FOLIC ACID DOES NOT IMPROVE ENDOTHELIAL FUNCTION IN OBESE CHILDREN AND ADOLESCENTS

  1. Alexia S Peña, MD (alexia.pena{at}adelaide.edu.au)1,
  2. Esko Wiltshire, MD, FRACP2,
  3. Roger Gent, DMU3,
  4. Lino Piotto, DMU3,
  5. Craig Hirte, BSC (hons)4 and
  6. Jennifer Couper, MD, FRACP1,,5
  1. 1 Endocrinology and Diabetes Department
  2. 3 Medical Imaging
  3. 4 Public Health Research Unit
  4. 5 Department of Paediatrics. University of Adelaide, Women's and Children's Hospital, 72 King William Rd, North Adelaide, SA, 5006, Australia
  5. 2 Department of Paediatrics and Child Health, Wellington School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington South, New Zealand

    Abstract

    Objective Obese children have severe endothelial dysfunction as measured by flow mediated dilation (FMD). We have shown that folic acid normalizes endothelial function in children with type 1 diabetes who have a similar degree of endothelial dysfunction but, lower total homocyst (e) ine (tHcy) and higher folate status. Our aim was to evaluate, for the first time, the effect of folate supplementation on endothelial dysfunction in obese children.

    Research Design and Methods Fifty-three obese subjects (13.3 ± 2.2 years, 26 males, BMI z-score 2.29 ± 0.25) participated in a randomized, double blind, placebo controlled, parallel trial of oral folic acid (5 mg/day) or placebo for 8 weeks. Before and after the intervention we assessed endothelial function (FMD), smooth muscle function (glyceryl trinitrate induced dilatation: GTN), high sensitive C reactive protein (hsCRP), tHcy, serum folate, red cell folate (RCF) and lipids.

    Results There were no group differences at baseline. FMD did not change with the intervention [folic acid group pre and post intervention: 6.42 ± 5.03% and 6.56 ± 4.79 % vs. placebo group 5.17 ± 3.54% and 5.79 ± 4.26 % (p=0.6)]. Folate supplementation increased serum folate and RCF by 18.4 nmol/L (p < 0.001) and 240.1 nmol/L (p<0.001), respectively and decreased tHcy by 0.95 μmol/L (p=0.008). The intervention did not change GTN, hsCRP or lipids.

    Conclusions Folic acid supplementation does not improve endothelial function in obese children without diabetes despite increasing folate status and reducing tHcy. This is in contrast to the response to folate in children with type 1 diabetes.

    Footnotes

      • Received December 12, 2006.
      • Accepted May 13, 2007.

    This Article

    1. Published online before print May 22, 2007, doi: 10.2337/dc06-2505
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