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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 Bor , Anne Marie Wulff , Ebba Nexo and Henrik Krarup
Published/Copyright: February 6, 2008
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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.


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,

Received: 2007-9-21
Accepted: 2007-11-15
Published Online: 2008-02-6
Published in Print: 2008-03-01

©2008 by Walter de Gruyter Berlin New York

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