{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:06:12Z","timestamp":1790219172757,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T00:00:00Z","timestamp":1522627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: The correlation between abnormal vitamin serum levels and chronic liver disease has been previously described in literature. However, the association between the severity of folate serum levels (B9), vitamin B12 and nonalcoholic steatohepatitis (NASH) has not been widely evaluated. Therefore, the aim of this study was to investigate the existence of such a correlation in a cohort of NASH patients. Methods: All patients aged 18 years and older who were diagnosed with biopsy-proven NASH at the EMMS hospital in Nazareth during the years 2015\u20132017 were enrolled in this study. Data regarding demographic, clinical and laboratory parameters was collected. Patients with other liver diseases were excluded. Results: Eighty-three NASH patients were enrolled during the study period. The mean age was 41 \u00b1 11 years and the majority of patients were male. Mean values of folate and B12 were 9.85 \u00b1 10.90 ng\/mL and 387.53 \u00b1 205.50 pg\/mL, respectively. Half of the patients were presented with a grade 1 steatosis (43.4%), a grade 2 fibrosis (50.6%) and a grade 3 activity score (55.4%). The fibrosis grade was significantly correlated with low folate levels on multivariate analysis (p-value &lt; 0.01). Similarly, low B12 levels were significantly associated with a higher fibrosis grade and NASH activity (p-value &lt; 0.001 and p-value &lt; 0.05 respectively). Conclusion: Our study demonstrated a statistically significant correlation between low levels of folate and vitamin B12 with the histological severity of NASH. These findings could have diagnostic and therapeutic implications for patient management and follow-up.<\/jats:p>","DOI":"10.3390\/nu10040440","type":"journal-article","created":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T12:32:20Z","timestamp":1522672340000},"page":"440","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Folate and B12 Levels Correlate with Histological Severity in NASH Patients"],"prefix":"10.3390","volume":"10","author":[{"given":"Mahmud","family":"Mahamid","sequence":"first","affiliation":[{"name":"Endoscopy Unit, Nazareth Hospital EMMS, 16100 Nazareth, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, 13195 Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naim","family":"Mahroum","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, 52621 Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-868X","authenticated-orcid":false,"given":"Nicola","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"School of Public Health, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasem","family":"Shalaata","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, 13195 Safed, Israel"},{"name":"Internal Medicine Department, Nazareth Hospital EMMS, 16100 Nazareth, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yarden","family":"Yavne","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, 52621 Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2738-8784","authenticated-orcid":false,"given":"Mohammad","family":"Adawi","sequence":"additional","affiliation":[{"name":"Ziv and Padeh Medical centers, 13195 Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, 52621 Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel-Hashomer, Israel, Sackler Faculty of Medicine, Tel-Aviv University, 52621 Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"846","DOI":"10.4254\/wjh.v7.i6.846","article-title":"Non-alcoholic fatty liver disease: The diagnosis and management","volume":"7","year":"2015","journal-title":"World J. 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