Folate concentrations in pediatric patients with newly diagnosed inflammatory bowel disease.
BACKGROUND
Folate is postulated to protect against cell injury and long-term risk of cancer. Folate deficiency has been shown to be associated with inflammatory bowel disease (IBD). However, folate concentrations are poorly delineated in children with IBD.


OBJECTIVE
The objective was to compare folate concentrations between children with newly diagnosed IBD and healthy controls.


METHODS
Red blood cell folate (RBCF) and whole-blood folate (WBF) concentrations were measured in 78 children (mean age: 12.8 +/- 2.7 y): 22 patients with newly diagnosed untreated Crohn disease, 11 patients with ulcerative colitis, 4 patients with indeterminate colitis, and 41 controls. Vitamin supplementation and dietary intakes determined by food-frequency questionnaire were recorded for 20 IBD patients and 28 controls.


RESULTS
RBCF concentrations were 19.4% lower in controls (587.0 +/- 148.6 ng/mL) than in patients (728.7 +/- 185.8 ng/mL; P = 0.0004), and WBF concentrations were 11.1% lower in controls (218.2 +/- 49.7 ng/mL) than in patients (245.3 +/- 59.1 ng/mL; P = 0.031). Total folate intake was 18.8% higher in controls (444.7 +/- 266.7 microg/d) than in IBD patients (361.1 +/- 230.6 microg/d), but this difference was not statistically significant (P = 0.264). Folate intakes were below the Recommended Dietary Allowance (200-400 microg/d), adjusted for age and sex, in 35.4% of study subjects.


CONCLUSIONS
In contrast with previous evidence of folate deficiency in adult IBD patients, our data indicate higher folate concentrations in children with newly diagnosed untreated IBD than in controls. This finding was unexpected, especially in light of the higher dietary folate intakes and hematocrit values in children without IBD. The influence of IBD therapy on folate metabolism and the long-term clinical implications of high RBCF and WBF concentrations at the time of IBD diagnosis should be explored further.
Heyman
Melvin B
MB
Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143-0136, USA. mheyman@peds.ucsf.edu
Garnett
Elizabeth A
EA
Shaikh
Nishat
N
Huen
Karen
K
Jose
Folashade A
FA
Harmatz
Paul
P
Winter
Harland S
HS
Baldassano
Robert N
RN
Cohen
Stanley A
SA
Gold
Benjamin D
BD
Kirschner
Barbara S
BS
Ferry
George D
GD
Stege
Erin
E
Holland
Nina
N
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood*; D005494:Folic Acid Deficiency / Q000097:blood* / Q000150:complications; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D018673:Nutrition Policy; D009752:Nutritional Status; D011795:Surveys and Questionnaires
D005492:Folic Acid