Background: Even though several studies have demonstrated that periconceptional supplementation with folic acid (FA) reduces the occurrence of neural tube defects, FA fortification has been a topic of intense debate due to the possible adverse effects of higher folate status on several health conditions. Several countries, including Korea, have been indecisive as to whether fortification is warranted or not. It is therefore helpful for these countries to compare folate concentrations in their populations with populations exposed to mandatory FA fortification.Purpose: To evaluate the differences in the distribution of circulating concentrations of folate in Korea and the United States (US) at different time points.Methods: The Korean study populations consisted of women of child-bearing age recruited in 1999 and in 2009. The US study populations consisted of women of child-bearing age recruited in the post FA fortification era (2005 and 2009). Plasma and red blood cell (RBC) folate concentrations were measured using the Lactobacillus casei microbiological assay.Results: The percentage of US women with neural tube defect-protective levels of RBC folate was significantly higher compared to Korean women in 1999 and 2009. However, in 2009, when FA supplements became readily available for Koreans, 50% of Korean women in the study achieved the neural tube defect-protective level of RBC folate; 11% of them demonstrating supraphysiologic concentrations of plasma folate. Even though FA fortification in the US resulted in more than 80of women achieving >400 ng/mL of RBC folate by 2009, nearly 50% also demonstrated having supraphysiologic concentrations of plasma folate, which prompted some researchers to raise concerns about possible adverse effects of higher folate status on several health conditions.Conclusion: Encouraging Korean women of reproductive age to take FA supplements and evaluating the outcome of such efforts would be worthwhile prior to implementing a population-wide mandatory FA fortification in Korea.
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机译：背景：尽管有几项研究表明，围生期补充叶酸（FA）可以减少神经管缺陷的发生，但由于叶酸水平升高对几种健康状况的不利影响，FA强化一直是激烈争论的话题。包括韩国在内的几个国家对于是否需要设防一直持犹豫不决的态度。因此，将这些国家的人口中的叶酸浓度与接受强制性FA强化处理的人群进行比较是有帮助的。目的：评估韩国和美国（美国）在不同时间点循环叶酸浓度分布的差异。方法：韩国研究人群包括1999年和2009年招募的育龄妇女。美国研究人群包括FA设防后时期（2005年和2009年）招募的育龄妇女。使用干酪乳杆菌微生物测定法测量血浆和红细胞（RBC）叶酸浓度。结果：1999年和2009年，具有神经管缺陷保护水平的美国女性百分比明显高于韩国女性。但是， 2009年，当韩国人可以买到FA补充剂时，研究中50％的韩国妇女达到了RBC叶酸对神经管缺陷的保护水平;其中有11％的人表现出血浆叶酸的超生理浓度。尽管美国的FA强化措施到2009年使80多名女性的RBC叶酸达到> 400 ng / mL，但仍有近50％的女性表现出血浆叶酸的超生理浓度，这促使一些研究人员对高剂量的叶酸可能产生的不良反应提出了担忧结论：在韩国实施全民强制性FA强化之前，鼓励育龄的韩国妇女服用FA补充剂并评估此类努力的结果将是值得的。
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