Serum folate and homocysteine levels in obese females with non-alcoholic fatty liver.
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.
Hirsch
Sandra
S
Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile. shirsch@inta.cl
Poniachick
Jaime
J
Avendaño
Maritza
M
Csendes
Atila
A
Burdiles
Patricio
P
Smok
Gladys
G
Diaz
Juan C
JC
de la Maza
María Pía
MP
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
D006710:Homocysteine; D005492:Folic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D014805:Vitamin B 12