title: Serum folate and homocysteine levels in obese females with non-alcoholic fatty liver.
abstract: OBJECTIVE
  Folate depletion and hyperhomocysteinemia increase the risk for hepatic alcoholic damage and promote oxidative stress in animals. In addition, some investigators have reported an inverse association between serum folate and body mass index and a positive correlation between total homocysteine and fat mass. We investigated whether there is an association between serum folate and total homocysteine concentrations with the presence of non-alcoholic fatty liver disease (NAFLD) in obese subjects.
  
  
  METHODS
  Forty-three obese (body mass index > or =35 kg/m2) patients who underwent bariatric surgery and hepatic biopsy were included. Serum total homocyteine, folate and vitamin B12 concentrations and hepatic enzymes were measured. Liver biopsies were graded for the presence of fat, inflammation, and fibrosis on a scale from 0 to 3. A total histologic score was calculated based on the sum of partial scores. Severe NAFLD was defined as a total score of at least 4 or severe steatosis (partial score for fat = 3).
  
  
  RESULTS
  Severe NAFLD was present in 17 patients. Serum folate concentration was significantly lower in obese patients with NAFLD than in those with normal liver or minimal alterations (9.3 +/- 3.5 versus 12.2 +/- 3.1 ng/mL, P = 0.005). Serum total homocysteine and vitamin B12 concentrations were similar in both groups. An inverse correlation between serum folate concentration and body mass index was observed (r = -0.31, P = 0.046).
  
  
  CONCLUSIONS
  In this study, severe NAFLD in obese subjects was associated with lower serum folate concentrations and serum homocysteine and vitamin B12 concentrations were not associated with liver damage in obese subjects.
authors.affiliation: Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile. shirsch@inta.cl
authors.forename: Sandra
authors.initials: S
authors.lastname: Hirsch
authors.forename: Jaime
authors.initials: J
authors.lastname: Poniachick
authors.forename: Maritza
authors.initials: M
authors.lastname: Avendaño
authors.forename: Atila
authors.initials: A
authors.lastname: Csendes
authors.forename: Patricio
authors.initials: P
authors.lastname: Burdiles
authors.forename: Gladys
authors.initials: G
authors.lastname: Smok
authors.forename: Juan C
authors.initials: JC
authors.lastname: Diaz
authors.forename: María Pía
authors.initials: MP
authors.lastname: de la Maza
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D049088:Bariatrics; D015992:Body Mass Index; D016022:Case-Control Studies; D005234:Fatty Liver / Q000097:blood* / Q000201:enzymology / Q000473:pathology; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008111:Liver Function Tests; D009767:Obesity, Morbid / Q000097:blood* / Q000473:pathology / Q000601:surgery; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D014805:Vitamin B 12