Hostname: page-component-5db58dd55d-f6s65 Total loading time: 0 Render date: 2026-07-09T03:56:59.677Z Has data issue: false hasContentIssue false
  • English
  • Français

Plasma homocysteine, folate and vitamin B12 compared between rural Gambian and UK adults

Published online by Cambridge University Press:  19 February 2008

Sophie E. Moore ,
M. Azam Mansoor ,
Christopher J. Bates  and
Andrew M. Prentice
Sophie E. Moore
Affiliation:
Medical Research Council, Keneba, The Gambia Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
M. Azam Mansoor
Affiliation:
Division of Clinical Chemistry, Central Hospital in Rogaland, Stavanger, Norway
Christopher J. Bates*
Affiliation:
Medical Research Council Human Nutrition Research, Cambridge, UK
Andrew M. Prentice
Affiliation:
Medical Research Council, Keneba, The Gambia Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
*
*Corresponding author: Dr Christopher J. Bates, fax +44 (0) 1223 437515, email Chris.Bates@mrc-hnr.cam.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

The disease risk indicator plasma total homocysteine (tHcy) is influenced by genetic and environmental factors, including folate and vitamin B12 status. Little is known about the determinants of tHcy in rural West Africa. We explored the hypothesis that tHcy in rural Gambian adults might vary between the sexes and physiological groups, an/r with folate and vitamin B12 status. Comparisons were made with a British national survey. Non-pregnant Gambian women (n 158) had tHcy concentrations (geometric mean 9·0μmo/) similar to those of non-pregnant UK women (n 449; 9·4μmo/), whereas pregnant Gambian women (n 12) had significantly lower values (6·2μmo/). Gambian men (n 22) had significantly higher values (14·7μmo/) than British men (n 354; 10·8μmo/). Gambian lactating women and British men and women exhibited significant inverse relationships between loge(tHcy) and folate status; however, only the British subjects exhibited significant inverse relationships between loge(tHcy) and vitamin B12 status. In the British sample, and in Gambian lactating women, folate and vitamin B12 status variations together accounted for 20–25% of the variation in loge(tHcy). Within the UK, black-skinned adults had folate and tHcy levels similar to those of their white-skinned counterparts, but significantly higher vitamin B12 values. We conclude that, whereas folate and vitamin B12 status are similar between British and rural Gambian populations, tHcy is higher in Gambian men and lower in pregnant Gambian women, and that serum vitamin B12 values appear to be higher in black-skinned than white-skinned British subjects. Possible reasons are discussed.

Keywords

HomocysteineFolateVitamin B12GambiaWest AfricaUnited Kingdom

Information

Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 3 , September 2006 , pp. 508 - 515
Copyright
Copyright © The Nutrition Society 2006

References

Abdalla, SH, Corrah, PT & Mabey, DC (1986) Severe megaloblastic anaemia due to vitamin B 12 deficiency in The Gambia. Trans R Soc Trop Med Hyg 80, 557–562.CrossRefGoogle ScholarPubMed
Adjalla, CE, Amouzou, EK, Sanni, A, Abdelmouttaleb, I, Chabi, NW, Namour, F, Soussou, B & Gueant, JL (2003) Low frequency of mutated methylenetetrahydrofolate reductase 677C→T and 1298A→C genetics single nucleotide polymorphisms (SNPs) in sub-Saharan populations. Clin Chem Lab Med 41, 1028–1032.CrossRefGoogle Scholar
Amouzou, EK, Chabi, NW, Adjalla, CE, Rodriguez-Gueant, RM, Feillet, F, Villaume, C, Sanni, A & Gueant, JL (2004) High prevalence of hyperhomocysteinemia related to folate deficiency and the 677C→T mutation of the gene encoding methylenetetrahydrofolate reductase in coastal West Africa. Am J Clin Nutr 79, 619–624.CrossRefGoogle Scholar
Andersson, A, Hultberg, B, Brattstrom, L & Isaksson, A (1992) Decreased serum homocysteine in pregnancy. Eur J Clin Chem Clin Biochem 30, 377–379.Google ScholarPubMed
Bates, CJ, Fuller, NJ & Prentice, AM (1986) Folate status during pregnancy and lactation in a West African rural community. Hum Nutr Clin Nutr 40C, 3–13.Google Scholar
Bates, CJ, Prentice, AM & Paul, AA (1994) Seasonal variations in vitamins A, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: some possible implications. Eur J Clin Nutr 48, 660–668.Google Scholar
Bates, CJ, Prentice, AM, Prentice, A, Paul, AA & Whitehead, RG (1982) Seasonal variations in ascorbic acid status and breast milk ascorbic acid levels in rural Gambian women in relation to dietary intake. Trans Roy Soc Trop Med Hyg 3, 341–347.CrossRefGoogle Scholar
Blom, HJ (1998) Mutated 5,10-methylenetetrahydrofolate reductase and moderate hyperhomocysteinaemia. Eur J Pediatr 157, S131–S134.CrossRefGoogle ScholarPubMed
Boushey, CJ, Beresford, SAA, Omenn, GS & Motulsky, AG (1995) A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. J Am Med Assoc 274, 1049–1057.CrossRefGoogle ScholarPubMed
Cappuccio, FP, Bell, R, Perry, IJ, Gilg, J, Ueland, PM, Refsum, H, Sagnella, GA, Jeffery, S & Cook, DG (2002) Homocysteine levels in men and women of different ethnic and cultural background living in England. Atherosclerosis 164, 95–102.CrossRefGoogle ScholarPubMed
Carmel, R (1999) Ethnic and racial factors in cobalamin metabolism and its disorders. Semin Hematol 36, 88–100.Google ScholarPubMed
Cole, TJ (1993) Seasonal effects on physical growth and development. In Seasonality and Human Ecology, pp. 89–106 [Ulijaszek, SJ and Strickland, SS, editors]. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. London: HMSO.Google Scholar
Fiskerstrand, T, Refsum, H, Kvalheim, G & Ueland, PM (1993) Homocysteine and other thiols in plasma and urine: automated determination and sample stability. Clin Chem 39, 263–271.CrossRefGoogle ScholarPubMed
Fokkema, MR, Gilissen, MF, van Doormal, JJ, Volmer, M, Kema, IP & Muskiet, FAJ (2003) Fasting vs nonfasting plasma homocysteine concentrations for diagnosis of hyperhomocysteinemia. Clin Chem 49, 818–821.CrossRefGoogle ScholarPubMed
Gamble, MV, Ahsan, H, Liu, X, Factor-Litvak, P, Ilievski, V, Slavkovich, V, Parvez, F & Graziano, JH (2005) Folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh. Am J Clin Nutr 81, 1372–1377.CrossRefGoogle ScholarPubMed
Ganji, V & Kafai, MR (2003) Demographic, health, lifestyle, and blood vitamin determinants of serum total homocysteine concentrations in the third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 77, 826–833.CrossRefGoogle ScholarPubMed
Gerhard, GT, Malinow, MR, DeLoughery, TG, Evans, AJ, Sexton, G, Connor, SL, Wander, RC & Connor, WE (1999) Higher total homocysteine concentrations and lower folate concentrations in premenopausal black women than in premenopausal white women. Am J Clin Nutr 70, 252–260.CrossRefGoogle ScholarPubMed
Glew, RH, Conn, CA, Vanderjagt, TA, Calvin, CD, Obadofin, MOP, Crossey, M & Vanderjagt, DJ (2004) Risk factors for cardiovascular disease and diet of urban and rural dwellers in northern Nigeria. J Health Popul Nutr 22, 357–369.Google Scholar
Glew, RH, Kassam, HA, Bhanji, RA, Okorodudu, A & Vanderjagt, DJ (2002) Serum lipid profiles and risk of cardiovascular disease in three different male populations in northern Nigeria. J Health Popul Nutr 20, 166–174.Google ScholarPubMed
Gueant-Rodriguez, R-M, Gueant, J-L & Debard, R, et al. (2006) Prevalence of methylenetetrahydrofolate reductase 677T and 1298C alleles and folate status: a comparative study in Mexican, West African and European populations. Am J Clin Nutr 83, 701–707.CrossRefGoogle ScholarPubMed
Henderson, L, Gregory, J & Swan, G (2002) National Diet and Nutrition Survey: Adults Aged 19 to 64 Years, vol. 1, Types and Quantities of Foods Consumed. London: The Stationery Office.Google Scholar
Henderson, L, Irving, K, Gregory, J, Bates, CJ, Prentice, A, Perks, J, Swan, G & Farron, M (2003) The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years, vol. 3, Vitamin and Mineral Intake and Urinary Analytes. London: The Stationery Office.Google Scholar
Ingenbleek, Y & Young, VR (2004) The essentiality of sulfur is closely related to nitrogen metabolism: a clue to hyperhomocysteinemia. Nutr Res Rev 17, 135–152.CrossRefGoogle Scholar
Jacques, PF, Bostom, AG, Wilson, PWF, Rich, S, Rosenberg, IH & Selhub, J (2001) Determinants of plasma total homocysteine concentration in the Framingham Offspring cohort. Am J Clin Nutr 73, 613–621.CrossRefGoogle ScholarPubMed
Moller, J, Rasmussen, K & Christensen, L (1999) External quality assessment of methylmalonic acid and total homocysteine. Clinical Chemistry 45, 1536–1542.CrossRefGoogle ScholarPubMed
Moore, SE, Halsall, I, Howarth, D, Poskitt, EME & Prentice, AM (2001) Glucose, insulin and lipid metabolism in rural Gambians exposed to early malnutrition. Diabet Med 18, 646–653.CrossRefGoogle ScholarPubMed
Nexo, E, Engbaek, F, Ueland, PM, et al. (2000) Evaluation of novel assays in clinical chemistry: Quantification of plasma total homocysteine. Clin Chem 46, 1150–1156.CrossRefGoogle ScholarPubMed
Nygard, O, Refsum, H, Ueland, PM, Vollset, SE, et al. (1998) Major lifestyle determinants of plasma total homocysteine distribution: the Hordaland Homocysteine Study. Am J Clin Nutr 67, 263–270.CrossRefGoogle ScholarPubMed
Pancharuniti, N, Lewis, CA & Sauberlich, HE (1994) Plasma homocysteine, folate, and vitamin B-12 concentrations and risk for early-onset coronary artery disease. Am J Clin Nutr 59, 940–948.CrossRefGoogle ScholarPubMed
Prentice, AM, Cole, TJ, Foord, FA, Lamb, WH & Whitehead, RG (1987) Increased birthweight after prenatal dietary supplementation of rural African women. Am J Clin Nutr 46, 912–925.CrossRefGoogle ScholarPubMed
Prentice, AM, Cole, TJ, Moore, SE & Collinson, AC (1999) Programming the adult immune system. In Fetal Programming: Influence on Development and Disease in Later Life. Proceedings of the 36th RCOG Study Group, pp. 399–413 [O'Brien, PMS, Wheeler, T and Barker, DJP, editors]. London: John Libbey & Son.Google Scholar
Prentice, AM, Whitehead, RG, Roberts, SB & Paul, AA (1981) Long-term energy balance in childbearing Gambian women. Am J Clin Nutr 34, 2790–2799.CrossRefGoogle ScholarPubMed
Ruston, D, Hoare, S, Henderson, L, Gregory, J, Bates, CJ, Prentice, A, Birch, M, Swan, G & Farron, M (2004) National Diet and Nutrition Survey: Adults Aged 19 to 64 Years, vol. 4, Nutritional Status (Anthropometry and Blood Analytes), Blood Pressure and Physical Activity. London: The Stationery Office.Google Scholar
Shankar, AH (2000) Nutritional modulation of malaria morbidity and mortality. J Infect Dis 182, S37–S53.CrossRefGoogle ScholarPubMed
Shipchandler, MT & Moore, EG (1995) Rapid, fully automated measurement of plasma homocyst(e)ine with the Abbott IMx analyzer. Clin Chem 41, 991–994.CrossRefGoogle ScholarPubMed
Siekmann, JH, Allen, LH, Bwibo, NO, Demment, MW, Murphy, SP & Neumann, CG (2003) Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation. J Nutr 133, 3972S–3980S.CrossRefGoogle ScholarPubMed
Simpore, J, Pignatelli, S, Meli, C, Malaguarnera, M, Chillemi, R & Musumeci, S (2002) Nutritional and racial determinants of the increase in plasma homocysteine levels after methionine loading. Curr Ther Res 63, 459–473.CrossRefGoogle Scholar
Stabler, SP & Allen, RH (2004) Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr 24, 299–326.CrossRefGoogle ScholarPubMed
Topley, E (1968) Anaemias associated with splenomegaly among women villagers in an area where malaria is endemic. E Afr Med J 45, 190–202.Google Scholar
Ubbink, JB, Delport, R & Vermaak, WJH (1996) Plasma homocysteine concentrations in a population with a low coronary heart disease prevalence. J Nutr 126, 1254S–1257S.CrossRefGoogle Scholar
Ueland, PM, Refsum, H & Brattstrom, L (1992) Plasma homocysteine and cardiovascular disease. In Atherosclerotic Cardiovascular Disease, Hemostasis and Endothelial Function, pp. 183–236 [Francis, RBJ, editor]. New York: Marcel Dekker.Google Scholar
Ueland, PM, Refsum, H & Schneede, J (2000) Determinants of plasma homocysteine. In Homocysteine and Vascular Disease, pp. 59–82 [Robinson, K, editor]. Dordrecht: Kluwer Academic.CrossRefGoogle Scholar
Ueland, PM, Refsum, H, Stabler, SP, Malinow, MR, Andersson, A & Allen, RH (1993) Total homocysteine in plasma or serum. Methods and clinical applications. Clin Chem 39, 1764–1779.CrossRefGoogle ScholarPubMed
Ueland, PM, Refsum, H, Svardal, AM, Djurhaus, R & Helland, S (1987) Perturbation of homocysteine metabolism by pharmacological agents in experimental and clinical use. In Tumor Cell Differentiation. Biology and Pharmacology, pp. 269–278 [Aarbakke, J, Chiang, PK and Koeffler, HP, editors]. Clifton, NJ: Humana Press.CrossRefGoogle Scholar
van der Sande, MA, Ceesay, SM, Milligan, PJ, Nyan, OA, Banya, WA, Prentice, A, McAdam, KP & Walraven, GE (2001) Obesity and undernutrition and cardiovascular risk factors in rural and urban Gambian communities. Am J Publ Health 91, 1641–1644.CrossRefGoogle ScholarPubMed
Vanderjagt, DJ, Spelman, K, Ambe, J, Datta, P, Blackwell, W, Crossey, M & Glew, RH (2000) Folate and vitamin B12 status of adolescent girls in northern Nigeria. J Natl Med Assoc 92, 334–340.Google ScholarPubMed
Vollset, SE, Refsum, H & Ueland, PM (2001) Population determinants of homocysteine. Am J Clin Nutr 73, 499–500.CrossRefGoogle ScholarPubMed
Walker, MC, Smith, GN, Perkins, SL, Keely, EJ & Garner, PR (1999) Changes in homocysteine levels during normal pregnancy. Am J Obstet Gynecol 180, 660–664.CrossRefGoogle ScholarPubMed
Welch, GN & Loscalzo, J (1998) Homocysteine and atherothrombosis. New Engl J Med 338, 1042–1050.CrossRefGoogle ScholarPubMed