The potential role of folate status on pulmonary function in pediatric asthma
Maria Michelle Papamichael Nutrition Available online 7 April 2021, 111267
HIGHLIGHTS
• Raising global public health awareness is the upsurge in childhood bronchial asthma.
• Western lifestyle plays a part but little is known about folate intake and lung function in pediatric respiratory diseases including asthma
• This study highlighted the problem of low folate status in children suffering with asthma
• Girls’ folate deficient had significantly lower measurements of FVC, FEV1 and PEF than those with higher plasma concentrations. No association was observed in boys
• Prevention/management of folate deficiency in asthmatic children could improve lung function and overall health.
Objective
The aim of this study was to explore the relationship between plasma folate status and measures of airway disease (as reflected by spirometry) in asthmatic children on a Traditional Mediterranean diet. We hypothesized that folate deficiency is associated with lung function impairment in asthmatic children.
Methods
This cross-sectional study included 64 mild asthmatic children (52% male, mean age 8.0 ± 2.0 years) residing in Athens, Greece. Clinical assessments included spirometry and Fractional exhaled Nitric Oxide (FeNO). Plasma 5-Methyltetrahydrofolate (5-MTHF) was analysed using High Performance-Liquid Chromatography assay (HPLC) and examined in subjects using quartiles (Q1-Q4).
Results
Of the 64 children, 45.3% were folate deficient (5-MTHF <10 nmol/L). A positive relationship was observed between 5-MTHF and Forced Vital Capacity (FVC) (β = 0.79, 95%CI: 0.14, 1.44, Padj = 0.019), Forced Expiratory Volume in 1 second (FEV1) (β= 0.78, 95%CI: 0.01, 1.55; Padj = 0.046), and Peak Expiratory Flow (PEF) (β= 1.64, 95%CI: 0.14, 3.15; Padj = 0.033) in girls only, adjusting for BMI and regular exercise. Girls with low plasma folate concentrations (Q1), compared to girls with high concentrations (Q4) had 8.64% lower FVC [β = -8.64, 95%CI: -16.18, -1.09, Padj = 0.027], 10.35% FEV1 [β = - 10.35, 95% CI:-18.82, -1.89, Padj = 0.019], and 18.72% PEF [β= -18.72, 95%CI: -36.30, -1.14, Padj = 0.038].
Conclusion
The findings of this study highlight the potential negative impact of folate deficiency on pulmonary function in asthmatic girls, the importance of monitoring folate status in asthmatic children and early prevention strategies.
