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Clinical Chemistry 44: 1545-1550, 1998;
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(Clinical Chemistry. 1998;44:1545-1550.)
© 1998 American Association for Clinical Chemistry, Inc.

General Clinical Chemistry

Plasma folic acid cutoff value, derived from its relationship with homocyst(e)ine

D. A. Janneke Brouwer1,a, H. T. M. Erik Welten1, Dirk-Jan Reijngoud2, Jasper J. van Doormaal3, and Frits A. J. Muskiet1

1 Central Laboratory for Clinical Chemistry,
2 Laboratory for Metabolic Disorders, and
3 Atherosclerosis & Lipid Outpatient Clinics, Groningen University Hospital, G713E2, The Netherlands.
a Address correspondence to this author at: Central Laboratory for Clinical Chemistry, Groningen University Hospital, P.O. Box 30.001, NL-9700 RB Groningen, The Netherlands. Fax 31-503-612290; e-mail d.a.j.brouwer{at}lab.azg.nl.

We established the cutoff value for plasma folic acid, using plasma homocyst(e)ine as the functional marker. To do this, we investigated the relationship of the plasma folic acid of 103 apparently healthy adults with their fasting plasma homocyst(e)ine and with their plasma homocyst(e)ine 6 h after oral methionine challenge (100 mg/kg). We also studied the relationship of their plasma folic acid with the decline of fasting plasma homocyst(e)ine after 7 days of folic acid supplementation (5 mg/day). The three approaches suggested a cutoff value of 10 nmol/L. The chances of individuals to significantly (P <0.05) lower their plasma homocyst(e)ine after folic acid supplementation proved significantly higher at plasma folic acid concentrations <=10 nmol/L, as compared with folic acid concentrations above this value (odds ratio, 5.02; 95% confidence interval, 1.87–13.73). We suggest adopting a 10 nmol/L plasma folic acid cutoff value on functional grounds.




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