Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL
Objective: Assess the need for folate testing, frequency of corrective action, and determine reference level for serum folate. Methods: Serum folate levels in 5313 samples from 4448 patients, and clinical data were reviewed for patient characteristics and for (a) evidence of corrective action in pat...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2015-04-01
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| Series: | Practical Laboratory Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352551715000086 |
| _version_ | 1819275272018460672 |
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| author | Gurmukh Singh Hana Hamdan Vivek Singh |
| author_facet | Gurmukh Singh Hana Hamdan Vivek Singh |
| author_sort | Gurmukh Singh |
| collection | DOAJ |
| description | Objective: Assess the need for folate testing, frequency of corrective action, and determine reference level for serum folate. Methods: Serum folate levels in 5313 samples from 4448 patients, and clinical data were reviewed for patient characteristics and for (a) evidence of corrective action in patients with serum folate values <5.5 ng/mL, and (b) differences in patients with serum folate levels <5.5 ng/mL and patients with levels >25.7 ng/mL. Results: The prevalence of serum folate levels, in patients, <3.0, <4.0, <5.5, <7.0 and <13.0 ng/mL was 0.58%, 1.55%, 4.9%, 9.98% and 43.21% respectively. Patients with serum folate levels <5.5 ng/mL had lower serum albumin and hemoglobin. In 64% of patients with serum folate >25.7 ng/mL the sample was collected after supplementation with folic acid. Of the 128 patients with serum folate <5.5 ng/mL documentation of supplementation was present in only 38.9%. Conclusions: Serum folate levels are below the current ânormalâ level of 3.0 ng/mL in a larger proportion of tertiary care patients than that reported for ambulatory patients. In patients with folate deficiency, corrective action is lacking in >60% of the patients. Since serum folate levels â¥13.0 ng/mL are needed for optimal prevention of neural tube defects in the embryo/fetus, we propose that normal serum folate level should be designated to be â¥13.0 ng/mL. Keywords: Serum folate, Prevalence of folate deficiency, Neural tube defects, Optimum serum folate level, Utility of folate testing |
| first_indexed | 2024-12-23T23:21:41Z |
| format | Article |
| id | doaj.art-f4dc8a5f7d204971b4121429d86ec9e2 |
| institution | Directory Open Access Journal |
| issn | 2352-5517 |
| language | English |
| last_indexed | 2024-12-23T23:21:41Z |
| publishDate | 2015-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Practical Laboratory Medicine |
| spelling | doaj.art-f4dc8a5f7d204971b4121429d86ec9e22022-12-21T17:26:20ZengElsevierPractical Laboratory Medicine2352-55172015-04-0113541Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0 ng/mL to 13.0 ng/mLGurmukh Singh0Hana Hamdan1Vivek Singh2Department of Pathology, Georgia Regents University Medical Center, 1120, 15th Street, BI 2008A, Augusta, GA 30912, USA; Medical Director, HooperHolmes International Inc. 560N Rogers Road, Olathe, KS 66062, USA; Corresponding author. Tel.: +1 412 780 1974.Department of Pathology, University of Missouri-Kansas City School of Medicine, Truman Medical Center, 2310 Holmes Street, Kansas City, MO 64108, USADivision of Infectious Diseases, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USAObjective: Assess the need for folate testing, frequency of corrective action, and determine reference level for serum folate. Methods: Serum folate levels in 5313 samples from 4448 patients, and clinical data were reviewed for patient characteristics and for (a) evidence of corrective action in patients with serum folate values <5.5 ng/mL, and (b) differences in patients with serum folate levels <5.5 ng/mL and patients with levels >25.7 ng/mL. Results: The prevalence of serum folate levels, in patients, <3.0, <4.0, <5.5, <7.0 and <13.0 ng/mL was 0.58%, 1.55%, 4.9%, 9.98% and 43.21% respectively. Patients with serum folate levels <5.5 ng/mL had lower serum albumin and hemoglobin. In 64% of patients with serum folate >25.7 ng/mL the sample was collected after supplementation with folic acid. Of the 128 patients with serum folate <5.5 ng/mL documentation of supplementation was present in only 38.9%. Conclusions: Serum folate levels are below the current ânormalâ level of 3.0 ng/mL in a larger proportion of tertiary care patients than that reported for ambulatory patients. In patients with folate deficiency, corrective action is lacking in >60% of the patients. Since serum folate levels â¥13.0 ng/mL are needed for optimal prevention of neural tube defects in the embryo/fetus, we propose that normal serum folate level should be designated to be â¥13.0 ng/mL. Keywords: Serum folate, Prevalence of folate deficiency, Neural tube defects, Optimum serum folate level, Utility of folate testinghttp://www.sciencedirect.com/science/article/pii/S2352551715000086 |
| spellingShingle | Gurmukh Singh Hana Hamdan Vivek Singh Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL Practical Laboratory Medicine |
| title | Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL |
| title_full | Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL |
| title_fullStr | Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL |
| title_full_unstemmed | Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL |
| title_short | Clinical utility of serum folate measurement in tertiary care patients: Argument for revising reference range for serum folate from 3.0Â ng/mL to 13.0Â ng/mL |
| title_sort | clinical utility of serum folate measurement in tertiary care patients argument for revising reference range for serum folate from 3 0a ng ml to 13 0a ng ml |
| url | http://www.sciencedirect.com/science/article/pii/S2352551715000086 |
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