Folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh.
BACKGROUND
Indian Asian men residing in the United Kingdom have a higher prevalence of hyperhomocysteinemia than do their European counterparts. This has been largely attributed to dietary deficiencies in cobalamin associated with vegetarianism among these Indian Asians.


OBJECTIVE
We aimed to ascertain the prevalence of folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh.


METHODS
Plasma concentrations of homocysteine, folate, and cobalamin and urinary concentrations of creatinine were assessed in 1650 adults in Bangladesh.


RESULTS
The prevalence of hyperhomocysteinemia (men: >11.4 micromol/L; women: >10.4 micromol/L) was markedly (P < 0.0001) greater among men (63%; x +/- SD: 15.3 +/- 9.5 micromol/L) than among women (26%; 9.5 +/- 4.7 micromol/L). Folate was lower (9.8 +/- 6.5 and 12.3 +/- 7.6 nmol/L, respectively), whereas cobalamin was higher (281 +/- 115 and 256 +/- 118 pmol/L, respectively) (P < 0.0001 for both) among men than among women. Folate explained 15% and cobalamin explained 5% of the variation in homocysteine concentrations. For men, folate (P = 0.005) and cobalamin (P = 0.03) were positively correlated with urinary creatinine. Smoking (P < 0.0003) and betelnut use (P < 0.0002) were independent negative predictors of folate.


CONCLUSIONS
Bangladeshi men have a high prevalence of hyperhomocysteinemia, which is more closely associated with folate than with cobalamin, although other factors, eg, smoking and betelnut use, may also contribute to its cause. The positive correlations between urinary creatinine and plasma folate and cobalamin were unanticipated and could suggest that, in marginal nutrition, these vitamins may be limiting for creatine biosynthesis.
Gamble
Mary V
MV
Department of Environmental Health Sciences, School of Public Health, Columbia University, New York, NY 10032, USA. mvg7@columbia.edu
Ahsan
Habibul
H
Liu
Xinhua
X
Factor-Litvak
Pam
P
Ilievski
Vesna
V
Slavkovich
Vesna
V
Parvez
Faruque
F
Graziano
Joseph H
JH
D000328:Adult; D000368:Aged; D001114:Areca / Q000009:adverse effects; D001459:Bangladesh / Q000453:epidemiology; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003937:Diagnosis, Differential; D014676:Diet, Vegetarian / Q000009:adverse effects; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006397:Hematinics / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*
D006397:Hematinics; D006710:Homocysteine; D005492:Folic Acid; D003404:Creatinine; D014805:Vitamin B 12