385Prospective associations between serum homocysteine, folate, vitamin B12 and risk of metabolic syndrome

Background Both elevated homocysteine (Hcy) and metabolic syndrome (MetS) are associated with cardio-metabolic disease. However, the potential causality in the association between Hcy and MetS is unclear, and there is uncertainty about the importance of serum level of folate and vitamin B12 for MetS. The aim of this study was to determine the prospective associations between serum homocysteine, folate and vitamin B12, and incidence of MetS in a community-based cohort of Korean adults aged ≥ 40 years. Methods We measured serum Hcy, folate and vitamin B12 in 2,895 participants (1,187 men and 1,708 women) who did not have MetS. During follow-up (10,043 person-years), 471 MetS cases were newly diagnosed. Results Higher Hcy levels were positively associated with risk of MetS (adjusted incidence rate ratio, IRR 1.87; 95% CI, 1.07–3.25 for ≥15 compared with <10 μmol/L of Hcy in men; IRR 1.81; 95% CI, 1.06–3.08 for ≥10 compared with <5 μmol/L of Hcy in women). However, serum folate was not associated with MetS, and higher serum vitamin B12 levels were associated with a statistically significant protection of MetS in men only (IRR 0.61; 95% CI, 0.42–0.90; P for trend=0.0082 in the highest tertile). Conclusions Hcy levels were positively associated in men and women, and serum vitamin B12 was inversely associated with risk of MetS in men but not in women. Serum folate do not seem to be a protective marker for MetS. Key messages Our results extend previously reported associations of Hcy with MetS, and the absence of associations of folate with MetS.

Anemia and its consequences on human body; A comprehensive overview

Anemia is a pathological condition characterized by a reduction in the mass of red blood cells or the amount of hemoglobin. Anemia affects one-third of the world's population, with iron deficiency accounting for half of the cases. It's a major global public health problem that has an effect on maternal and child mortality, physical fitness, and referral to health-care providers. Underweight children have a greater prevalence of anemia, which can produce long-term developmental outcomes. Particular risk is presented by children 0-5 years, child-bearing mothers and pregnant women. Efforts to avoid anemia should concentrate on improving current supplementary iron and folate programs and on preventing folate and vitamin B12 anemia deficiency. In this review biological mechanism and condition of anemia development has been discussed. A further study is necessary to examine the function of additional nutrient deficits, the contribution of infectious and chronic illnesses in some populations, and the significance of hereditary hemoglobin disorders.

Pancytopenia in pregnant patients with COVID-19 infection and vitamin B12 deficiency: a case report study

Background: Folate and vitamin B 12 deficiency can lead to pancytopenia in pregnancy. Some cases of pancytopenia due to COVID-19 infection have also been reported. The two cases that we present are related to the coincidence of pregnancy and deficiency of folic acid and vitamin B12 with COVID-19 infection. Case presentation: A 26-year- woman G3P1L1A1 and 21-year-woman G2P1L1 presented with pancytopenia and mild COVID-19 infection. The antenatal period was uneventful, and both cases also had folate and vitamin B12 deficiency. They received blood products, folic acid, and vitamin B12 supplementation. COVID- 19 infection was managed well with analgesic and vital monitoring. Postpartum hemorrhage occurred in the second case, which was well managed with uterotonics. All laboratory parameters came out to be normal after three months of supplementation of folic acid and vitamin B12. Conclusion: Pancytopenia in pregnancy due to folate and vitamin B12 deficiency and COVID- 19 infection can be easily managed with timely intensive targeted therapy, but we should be extra vigilant while handling such complicated cases, keeping in mind all possible differential diagnoses for pancytopenia.