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Epidemiol Health > Accepted Articles
Epidemiology and Health 2022;e2022046.
DOI: https://doi.org/10.4178/epih.e2022046    [Accepted] Published online May 15, 2022.
Non-Linear Association between Serum Folate Concentration and Dyslipidemia: Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018
Taiyue Jin1  , Eun Young Park1  , Byungmi Kim1  , Jin-Kyoung Oh1,2 
1Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
2Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
Correspondence  Eun Young Park ,Tel: 031-920-2930, Email: goajoa@ncc.re.kr
Received: Feb 18, 2022  Accepted after revision: May 15, 2022
Abstract
Objectives:
We aimed to evaluate the association between serum folate concentration and prevalence of dyslipidemia.
Method:
A total of 4,477 adults (2,019 men and 2,458 women) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2018 were included. Serum samples were used to access folate concentration and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with a sampling weight was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Results:
Elevated TC, TG, LDL-cholesterol and HDL-cholesterol were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentration and prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the 1st tertile serum folate concentration group (OR [95% CI] = 1.38 [1.05-1.79]) compared to those in the 2nd tertile group. On the other hand, a higher prevalence of hyper-LDL cholesterolemia was identified for both the 1st and 3rd serum folate concentration tertile groups (OR [95% CI]: 1.49 [1.08-2.05] and 1.63 [1.20-2.20], respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.
Conclusions:
Non-linear associations may exist between serum folate concentration and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
Keywords: folate; dyslipidemia; hypercholesterolemia; hyper-LDL cholesterolemia; non-linear; KNHANES


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