Background Micronutrient deficiency is a global public health concern, especially among the adolescents of developing countries including India. Folate, an essential B-vitamin plays an indispensable role in various physiological processes throughout life. This is a cross-sectional study to determine prevalence of folate insufficiency among North-Indian school-going adolescents of various socio-economic backgrounds. Methods A total of 3129 healthy school-going adolescents from North India were selected for the study and circulatory folate levels were measured using an electrochemiluminescence assay. Relationship of circulatory folate with various biochemical and anthropometric parameters were evaluated. Genetic determinants of folate levels in the study population were explored via both genome-wide and exome-wide association studies. Results Our results indicate higher prevalence (41%) of folate insufficiency in urban adolescents attending government-funded schools, with distinct relationship of folate levels, biochemical parameters, and anthropometric traits with varied socioeconomic strata. Girls exhibited a higher percentage of folate insufficiency than their male contemporaries. Results from genome-wide association study indicate significant associations of MYO1B (p = 5.13 × 10-7), CDH9 (p = 5.36 × 10–7), and PANK3 (p = 6.66 × 10–7) genes with folate levels in adolescents. Single variant analysis from exome-wide association analysis reaffirms the association of a previously reported variant in MTHFR gene (rs1801133; p = 1.87 × 10–6) along with identification of novel missense variants in KRT7 (rs2608009; p = 2.16 × 10–6 and rs6580870; p = 9.49 × 10–6) and AK9 (rs1406957; p = 4.76 × 10–6) genes. Conclusions Our study highlights the importance of large-scale studies on prevalence of folate insufficiency and nutrigenomic regulation of folate levels in Indian population. Implementing multifaceted measures including food fortification, dietary diversification and health education in adolescents is crucial to combat folate deficiency in developing nations like India.

Unraveling folate deficiency: prevalence, biochemical associations, genetic determinants, and strategies for adolescent health in North India

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发表日期：

2025年5月14日

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Janaki M. Nair,
Shraddha Chakraborty,
Khanmi Kasomva,
Ganesh Chauhan,
Sandeep Mathur,
Analabha Basu,
Nikhil Tandon,
Dwaipayan Bharadwaj

摘要

Background

Micronutrient deficiency is a global public health concern, especially among the adolescents of developing countries including India. Folate, an essential B-vitamin plays an indispensable role in various physiological processes throughout life. This is a cross-sectional study to determine prevalence of folate insufficiency among North-Indian school-going adolescents of various socio-economic backgrounds.

Methods

A total of 3129 healthy school-going adolescents from North India were selected for the study and circulatory folate levels were measured using an electrochemiluminescence assay. Relationship of circulatory folate with various biochemical and anthropometric parameters were evaluated. Genetic determinants of folate levels in the study population were explored via both genome-wide and exome-wide association studies.

Results

Our results indicate higher prevalence (41%) of folate insufficiency in urban adolescents attending government-funded schools, with distinct relationship of folate levels, biochemical parameters, and anthropometric traits with varied socioeconomic strata. Girls exhibited a higher percentage of folate insufficiency than their male contemporaries. Results from genome-wide association study indicate significant associations of MYO1B (p = 5.13 × 10^-7), CDH9 (p = 5.36 × 10^–7), and PANK3 (p = 6.66 × 10^–7) genes with folate levels in adolescents. Single variant analysis from exome-wide association analysis reaffirms the association of a previously reported variant in MTHFR gene (rs1801133; p = 1.87 × 10^–6) along with identification of novel missense variants in KRT7 (rs2608009; p = 2.16 × 10^–6 and rs6580870; p = 9.49 × 10^–6) and AK9 (rs1406957; p = 4.76 × 10^–6) genes.

Conclusions

Our study highlights the importance of large-scale studies on prevalence of folate insufficiency and nutrigenomic regulation of folate levels in Indian population. Implementing multifaceted measures including food fortification, dietary diversification and health education in adolescents is crucial to combat folate deficiency in developing nations like India.