Relationship of several serum folate forms with kidney function and albuminuria: cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES) 2011-2018

Authors：Liu, Mengyi; Zhou, Chun; Zhang, Zhuxian; Li, Qinqin; He, Panpan; Zhang, Yuanyuan; Li, Huan; Liu, Chengzhang; Hou, Fan Fan; Qin, Xianhui^*

Source：British Journal of Nutrition, 2022, 127(7): 1050-1059.

DOI：10.1017/S0007114521001665

• 5-methyltetrahydrofolate
• Unmetabolised folic acid
• MeFox
• Reduced eGFR
• Albuminuria

We aim to examine the relation of several folate forms (5-methyltetrahydrofolate (5-mTHF), unmetabolised folic acid (UMFA) and MeFox) with kidney function and albuminuria, which remained uncertain. The cross-sectional study was conducted in 18 757 participants from National Health and Nutrition Examination Survey 2011-2018. The kidney outcomes were reduced estimated glomerular filtration rate (eGFR) (<60 ml/min/1 center dot 73 m(2)), microalbuminuria (albumin:creatinine ratio (ACR) of 30-299 mg/g) and macroalbuminuria (ACR >= 300 mg/g). Overall, there were significant inverse associations between serum 5-mTHF and kidney outcomes with significant lower prevalence of reduced eGFR (OR, 0 center dot 71; 95 % CI: 0 center dot 57, 0 center dot 87) and macroalbuminuria (OR, 0 center dot 65; 95 % CI: 0 center dot 46, 0 center dot 91) in participants in quartiles 3-4 (v. quartiles 1-2; both P (for trend) across quartiles <0 center dot 05). In contrast, there were significant positive relationship between serum UMFA and kidney outcomes with significant higher prevalence of reduced eGFR in participants in quartiles 2-4 (v. quartile 1; OR, 2 center dot 12; 95 % CI: 1 center dot 45, 3 center dot 12; P (for trend) <0 center dot 001) and higher prevalence of macroalbuminuria in participants in quartile 4 (v. quartiles 1-3; OR, 1 center dot 46; 95 % CI: 1 center dot 06, 2 center dot 01; P (for trend) <0 center dot 001). However, there was no significant associations of 5-mTHF and UMFA with microalbuminuria. In addition, there were significant positive relationships of serum MeFox with reduced eGFR, microalbuminuria and macroalbuminuria (all P (for trend) <0 center dot 01). In conclusion, higher 5-mTHF level, along with lower UMFA and MeFox level, was associated with lower prevalence of kidney outcomes, which may help counsel future clinical trials and nutritional guidelines regarding the folate supplement.

• Institution
  安徽医科大学; 南方医科大学