Serum Folate And Cytokines In Heterozygous Beta-Thalassemia

Introduction Folate deficiency is commonly reported in beta-thalassemia. Individuals heterozygous for beta-thalassemia may have higher folate requirements than normal individuals.Objectives: To document the concentration of serum total folate and its forms in beta-thalassemia heterozygote users (beta-TmU) and nonusers (beta-TmN) of 5 mg folic acid/d; to determine whether folic acid (FA) consumption from fortified foods allows beta-Tm patients, who do not take FA supplements, to meet their dietary folate requirements; and to investigate the association between higher serum unmetabolized folic acid (UMFA) and inflammatory cytokine concentrations.Methods Serum total folate and forms were measured in 42 beta-Tm (13 beta-TmU and 29 beta-TmN) and 84 healthy controls. The mononuclear leucocyte mRNA expression of relevant genes and their products and hematological profiles were determined.Results beta-TmU had higher serum total folate, 5-methyltetrahydrofolate, UMFA, and tetrahydrofolate (THF) compared with beta-TmN. The beta-TmN had lower serum total folate and THF than controls. Plasma total homocysteine (tHcy) was lower in beta-TmU compared with both beta-TmN and controls, while beta-TmN had higher tHcy than controls. beta-TmU had higher IL-8 than their controls while beta-TmN had higher IL-6 and IL-8 than their controls. beta-TmU have higher levels of serum total folate, 5- methyltetrahydrofolate, UMFA, and THF than controls. There was no association between UMFA concentrations and cytokine levels.Conclusions Mandatory flour fortification with FA in Brazil may be insufficient for beta-TmN, since they have higher tHcy and lower serum total folate than controls. Furthermore, beta-TmN have higher IL-6 levels than beta-TmU. UMFA was not associated with inflammatory cytokine levels.