Associations among Folate, Vitamin B12 and Homocysteine levels in neonates in Bangladesh
P. Faruque 1, B. Bhowmik2, M.A. Samad3

1Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
2Centre of Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
3National Healthcare Network, Diabetic Association of Bangladesh, Mirpur-10, Dhaka, Bangladesh

Background: Vitamin B12 and folate are important cofactors involved in homocysteine metabolism. The high level of total homocysteine has received considerable interest because it is associated with high risk for cardiovascular disease. 
Aims: To determine the associations between serum folates, RBC folate, vitamin B12 and homocysteine levels in newborns in Bangladesh.
Methods: A total of 616 neonates were investigated in a randomized controlled trial conducted in 5 different areas of Dhaka city in Bangladesh. Cord blood samples were obtained at the time of delivery from the newborns. Serum folate, RBC folate and vitamin B12 were measured using electrochemiluminescence immunoassay and serum total homocysteine were measured using Microparticle Enzyme Immunoassay. Both spearman correlation and linear regression analysis were used to test the association. 
Results: The median (interquartile range) serum folates, RBC folate, serum vitamin B12 and homocysteine levels in cord blood were 15.4 (6.8) ng/ml, 217.8 (159.3) ng/ml, 327 (200) pg/ml, and 4.5 (2.2) µmol/l, respectively. A significant positive correlation was observed between serum vitamin B12 and RBC folate levels (r = 0.69, p = <0.001). Total homocysteine had shown negative correlation with vitamin B12 (r = -0.17, p = <0.001) and RBC folate (r = -0.14, p = <0.001). No significant association was observed between serum folate with vitamin B12 and homocysteine. 
Discussion: Study has found a significant association between RBC folates, vitamin B12 and homocysteine levels in newborn.  Our findings suggest that the neonates are at risk to develop cardiovascular disease in future. We propose that maternal and neonatal health could be improved by simply supplementing folate-enriched diet. We need prospective study to confirm these findings.

Associations among folate, vitamin B12 and homocysteine levels in neonates in Bangladesh