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Individuals heterozygous for \u03b2\u2010thalassemia may have higher folate requirements than normal individuals.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p><jats:bold>Objectives:<\/jats:bold> To document the concentration of serum total folate and its forms in \u03b2\u2010thalassemia heterozygote users (\u03b2\u2010TmU) and nonusers (\u03b2\u2010TmN) of 5\u00a0mg folic acid\/d; to determine whether folic acid (FA) consumption from fortified foods allows beta\u2010Tm patients, who do not take FA supplements, to meet their dietary folate requirements; and to investigate the association between higher serum unmetabolized folic acid (UMFA) and inflammatory cytokine concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum total folate and forms were measured in 42 \u03b2\u2010Tm (13 \u03b2\u2010TmU and 29 \u03b2\u2010TmN) and 84 healthy controls. The mononuclear leucocyte mRNA expression of relevant genes and their products and hematological profiles were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\u03b2\u2010TmU had higher serum total folate, 5\u2010methyltetrahydrofolate, UMFA, and tetrahydrofolate (THF) compared with \u03b2\u2010TmN. The \u03b2\u2010TmN had lower serum total folate and THF than controls. Plasma total homocysteine (tHcy) was lower in \u03b2\u2010TmU compared with both \u03b2\u2010TmN and controls, while \u03b2\u2010TmN had higher tHcy than controls. \u03b2\u2010TmU had higher IL\u20108 than their controls while \u03b2\u2010TmN had higher IL\u20106 and IL\u20108 than their controls. \u03b2\u2010TmU have higher levels of serum total folate, 5\u2010 methyltetrahydrofolate, UMFA, and THF than controls. There was no association between UMFA concentrations and cytokine levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mandatory flour fortification with FA in Brazil may be insufficient for \u03b2\u2010TmN, since they have higher tHcy and lower serum total folate than controls. Furthermore, \u03b2\u2010TmN have higher IL\u20106 levels than \u03b2\u2010TmU. UMFA was not associated with inflammatory cytokine levels.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.13287","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T11:08:57Z","timestamp":1594724937000},"page":"718-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Serum folate and cytokines in heterozygous \u03b2\u2010thalassemia"],"prefix":"10.1111","volume":"42","author":[{"given":"Cl\u00f3vis","family":"Paniz","sequence":"first","affiliation":[{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas Faculdade de Ci\u00eancias Farmac\u00eauticas Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas Universidade Federal de Santa Maria Santa Maria Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maylla Rodrigues","family":"Lucena","sequence":"additional","affiliation":[{"name":"Disciplina de Hematologia e Hemoterapia Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliano Felix","family":"Bertinato","sequence":"additional","affiliation":[{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas Faculdade de Ci\u00eancias Farmac\u00eauticas Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnun Nueldo Nunes","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Departamento de Patologia Cl\u00ednica Faculdade de Ci\u00eancias M\u00e9dicas Universidade de Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme Wataru","family":"Gomes","sequence":"additional","affiliation":[{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas Faculdade de Ci\u00eancias Farmac\u00eauticas Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Stella","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Disciplina de Hematologia e Hemoterapia Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5193-8854","authenticated-orcid":false,"given":"Maria de F\u00e1tima","family":"Sonati","sequence":"additional","affiliation":[{"name":"Departamento de Patologia Cl\u00ednica Faculdade de Ci\u00eancias M\u00e9dicas Universidade de Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera L\u00facia Nascimento","family":"Blaia\u2010D Avila","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Hematologia Faculdade de Medicina e Ci\u00eancias da Sa\u00fade Pontif\u00edcia Universidade Cat\u00f3lica de S\u00e3o Paulo Sorocaba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine UC Davis School of Medicine Sacramento CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6681-2210","authenticated-orcid":false,"given":"Elvira Maria","family":"Guerra\u2010Shinohara","sequence":"additional","affiliation":[{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas Faculdade de Ci\u00eancias Farmac\u00eauticas Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Disciplina de Hematologia e Hemoterapia Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Faculdade e Ci\u00eancias Farmac\u00eauticas Alimentos e Nutri\u00e7\u00e3o Universidade Federal de Mato Grosso do Sul Campo Grande MS Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2016.173"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12464"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddw170"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e3181cd68ed"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2010.05578.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/394295"},{"key":"e_1_2_8_8_1","unstructured":"Brasil. 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