title: Maternal plasma pyridoxal-5'-phosphate concentrations and risk of isolated oral clefts in the Philippines.
abstract: BACKGROUND
  We report that inadequate vitamin B-6 status of Filipino mothers, assessed by erythrocyte aspartate aminotransferase activity coefficient (EAST-AC), is associated with an increased risk for isolated cleft lip with or without cleft palate (CL/P) in their children. Its association with the status assessed by plasma pyridoxal-5'-phosphate (PLP) concentrations is unknown.
  
  
  METHODS
  In a case-control study in the Philippines including 46 cases (mothers of a child with CL/P) and 392 controls (mothers of an unaffected child), we evaluated the association between the risk for CL/P and maternal vitamin B-6 status assessed by PLP and EAST-AC.
  
  
  RESULTS
  The ORs of CL/P were estimated by classifying mothers by PLP (>30, 20-30, and <20 nmol/L). Using the highest PLP group as the reference, ORs (95% CIs) were 1.03 (0.45-2.37) and 2.66 (1.30-5.50) for the middle and lowest groups, respectively (p trend = .01). In multivariate models controlling for various covariates including folate, the risk for CL/P was approximately 12 times higher in mothers with inadequate vitamin B-6 status, assessed by both PLP and EAST-AC values, compared to those with adequate status by both values.
  
  
  CONCLUSIONS
  Inadequate vitamin B-6 status assessed by maternal PLP and EAST-AC values independently and both combined was associated with an increased risk for CL/P. The association was highest when both values were considered, suggesting that the measurement of both PLP and EAST-AC provides better assessment of vitamin B-6 status than either measurement alone.
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. tamurat@uab.edu
authors.forename: Tsunenobu
authors.initials: T
authors.lastname: Tamura
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Munger
authors.forename: Buena
authors.initials: B
authors.lastname: Nepomuceno
authors.forename: Christopher
authors.initials: C
authors.lastname: Corcoran
authors.forename: Joselito
authors.initials: J
authors.lastname: Cembrano
authors.forename: Florentino
authors.initials: F
authors.lastname: Solon
mesh_terms: D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood / Q000378:metabolism; D016022:Case-Control Studies; D002971:Cleft Lip / Q000209:etiology*; D002972:Cleft Palate / Q000209:etiology*; D005260:Female; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D009035:Mothers; D010679:Philippines; D011247:Pregnancy; D011732:Pyridoxal Phosphate / Q000097:blood*; D012307:Risk Factors; D012923:Social Class
chemical_list: D011732:Pyridoxal Phosphate; D001219:Aspartate Aminotransferases