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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Infrequency of low red blood cell (RBC) folate levels despite no folate fortification program: a study based on results from routine requests for RBC folate

Mustafa Vakur Bor1 / Anne Marie Wulff2 / Ebba Nexo3 / Henrik Krarup4

1Department of Clinical Biochemistry, THG, AS, Aarhus University Hospital, Aarhus, Denmark and Department of Clinical Biochemistry, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

2Department of Clinical Biochemistry, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

3Department of Clinical Biochemistry, THG, AS, Aarhus University Hospital, Aarhus, Denmark

4Department of Clinical Biochemistry, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

Corresponding author: Mustafa Vakur Bor, MD, PhD, Department of Clinical Biochemistry, Tage Hansens Gade 2, 8000 Aarhus C, Denmark Phone: +45-8-6497326, Fax: +45-8-9493060,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 46, Issue 3, Pages 401–404, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2008.069, February 2008

Publication History

Received:
2007-09-21
Accepted:
2007-11-15
Published Online:
2008-02-06

Abstract

Background: We investigated the prevalence of a low level of red blood cell (RBC) folate in individuals suspected to be deficient and further evaluated the clinical consequence of identifying an individual with a low folate level in a population where no fortification with folate has been introduced.

Methods: We conducted a retrospective review of all RBC folate analyses requested in one of the university hospitals in Denmark and identified patients with abnormally low (<350 nmol/L) and high (>1700nmol/L) folate levels. For requests from the hospital, we evaluated the clinicians' response to a decreased level of folate.

Results: A total of 12,932 RBC folates requested from the hospital (26%) or from general practitioners (GPs) (74%) were investigated. RBC folate levels were low in a comparable fraction of those requested from the hospital (1.7%) and from the GPs (1.3%). A high level of RBC folate was observed more often than a low RBC folate and occurred considerably more frequently (p<0.0001) in patients referred from the hospital (4.9%) than amongst those referred from GPs (1.2%). The clinicians' response rate to a low folate was around 60% and occurred more often for patients with a low level of cobalamins than in other patients.

Conclusions: Low RBC folate values are rare in Danish patients despite no folate fortification program. Further, the clinical reaction to a low folate value is unexpectedly low.

Clin Chem Lab Med 2008;46:401–4.

Keywords: clinicians' reaction; fortification; low red blood cell folate

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[1]
Alexis J. Hure, Clare E. Collins, and Roger Smith
Maternal and Child Health Journal, 2012, Volume 16, Number 4, Page 792

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