Associations of different serum folate forms with indices of nonalcoholic fatty liver disease and advanced fibrosis - 09/02/23

Doi : 10.1016/j.orcp.2023.01.004

Sisi Yang ^a,^b,^c,^d, Ziliang Ye ^a,^b,^c,^d, Mengyi Liu ^a,^b,^c,^d, Yanjun Zhang ^a,^b,^c,^d, Qimeng Wu ^a,^b,^c,^d, Chun Zhou ^a,^b,^c,^d, Zhuxian Zhang ^a,^b,^c,^d, Panpan He ^a,^b,^c,^d, Yuanyuan Zhang ^a,^b,^c,^d, Huan Li ^a,^b,^c,^d, Chengzhang Liu ^a,^b,^c,^d,^e, Xianhui Qin ^a,^b,^c,^d,^⁎
^a Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
^b National Clinical Research Center for Kidney Disease, Guangzhou 510515, China
^c State Key Laboratory of Organ Failure Research, Guangzhou 510515, China
^d Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
^e Institute of Biomedicine, Anhui Medical University, Hefei 230032, China

^⁎Correspondence to: Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China.Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong LaboratoryGuangzhou510515China

Abstract

Objective

We aim to examine the associations of different serum folate forms (total folate, 5-methyltetrahydrofolate [5-mTHF] and unmetabolized folic acid [UMFA]), with the prevalence of nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis.

Methods

This cross-sectional analysis was conducted in 6610 participants aged ≥ 18 years from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) database. NAFLD was defined as a United States fatty liver index (USFLI) ≥ 30. Advanced fibrosis was defined as a Fibrosis-4 score (FIB-4) > 3.25, a NAFLD Fibrosis Score (NFS) > 0.676, and a Hepamet Fibrosis Score (HFS) ≥ 0.47, respectively.

Results

The prevalence of NAFLD was 34.5%. Overall, serum total folate and 5-mTHF were inversely associated with the prevalence of NAFLD (both P for trend across quartiles <0.001). A similar trend was found for advanced fibrosis based on NFS and HFS (both P for trend across quartiles <0.05). However, a higher concentration of UMFA was significantly related to a higher prevalence of NAFLD (P for trend across quartiles =0.004). A similar relation was found for advanced fibrosis based on NFS (P for trend across quartiles =0.024).

Conclusions

Higher concentrations of serum total folate and 5-mTHF were associated with a lower prevalence of NAFLD and advanced fibrosis, while a higher concentration of UMFA was related to a higher prevalence of NAFLD.

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Highlights

•	A higher concentration of serum total folate was related to a lower prevalence of NAFLD and advanced fibrosis.
•	A higher concentration of serum 5-mTHF was related to a lower prevalence of NAFLD and advanced fibrosis.
•	A higher concentration of serum unmetabolized folic acid (UMFA) was related to a higher prevalence of NAFLD.

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Keywords : Total folate, 5-methyltetrahydrofolate, Unmetabolized folic acid, Nonalcoholic fatty liver disease, Advanced fibrosis

Plan

Introduction

Methods

Study design and population

Measurements of serum folate forms

Definition of NAFLD and advanced fibrosis

Clinical and laboratory evaluations

Statistical analysis

Results

Baseline characteristic of participants

Associations between different folate forms and prevalence of NAFLD

Associations between different folate forms and prevalence of advanced fibrosis

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Vol 17 - N° 1

P. 58-65 - janvier 2023 Retour au numéro

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Associations of different serum folate forms with indices of nonalcoholic fatty liver disease and advanced fibrosis - 09/02/23

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