Supplementation with Folic Acid or 5-Methyltetrahydrofolate and Prevention of Neural Tube Defects: An Evidence-Based Narrative Review

神经管 叶酸 叶酸补充 叙述的 叙述性评论 医学 内科学 生物 重症监护医学 艺术 文学类 遗传学 胚胎
作者
María de Lourdes Samaniego-Vaesken,Carmen Moráis-Moreno,Alejandra Carretero-Krug,Ana María Puga,Ana Montero-Bravo,Teresa Partearroyo,Gregorio Varela‐Moreiras
出处
期刊:Nutrients [Multidisciplinary Digital Publishing Institute]
卷期号:16 (18): 3154-3154
标识
DOI:10.3390/nu16183154
摘要

Background: Folic acid (FA), which in its chemical form is pteroylglutamic acid, is the fully oxidised, water-soluble, monoglutamic form of vitamin B9. This compound is part of the folate group but with higher bioavailability, and it is found in vitamin supplements and fortified foods and drugs. Folate metabolism is complex and associated with various metabolic pathways, all of which confer protection on the cell and allow its survival. Methods: We conducted a non-systematic search of articles published in English and Spanish including controlled trials, cohort studies, systematic re-views, and meta-analyses were included, as well as key studies in animal models related to pharmacokinetic studies. Search terms encompassed: “folic acid”, “folates”, “5-metyltetrahydrofolate”, “5-MTHF”, “neural tube defects”, “supplementation”, “fortification”, AND “homocysteine” Results: A crucial role demonstrated for FA is to help prevent neural tube defects (NTDs). However, more studies are definitely still needed to establish 5-MTHF as a safe and effective therapeutic approach comparable with FA. Moreover, there is a lack of clinical studies that evaluate the efficacy of 5-MTHF supplementation in the prevention of NTDs. The present evidence-based narrative review discusses differences between FA and 5-MTHF in terms of structure, metabolism, bioavailability, clinical efficacy, and safety. Conclusions: Despite the potential value of 5-MTHF as an alternative to FA, clinical studies would be urgently needed to support the efficacy, dosage, timing, and/or safety of its use as a supplement.
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