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学科主题: 临床医学
题名:
Population red blood cell folate concentrations for prevention of neural tube defects: bayesian model
作者: Crider, Krista S.1; Devine, Owen1; Hao, Ling2,3; Dowling, Nicole F.1; Li, Song4; Molloy, Anne M.5; Li, Zhu2; Zhu, Jianghui2,6; Berry, Robert J.1
刊名: BMJ-BRITISH MEDICAL JOURNAL
发表日期: 2014-07-29
DOI: 10.1136/bmj.g4554
卷: 349
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: FOLIC-ACID FORTIFICATION ; DOUBLE-BLIND TRIAL ; UNITED-STATES ; CHILDBEARING AGE ; HOMOCYSTEINE CONCENTRATIONS ; ERYTHROCYTE FOLATE ; FOOD FORTIFICATION ; SPINA-BIFIDA ; WOMEN ; SUPPLEMENTATION
英文摘要:

Objective To determine an optimal population red blood cell (RBC) folate concentration for the prevention of neural tube birth defects.

Design Bayesian model.

Setting Data from two population based studies in China.

Participants 247 831 participants in a prospective community intervention project in China (1993-95) to prevent neural tube defects with 400 mu g/day folic acid supplementation and 1194 participants in a population based randomized trial (2003-05) to evaluate the effect of folic acid supplementation on blood folate concentration among Chinese women of reproductive age.

Intervention Folic acid supplementation (400 mu g/day).

Main outcome measures Estimated RBC folate concentration at time of neural tube closure (day 28 of gestation) and risk of neural tube defects.

Results Risk of neural tube defects was high at the lowest estimated RBC folate concentrations (for example, 25.4 (95% uncertainty interval 20.8 to 31.2) neural tube defects per 10 000 births at 500 nmol/L) and decreased as estimated RBC folate concentration increased. Risk of neural tube defects was substantially attenuated at estimated RBC folate concentrations above about 1000 nmol/L (for example, 6 neural tube defects per 10 000 births at 1180 (1050 to 1340) nmol/L). The modeled dose-response relation was consistent with the existing literature. In addition, neural tube defect risk estimates developed using the proposed model and population level RBC information were consistent with the prevalence of neural tube defects in the US population before and after food fortification with folic acid.

Conclusions A threshold for "optimal" population RBC folate concentration for the prevention of neural tube defects could be defined (for example, approximately 1000 nmol/L). Population based RBC folate concentrations, as a biomarker for risk of neural tube defects, can be used to facilitate evaluation of prevention programs as well as to identify subpopulations at elevated risk for a neural tube defect affected pregnancy due to folate insufficiency.

语种: 英语
项目资助者: Centers for Disease Control and Prevention
WOS记录号: WOS:000339906000002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/66965
Appears in Collections:北京大学第三临床医学院_期刊论文

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作者单位: 1.Peking Univ, Hlth Sci Ctr, Beijing 100871, Peoples R China
2.US Ctr Dis Control & Prevent, US Embassy, Beijing, Peoples R China
3.Peking Univ, Hosp 3, Beijing 100871, Peoples R China
4.Univ Dublin Trinity Coll, Sch Med, Dublin 2, Ireland
5.Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA
6.China Natl Ctr Food Safety Risk Assessment, Div Risk Assessment, Beijing, Peoples R China

Recommended Citation:
Crider, Krista S.,Devine, Owen,Hao, Ling,et al. Population red blood cell folate concentrations for prevention of neural tube defects: bayesian model[J]. BMJ-BRITISH MEDICAL JOURNAL,2014,349.
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