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The direction of the difference between Canadian and American erythrocyte folate concentrations is dependent on the assay method employed: a comparison of the Canadian Health Measures Survey and National Health and Nutrition Examination Survey

机译：加拿大和美国红细胞叶酸浓度之间差异的方向取决于所采用的测定方法：加拿大卫生措施调查与国家健康与营养检查调查的比较

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摘要

Fortification of select grain products with folic acid and periconceptional supplementation recommendations in Canada and the USA have improved folate status, and have been associated with a reduced risk of neural tube defects. In the present study, we aimed to conduct a comparison of erythrocyte folate concentrations from the 2007–9 Canadian Health Measures Survey (CHMS) and the 2007–8 US National Health and Nutrition Examination Survey (NHANES). Erythrocyte folate concentration was assessed in participants aged 6–79 years (CHMS, n 5248; NHANES, n 7070). To account for different folate assays employed – Immulite 2000 immunoassay (CHMS) and microbiological assay (NHANES) – a conversion equation was generated (n 152 adults) to adjust the CHMS data. t Tests were used to examine country differences. Median Canadian erythrocyte folate concentrations (method-adjusted) were lower than those of Americans (988 and 1100 nmol/l, respectively), but unadjusted median Canadian erythrocyte folate concentrations were higher (1250 nmol/l). The upper 95% CI boundary of the method-adjusted Canadian erythrocyte folate distribution overlapped that of the American erythrocyte folate concentrations, while the lower 95% CI boundary of the method-adjusted Canadian erythrocyte folate data was below the American distribution. In summary, the fact that erythrocyte folate concentrations were either higher or lower in Canadians compared with Americans, depending on whether an adjustment was made to account for assay differences, suggests that caution must be exercised in evaluating erythrocyte folate data from different countries because analytical methods are not readily comparable. Furthermore, we cannot unequivocally conclude that there are true differences in erythrocyte folate concentrations between the Canadian and American populations in the post-fortification era.
机译：在加拿大和美国，使用叶酸对某些谷物产品进行强化，并建议进行围产期补充，从而改善了叶酸状况，并降低了神经管缺陷的风险。在本研究中，我们旨在比较2007–9年加拿大卫生措施调查（CHMS）和2007–8美国国家健康与营养检查（NHANES）中的红细胞叶酸浓度。评估了6-79岁参与者的红细胞叶酸浓度（CHMS，n 5248； NHANES，n 7070）。为了说明采用的不同叶酸测定法-Immulite 2000免疫测定法（CHMS）和微生物测定法（NHANES）-生成了一个转换方程（n 152位成年人）来调整CHMS数据。 t测试用于检验国家差异。加拿大红细胞叶酸中位数浓度（方法调整后）低于美国人（分别为988和1100 nmol / l），但未经调整的加拿大红细胞叶酸中位数较高（1250 nmol / l）。经方法调整的加拿大红细胞叶酸浓度分布的较高95％CI边界与美国经血红细胞叶酸浓度的重叠，而经方法调整的加拿大红细胞叶酸数据的较低95％CI边界低于美国分布。总而言之，加拿大人的红细胞叶酸浓度高于或低于美国人，这取决于是否进行了调整以考虑到分析差异，这表明在评估来自不同国家的红细胞叶酸数据时必须谨慎，因为分析方法不容易比较。此外，我们不能毫无疑问地得出结论，在强化后时代，加拿大人和美国人之间的红细胞叶酸浓度确实存在差异。

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