, “Low B12 level is associated with maternal obesity and higher birtweight in gestational diabetes,” J Dev Orig Health Dis, vol. 2, no. SI, pp. S128-S129, Sep. 2011.
 R. D. Silva, F. M. F. Malta, M. F. F. S. C. Correia, and M. G. P. D. A. Burgos, “Serum vitamin B12, iron and folic acid deficiencies in obese individuals submitted to different bariatric techniques,” ABCD-Braz Arch Dig Surg, vol. 29, suppl.1, pp. 62-66, 2016.
 B. A. Knight, B. M. Shields, A. Brook, A. Hill, D. S. Bhat, A. T. Hattersley, and C. S. Yajnik, “Lower circulating B12 is associated with higher obesity and insulin resistance during pregnancy in a non-diabetic white British population,” PLoS ONE, vol. 10, no. 8, Art no. e0135268, Aug. 2015.
 E. H. Miranti, R. Stolzenberg-Solomon, S. J. Weinstein, J. Selhub, S. Mannisto, P. R. Taylor, N. D. Freedman, D. Albanes, C. C. Abnet, and G. Murphy, “Low vitamin B12 increases risk of gastric cancer: A prospective study of one-carbon metabolism nutrients and risk of upper gastrointestinal tract cancer,” Int J Cancer, vol. 141, no. 6, pp. 1120-1129, Sep. 2017.
 S. Chittiboyina, Z. X. Chen, E. G. Chiorean, L. M. Kamendulis, and B. A. Hocevar, “The role of the folate pathway in pancreatic cancer risk,” PLoS ONE, vol. 13, no. 2 pp. e0193298, Feb. 2018.
 S. Kupeli, G. Sezgin, and I. Bayram, “Vitamin B12 and folic acid levels in childhood cancers,” Pediatr Blood Cancer, vol. 63, no.3, pp. S284, Nov. 2016.
 R. H. Xie, Y. J. Liu, R. Retnakaran, A. J. MacFarlane, J. Hamilton, G. Smith, M. C. Walker, and S. W. Wen, “Maternal folate status and obesity/insulin resistance in the offspring: a systematic review,” Int J Obes, vol. 40, no. 1, pp.1-9, Jan. 2016.
 C. J. Piyathilake, S. Badiga, R. D. Alvarez, E. E. Partridge, and G. L. Johanning, “A lower degree of PBMC L1 methylation is associated with excess body weight and higher HOMA-IR in the presence of lower concentrations of plasma folate,” PLoS ONE, vol. 8, no. 1, pp. e54544, 2013.
 K. Suriyaprom, B. Phonrat, P. Satitvipawee, A. Tungtrongchitr, and R. Tungtrongchitr, “Homocysteine but not serum amyloid A, vitamin A and E related to increased risk of metabolic syndrome in post-menapausal Thai women,” Int J Vitam Nutr Res, vol. 84, no. 1-2, pp. 35-44, 2014.
 M. Narang, M. Singh and S. Dange, “Serum homocysteine, vitamin B12 and folic acid levels in patients with metabolic syndrome,” J Assoc Physicians India, vol. 64, no. 7, pp. 2-26, Jul. 2016.
 G. Hergene, A. Onat, S. Albayrak, H. Ozhan, H. Uyarel, and G. Can. “Serum folate and vitamin B12 levels in Turkish women: Inverse associations with metabolic syndrome, but none with coronary heart disease,” Clin Chem, vol 53, no.6, pp.A49, Jun 2007.
 S. Ozer, E. Sonmezgoz, and O. Demir, “Negative correlation among vitamin B12 levels, obesity severity and metabolic syndrome in obese children: A case control study,” J Pak Med Assoc, vol. 67, no. 11, pp. 1648-1653, Nov. 2017.
 M. Ho, J. H. Halim, M. L. Gow, N. El-Haddad, T. Marzulli, L. A. Baur, C. T. Cowell, and S. P. Garnett, “Vitamin B12 in Obese Adolescents with Clinical Features of Insulin Resistance,” Nutrients, vol. 6, no. 12, pp. 5611-5618, Dec.2014.
 L. R. Anastacio, G. L. Ferreira, H. de Sena Riberio, J. C. Liboredo, A. S. Lima, and M. I. Toulson Davisson Correla, “Metabolic syndrome after liver transplantation: prevalence and predictive factors,” Nutrition, vol. 27, no. 9, pp. 931-937, Sep. 2011.
 L. Majnaric, F. Babic, A. Lukacova, and A. Holzinger, “The metabolic syndrome characteristics extended by using a machine learning approach,” Atherosclerosis, vol. 241, no. 1, pp. E171, Jul, 2015.
 Y. Tamai, K. Wada, M. Tsuji, K. Nakamura, Y. Sahashi, K. Watanabe, K. Yamamoto, K. Ando, and C. Nagata, “ Dietary intake of vitamin B12 and folic acid is associated with lower blood pressure in Japanese preschool children,” Am J Hypertens, vol. 24, no. 11, pp. 1215-1221, Nov. 2011.
 S. A. Chiplonkar, V. V. Agte, K. V. Tarwadi, K. W. Paknikar, and U. P. Divata, “Micronutrient deficiencies as predisposing factors for hypertension in lactovegeterian Indian adults,” Am J Coll Nutr, vol. 23, no. 3, pp. 239-247, Jun. 2004.
 H. H. Hagar, “Folic acid and vitamin B12 supplementation attenuates isoprenaline-induced myocardial infarction in experimental hyperhomocysteinemic rats,” Pharmacol Res, vol. 46, no. 3, pp. 213-219, Sep. 2002.