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L'objectif de ce projet était de déterminer l'effet d'un supplément combiné d'acide folique (320 mg) et de vitamine B12 (10 mg) sur le développement du follicule dominant ovarien chez la vache laitière en période postpartum. Des injections intramusculaires hebdomadaires de vitamines ont été données à partir de la troisième semaine prévêlage jusqu'à la neuvième semaine postvêlage. Suite à la ponction transvaginale d'un follicule dominant, le volume de liqueur folliculaire récolté était plus grand chez les vaches ayant reçu des injections de vitamines. L'analyse de l'expression génique des cellules de la granulosa des follicules dominants (diamètre > 12 mm) menée sur la biopuce bovine d'EmbryoGENE indique que le traitement entraîne une faible expression des gènes associés au cycle cellulaire et une expression plus élevée des gènes associés à l'ovulation. Enfin, les résultats suggèrent que les cellules de la granulosa étaient plus différenciées en raison d'une probable amélioration du métabolisme énergétique au cours de la période postpartum chez les vaches traitées.

Le but du présent travail était de déterminer si les effets d’une supplémentation en acide folique sur les performances de lactation étaient dus à une amélioration de la méthylnéogénèse et si l’apport en vitamine B12 pouvait interférer avec cette voie métabolique. Dans cette éventualité, la supplémentation en méthionine, une importante source de groupements méthyles préformés, devrait réduire les besoins en ces vitamines. Soixante vaches multipares recevaient soit une alimentation calculée pour couvrir 76% des besoins en méthionine (M-) soit la même alimentation supplémentée avec 18g de méthionine protégée de la dégradation ruminale (M+). À l’intérieur de chaque niveau de méthionine, les vaches recevaient soit aucun supplément vitaminique (B9-B12-), soit des injections intramusculaires hebdomadaires de 160mg d’acide folique seules (B9+B12-) ou combinées avec 10mg de vitamine B12 (B9+B12+), de 3 semaines avant jusqu’à 16 semaines après le vêlage. À 12 semaines de lactation, des cinétiques de glucose et de méthionine ont été mesurées par dilution d’isotopes en infusant du D-[U13-C]glucose, [13C]NaHCO3 et de la L-[1-13C, 2H3]méthionine à 24 vaches des traitements M-B9-B12-, M-B9+B12+, M+ B9-B12- et M+B9+B12+. Des échantillons de lait, de sang et de foie ont été collectés pour mesurer les performances de lactation, différents métabolites et l’expression génique d’enzymes clés du métabolisme énergétique et du cycle des méthylations. Parallèlement à une augmentation des concentrations en folates et en vitamine B12 dans le lait, le plasma et le foie, l’administration conjointe de ces vitamines augmentait la production laitière. Les suppléments de méthionine ont modifié l’abondance en ARNm d’enzymes clés du cycle des méthylations alors que la supplémentation en acide folique diminuait les concentrations plasmatiques d'homocystéine sans effet sur les performances des animaux. Le supplément d’acide folique et de vitamine B12 augmentait les flux corporels de glucose d’une amplitude quantitativement similaire à l’augmentation du rendement en lactose ainsi que l’expression du gène de la méthylmalonyl-CoA mutase, une enzyme essentielle pour l’entrée du propionate dans le cycle de Krebs. Les effets du supplément d'acide folique et vitamine B12 sur les performances de lactation étaient probablement dus à une augmentation de l’efficacité du métabolisme du glucose plutôt qu’à un effet sur la méthylnéogénèse. / The aim of the present study was to determine if the effects of supplementary folic acid on lactational performance were due to improved methylneogenesis and if the supply in vitamin B12 could interfere with this metabolic pathway. In this eventuality, supplementary methionine, a major source of preformed methyl groups, should reduce the requirement for these vitamins. Sixty multiparous cows were fed either a diet calculated to supply 76% of methionine requirement (M-) or the same diet supplemented with 18 g of rumen-protected methionine (M+). Within each level of methionine, cows received either no vitamin supplement (B9-B12-), weekly intramuscular injections of 160 mg of folic acid alone (B9+B12-) or combined with 10 mg of vitamin B12 (B9+B12+), from 3 wk before to 16 wk after calving. At 12 week of lactation, glucose and methionine kinetics were measured by isotope dilution using infusions of D-[U13C]glucose, [13C]NaHCO3 and L-[1-13C, 2H3]methionine on 24 cows in treatments M-B9-B12-, M-B9+B12+, M+ B9-B12- et M+B9+B12+. Milk, blood and liver samples were collected to measure lactational performance, different metabolites and gene expression of key enzymes of energy metabolism and methylation cycle. The results showed that, in parallel with an increase in folates and vitamin B12 concentrations in milk, plasma and liver, administration of folic acid and vitamin B12 together increased milk production. The supplements of methionine affected methylation cycle by acting on mRNA abundance of key enzymes of this cycle whereas supplementary folic acid decreased plasma concentrations of homocysteine without any effect on animal performance. Intramuscular injections of folic acid and vitamin B12 increased whole body flux of glucose with a similar quantitative magnitude as the observed increment in milk lactose yield. Vitamin supplements increased also gene expression of the methylmalonyl-CoA mutase, an essential enzyme for the entry of propionate in the Krebs cycle. These results indicate that the effects of the combined supplements of folic acid and vitamin B12 on lactational performance are probably due to an improved efficiency of glucose metabolism rather than an effect on methylneogenesis.

Submitted in fulfillment of the requirements of the degree of Doctor of Technology: Health Sciences, Durban University of Technology, Durban, South Africa, 2015. / Background: In a vulnerable low-income group with a confirmed high risk of cardiovascular disease, like the elderly in the Sharpeville care centre, an acute intervention is needed in order to improve their health profile. Previous studies suggested homocysteine lowering by vitamin B12, B6 and folate supplementation. The effect of vitamin B12, B6 and folate supplementation on the inflammatory response, thrombotic risk, lipid profile, hypertension, risk of metabolic syndrome and homocysteine metabolism in an elderly, black South African population has never been reported. Objectives: The main aim of this interventional study was to assess the effect of vitamins B12, B6 and folate supplementation at 200% RDA for six months on cardiovascular risk markers of an elderly semi-urbanised black South African community. Design: This study was an experimental intervention non-equivalent control group study design in 104 purposively selected samples of all the elderly attending the day-care centre. Setting and participants: A homogeneous group of respondents was included in the study. All subjects were equivalent in age (>60 years), race (black), unemployed/pensioners (socio-demographic) and 60 years and older attending a day care centre in Sharpeville, situated in the Vaal region, Gauteng, SA. Measurements: The distinctiveness of this study lies in the broad panel of parameters evaluating the CVR in correlation with the increased nutritional intake of vitamin B6, B12 and folate. These included: weight, height, waist, serum cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, blood pressure, fibrinogen, high-sensitivity C-reactive protein (HS–CRP), homocysteine, vitamin B12, folate, glucose, insulin, adiponectin and fibronectin. Results: A very high incidence (66.36%) of hyperhomocysteinaemia is present in the sample. The mean serum homocysteine level in hyperhomocysteinaemic individuals decreased statistically significantly from 25.00±8.00 umol/l to 18.80±12.00 umol/l after the intervention. The number of respondents with an increased homocysteine level decreased from 100% (baseline) to 67% (follow-up). The supplementation was beneficial (statistically significant changes) to the glucose levels, fibrinolytic status, vitamin B6 serum levels, fibronectin levels and haemopoeiesis (decreased macrocytosis) of all the individuals (regardless of their homocysteine status). Conclusion: It is concluded that supplementation of vitamins B6, B12 and folate at 200% RDA for six months is an effective homocysteine-lowering approach as a strategy to reduce hyperhomocysteinaemia in an elderly population and thereby reduce cardiovascular risk (CVR). The supplementation intervention mentioned is not an effective multifactorial strategy to decrease CVR although beneficial effects were found with other CVR markers independent of homocysteine status.

Thesis (MTech (Food Technology))--Cape Peninsula University of Technology, 2016. / In South Africa malnutrition exists due to inadequate dietary intake of micronutrients which is one of the major causes of vitamin deficiencies leading to disease. The treatment of malnutrition over the past years has been a considerable burden on the South African economy. Therefore, food fortification is one of the current strategies used to minimize malnutrition by increasing the nutritional value of staple foods. Commercial dairy products and pharmaceutical nutritional products (food supplements) in South Africa have been developed and produced for affluent consumers. Hence the need to develop an affordable fortified dairy product for the majority of South Africans prompted this study aimed at using a “naturally” fortified kefir beverage with vitamin B12 and folate to increase B-vitamins levels. Since Propionibacterium freudenreichii and Streptococcus thermophilus are known to be good producers of vitamin B12 and folate, respectively, and propionibacteria has the ability to grow symbiotically in the presence of lactic acid bacteria, the inclusion of these organisms with the kefir grains was an achievable objective. In order to conduct the analysis of vitamin B12 and folate in the samples, sample extraction and HPLC assay techniques were developed. The extraction of vitamin B12 and folate were achieved by using KCN extraction buffer and the trienzymatic method, respectively. The samples were also subjected to purification and concentration using solid phase extraction for optimum results. All standards and samples were flushed with nitrogen gas and stored for a maximum of 2 weeks at –20°C to prevent B-vitamin deterioration. The HPLC assembly for the vitamin B12 analysis included a Luna C18 column and a diode array detector (DAD) for the detection and quantification. For the folate analysis it included a Zorbax SB-C18 and Luna C18 columns in tandem and the fluorescence detector (FLD) was used for the detection and quantification of THF, 5-CH3-THF and 5-CHO-THF, while the DAD was used for PGA and pteroyltri-γ-L-glutamic acid concentration in the samples.

Submitted by JACIARA CRISTINA ALMEIDA DO AMARAL (jaciaramaral@ufpa.br) on 2018-11-05T17:28:58Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) PROJETO DE MESTRADO FERNANDA FARIAS DE ALCÂNTARA.pdf: 1138273 bytes, checksum: 8a0c741f6de9fa8fefac60fbbc74ae4b (MD5) / Approved for entry into archive by JACIARA CRISTINA ALMEIDA DO AMARAL (jaciaramaral@ufpa.br) on 2018-11-05T17:30:47Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) PROJETO DE MESTRADO FERNANDA FARIAS DE ALCÂNTARA.pdf: 1138273 bytes, checksum: 8a0c741f6de9fa8fefac60fbbc74ae4b (MD5) / Made available in DSpace on 2018-11-05T17:30:48Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) PROJETO DE MESTRADO FERNANDA FARIAS DE ALCÂNTARA.pdf: 1138273 bytes, checksum: 8a0c741f6de9fa8fefac60fbbc74ae4b (MD5) Previous issue date: 2018-10-11 / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / O câncer gástrico nas últimas décadas vem apresentando uma queda em número de casos, o que muito se deve ao progresso no que tange a saúde sanitária, e ao maior acesso da população a políticas educacionais. No entanto, continua sendo a terceira causa de morte a nível mundial entre homens e mulheres. Tais mortes, geralmente estão vinculadas ao diagnóstico tardio. O presente estudo pretende pelas dosagens de homocisteína, vitamina B12 e ácido fólico, montar um perfil de biomarcadores de triagem, os quais possam ser inseridos na rotina comum de exames, visando o diagnóstico célere da doença. Foram analisadas 207 amostras de caso controle e 207 de pacientes com câncer gástrico, em ambos foram realizadas as dosagens bioquímicas de homocisteína, ácido fólico e vitamina B12, pareadas em relação a idade, localização do tumor, sub-tipo, classificação tumoral, infecção por EBV (Epstein-Barr Vírus), e Helicobacter pilory. Para dosagem da tríade, foram utilizadas técnicas quimioluminescência, e as demais variáveis foram obtidas pelas informações hospitalares. Como resultados, foram encontradas diferenças significativas entre as médias da tríade dos pacientes com câncer em relação ao controle, em todas as variáveis pareadas. Em conclusão, nosso estudo mostrou que a análise da tríade (homocisteína, vitamina b12 e ácido fólico) tem seu valor no diagnóstico do câncer gástrico, podendo futuramente ser um eficaz marcador de triagem para este tipo de câncer. / Gastric cancer in the last decades has shown a decrease in the number of cases, which is much due to the progress in sanitary health, and the greater access of the population to educational policies. However, it remains the third leading cause of death worldwide between men and women. Such deaths are usually linked to late diagnosis. The present study intends to establish a profile of screening biomarkers by the homocysteine, vitamin B12 and folic acid dosages, which can be inserted in the routine routine of examinations, aiming the rapid diagnosis of the disease. A total of 207 control and 207 cases of gastric cancer patients were analyzed, both of which were biochemical measurements of homocysteine, folic acid and vitamin B12, matched in relation to age, tumor location, subtype, tumor classification, EBV (Epstein-Barr Virus), and Helicobacter pylori. For the triad dosage, chemiluminescence techniques were used, and the other variables were obtained by hospital information. As results, significant differences were found between the means of the triad of cancer patients in relation to the control, in all paired variables. In conclusion, our study showed that the triad analysis (homocysteine, vitamin b12 and folic acid) has its value in the diagnosis of gastric cancer, and may in the future be an effective marker of screening for this type of cancer. / UFPA - Universidade Federal do Pará

Realizou-se um estudo descritivo conduzido no Hospital de Clínicas de Porto Alegre, no período de outubro de 2001 a outubro de 2002, com pacientes HIV positivos e anêmicos. Objetivo: avaliar a associação entre anemia e o perfil nutricional em uma amostra de pacientes HIV+ . Métodos: Foram incluídos 34 pacientes maiores de 18 anos, sendo todos pacientes diagnosticados com anemia. Foram analisados exames laboratoriais, avaliação da ingestão alimentar (recordatório alimentar de 24h), freqüência alimentar e coleta dos parâmetros antropométricos dos pacientes. Resultados: O recordatório alimentar de 24 horas demonstrou a deficiência na ingestão de folato pela maioria dos pacientes; enquanto que vitamina B12 e ferro estiveram de acordo com as RDA’s. Conclusão: A causa da anemia nestes pacientes talvez não tenha sido em função desta deficiente ingestão de folato, ainda mais por se tratar de um estudo descritivo. Ressalta-se a importância do profissional para o acompanhamento nutricional destes pacientes, para a promoção de um adequado estado nutricional e qualidade de vida. / Was develop a descritive study conducted in the Porto Alegre Clinics’ Hospital, from october 2001 to October 2002, with positive HIV and anemics patients. Objectives: Evaluate the association between anemia and nutritional status in positive HIV patients. Methodology: Were included 34 patients under 18 years old, all diagnosed with anemia. Laboratorial exams, evaluation of food intake (24h register), questionary of food intake frequence and anthropometrics data were collected. Results: The 24h register food intake showed the deficiency in folate intake by most of patients ,while vitamine B12 and iron intake were accorded RDA’s. Conclusions: The etiology of anemia in these patients maybe wasn´t cause by this folate deficiency, also because this was a describe study. The presence of a professional appears to be important for the nutritional treatment of these patients, to develop a health nutrional status and quality of life.

Cobalamin (vitamin B12) is one of several essential micronutrients needed by the human organism. Other important micronutritients, which interplay with vitamin B12, are folate and iron. During the last ten years, the attention has been drawn to different forms of neurological disorders supposed to be caused by vitamin B12 deficiency. Vitamin B12 deficiency states are common among elderly patients in primary health care and sometimes in hospital care, especially in geriatric practice. This is a study to define the cobalamin treatment traditions, among Swedish physicians in the period 1990 – 2000. The period was distinguished by an intense debate on the issue by the physicians, an increase of cobalamin consumption, and a shift from parenteral therapy towards oral high-dose therapy. It had been known that symptoms of cobalamin deficiency could start in the nervous system. This knowledge was reinforced by the application of homocysteine and methyl-malonic acid (MMA) in deficiency diagnosis. Introduction of homocysteine and MMA in deficiency diagnosis changed the view on deficiency prevalence, by identifying persons at risk to develop B12 deficiency prior to established symptoms. In this study, Swedish physicians are regarded mainly as receivers of communication about the markers homocysteine and MMA, and deficiency states of cobalamin and folate. The main senders were scientists from North America, Norway, Denmark, and Sweden. This study sets the senders and the receivers of cobalamin communication on a collegial level and quantifies and evaluates the feed-back from the receivers. The receivers, gen¬eral practitioners and geriatricians, appeared to be familiar with old knowledge and frontier concepts in the field. Thus, it is suggested that the increase of B12 prescriptions in Sweden 1990 – 2000 reflected an increased awareness of B12-associated clinical problems among the physicians managing the majority of deficiency patients, although a possible overconsumption of pharmaceutical drugs must be kept in mind.

Anemia and micronutrient deficiencies in infancy are common in low-income settings. These are partly due to maternal malnutrition and may impair child health and development. We studied the impact of maternal food and micronutrient supplementation, duration of exclusive breastfeeding (EBF), growth and infection on infant anemia and micronutrient status. In the MINIMat trial in Matlab, Bangladesh, pregnant women were randomized to Early or Usual promotion of enrolment in a food supplementation program and to one of three daily micronutrient supplements. Capsules containing 400µg folic acid and (a) 30 mg iron (Fe30Fol), (b) 60 mg iron (Fe60Fol), (c) 30 mg iron and other micronutrients (MMS) were provided from week 14 of gestation. Capsule intake was assessed with the eDEM device recording supplement container openings. Blood samples (n=2377) from women at week 14 and 30 were analyzed for hemoglobin (Hb). Duration of EBF and infant morbidity was based on monthly maternal recalls. Infants were weighed and measured monthly. Blood samples (n=1066) from 6-months-old infants were analyzed for Hb and plasma ferritin, zinc, retinol, vitamin B12 and folate. In women, Hb increase per capsule reached a plateau at 60 Fe60Fol capsules, indicating that nine weeks of daily supplementation produced maximum Hb response. Anemia was common (36%) at capsule intakes >60 indicating other causes of anemia than iron deficiency. In infants, vitamin B12 deficiency prevalence was lower in the MMS (26.1%) than in the Fe30Fol group (36.5%), (p=0.003) and zinc deficiency prevalence was lower in the Usual than in the Early group. There were no other differential effects of food or micronutrient supplementation on infant anemia or micronutrient status. Infants exclusively breast-fed for 4-6 months had a higher mean plasma zinc concentration (9.9±2.3 µmol/L) than infants exclusively breast-fed for <4 months (9.5±2.0 µmol/L), (p< 0.01). No other differences in anemia, iron or zinc status were observed between EBF categories. Infection, low birth weight and iron deficiency were independent risk factors for infant anemia. Regardless of studied interventions, prevalence of anemia (43%), deficiency of zinc (56%), vitamin B12, vitamin A (19%) and iron (22%) in infancy was high and further preventive strategies are needed. / MINIMat

Background Colorectal cancer (CRC) is the second most common malignancy in developed countries. The mortality is high, with nearly half of patients dying from the disease. The primary treatment of CRC is surgery, and decisions about additional treatment with chemotherapy are based mainly on tumor stage. Novel prognostic markers that identify patients at high risk of recurrence and cancer-related death are needed. The development of CRC has been described in terms of two different pathways; the microsatellite instability (MSI) and chromosomal instability (microsatellite stable, MSS) pathway. More recently, the CpG island methylator phenotype (CIMP), characterized by frequent DNA hypermethylation, has been described as an alternative pathway of tumorigenesis. The event of DNA methylation is dependent on one-carbon metabolism, in which folate and vitamin B12 have essential functions. The purpose of this thesis was to study CIMP in CRC. The specific aims were to investigate the potential role of components of one-carbon metabolism as risk factors for this subgroup of tumors, and the prognostic importance of CIMP status, taking into consideration important confounding factors, such as MSI and tumor-infiltrating T cells. Methods CRC cases and referents included in the Northern Sweden Health and Disease Study (NSHDS, 226 cases and 437 referents) and CRC cases in the Colorectal Cancer in Umeå Study (CRUMS, n=490) were studied. Prediagnostic plasma concentrations of folate and vitamin B12 were analyzed in NSHDS. In both study groups, CIMP status was determined in archival tumor tissue by real-time quantitative PCR using an eight-gene panel (CDKN2A, MLH1, CACNA1G, NEUROG1, RUNX3, SOCS1, IGF2 and CRABP1). MSI screening status and the density of tumor-infiltrating T cells were determined by immunohistochemistry.  Results An inverse association was found between plasma concentrations of vitamin B12 and rectal, but not colon, cancer risk. We also found a reduced risk of CIMP-high and CIMP-low CRC in study subjects with the lowest levels of plasma folate. We found that patients with CIMP-low tumors in both NSHDS and CRUMS had a poorer prognosis compared with CIMP-negative, regardless of MSI screening status. We also found that MSS CIMP-high patients had a poorer prognosis compared with MSS CIMP-negative. The density of tumor-infiltrating T cells and CIMP status were both found to be independent predictors of CRC patient prognosis. A particularly poor prognosis was found in patients with CIMP-low tumors poorly infiltrated by T cells. In addition, the density of T cells appeared to be more important than MSI screening status for predicting CRC patient prognosis. Conclusion Rather than being one disease, CRC is a heterogeneous set of diseases with respect to clinico-pathological and molecular characteristics. We found that the association between risk and plasma concentration of vitamin B12 and folate depends on tumor site and CIMP status, respectively. Patient prognosis was found to be different depending on CIMP and MSI screening status, and the density of tumor-infiltrating T cells.