Folic Acid and Creatine as Therapeutic Approaches to Lower Blood Arsenic: A Randomized Controlled Trial
Peters BA, Hall MN, Liu X, Parvez F, Sanchez TR, van Geen A, Mey JL, Siddique AB, Shahriar H, Uddin MN, Islam T, Balac O, Ilievski V, Factor-Litvak P, Graziano JH, Gamble MV
Environmental health perspectives · 78 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institutes of Health
- Gobierno
- National Cancer Institute
- Gobierno
- National Institute of Environmental Health Sciences
- Gobierno
- NIEHS NIH HHS
- Gobierno
- NCI NIH HHS
- Subvenciones
- National Cancer Institute (R01 CA133595); National Institute of Environmental Health Sciences (P30 ES009089); National Institute of Environmental Health Sciences (P42 ES10349); National Institute of Environmental Health Sciences (R00 ES018890); National Institute of Environmental Health Sciences (P42ES010349); National Institute of Environmental Health Sciences (P30-ES09089); National Institutes of Health (R01CA133595); National Institutes of Health (P42 ES 10349); National Institutes of Health (P30 ES 09089)
Según 5 financiadores declarados.
Publicación
- Publicado
- 2015-05-15 · Environ Health Perspect · vol. 123 · número 12 · págs. 1294–1301
- Editorial
- National Institute of Environmental Health Sciences
- Citado
- 95 citas · más que el 99% de estudios similares · 11.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 38 trabajos
- Acceso
- Acceso abierto (revista) · PUBLIC-DOMAIN
- Áreas de investigación
- Arsenic contamination and mitigation · Folate and B Vitamins Research · Heavy Metal Exposure and Toxicity
- Palabras clave
- Creatine, Placebo, Medicine, Creatinine, Population, Randomized controlled trial, Internal medicine, Urine, Physiology, Gastroenterology, Environmental health, Pathology
- MeSH
- humans, arsenic, creatine, creatinine, folic acid, water pollutants, chemical, water purification, methylation, dietary supplements, adult, aged, middle aged, bangladesh, female, male, drinking water
16 autores
- Brandilyn A. Peters🇺🇸Center for Environmental Health
- Megan N. Hall
- Xinhua Liu🇺🇸Columbia University
- Faruque Parvez🇺🇸Center for Environmental Health
- Tiffany R. Sanchez🇺🇸Center for Environmental Health
- Alexander van Geen🇺🇸Lamont-Doherty Earth Observatory; Columbia University
- Jacob L. Mey🇺🇸Lamont-Doherty Earth Observatory; Columbia University
- Abu Baker Siddique
- Hasan Shahriar
- Mohammad Nasir Uddin
- Tariqul Islam
- Olgica Balac🇺🇸Center for Environmental Health
- Vesna Ilievski🇺🇸Center for Environmental Health
- Pam R Factor-Litvak
- Joseph H. Graziano🇺🇸Center for Environmental Health
- Mary V. Gamble🇺🇸Center for Environmental Health
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The World Health Organization estimates that > 140 million people worldwide are exposed to arsenic (As)-contaminated drinking water. As undergoes biologic methylation, which facilitates renal As elimination. In folate-deficient individuals, this process is augmented by folic acid (FA) supplementation, thereby lowering blood As (bAs). Creatinine concentrations in urine are a robust predictor of As methylation patterns. Although the reasons for this are unclear, creatine synthesis is a major consumer of methyl donors, and this synthesis is down-regulated by dietary/supplemental creatine.
Objectives
Our aim was to determine whether 400 or 800 μg FA and/or creatine supplementation lowers bAs in an As-exposed Bangladeshi population.
Methods
We conducted a clinical trial in which 622 participants were randomized to receive 400 μg FA, 800 μg FA, 3 g creatine, 3 g creatine+400 μg FA, or placebo daily. All participants received an As-removal filter on enrollment, and were followed for 24 weeks. After the 12th week, half of the two FA groups were switched to placebo to evaluate post-treatment bAs patterns.
Results
Linear models with repeated measures indicated that the decline in ln(bAs) from baseline in the 800-μg FA group exceeded that of the placebo group (weeks 1-12: β= -0.09, 95% CI: -0.18, -0.01; weeks 13-24: FA continued: β= -0.12, 95% CI: -0.24, -0.00; FA switched to placebo: β= -0.14, 95% CI: -0.26, -0.02). There was no rebound in bAs related to cessation of FA supplementation. Declines in bAs observed in the remaining treatment arms were not significantly different from those of the placebo group.
Conclusions
In this mixed folate-deficient/replete study population, 12- and 24-week treatment with 800 μg (but not 400 μg) FA lowered bAs to a greater extent than placebo; this was sustained 12 weeks after FA cessation. In future studies, we will evaluate whether FA and/or creatine altered As methylation profiles.
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