Assessment of dietary folate consumption and serum folate level among β-thalassaemia traits

Abstract

There is no consensus among clinicians regarding the necessity of regular folic acid replacement for individuals with heterozygous β-thalassemia (BTT). The increased ineffective erythropoiesis, albeit to a mild degree, could make them vulnerable to folate deficiency, especially if there is an associated dietary deficiency. Community- based studies in Sri Lanka have previously shown a high prevalence of folate deficiency in the community, reaching even 43%; very likely suggestive of dietary deficiency. This study was designed to assess dietary folate consumption and serum folate levels in those with BTT viz a viz healthy matched controls. This case-control study includes 100 sets of samples, including a β-thalassaemia trait and an age, sex and BMI-matched normal individual from the same household in each set, aged between 5 to 25 years. Serum folate levels were determined using a fully automated Cobas immunoassay analyzer. The dietary intake of each participant was determined by recording 24-hour dietary recall on three consecutive days. Based on the results, 33 out of 98 (34%) cases had serum folate deficiency with a mean of 4.88 ng/mL, while 24 out of 99 (24%) controls had serum folate deficiency (defined as <3 ng/mL) with a mean of 4.76 ng/mL. Additionally, 37% (36/98) of cases and 49% (48/99) of controls were at risk of deficiency (defined as 3-5.9 ng/mL). Statistical analysis did not reveal any significant differences (p>0.05) in serum folate levels between cases and controls. Dietary folate intake was low but not significantly different between those with BTT (mean 181 μg; 96% <RDA) and controls (mean; 182 μg; 97%<RDA). There was no significant correlation between serum folate or dietary folate levels among cases (r= 0.097) or controls (r=0.098). In conclusion, there were high levels of folate deficiency in both controls and those with BTT (>24% and 34%), but those with BTT were no more likely to be folate deficient than the controls.