The Impact of Folic Acid/VB12 Deficiency on Essential Hypertension in Children and Adolescents: from a Nested Case-control and a Cohort Study

Abstract

Abstract Aims To explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated BP in children and adolescents. Methods A nested case-control study was conducted to select 326 subjects (116:210) from an established cohort. And a cohort study was also conducted, which included 270 participants without hypertension at baseline and followed in 2019. Questionnaires, physical examinations, and blood biochemical tests were performed at baseline and follow-up. The relationships between FA, VB12, and blood pressure (BP) levels /elevated BP in children and adolescents were investigated using both a nested case control and a cohort study. Results FA and VB12 levels were lower in the elevated BP group than in the control group, and homocysteine levels were higher than that in the control group. In the elevated BP group, overweight/obese children had lower FA than overweight/obese children in the control group. FA was positively correlated with high-density lipoprotein (HDL) and Apo lipoprotein A (APOA), but negatively correlated with triglyceride (TG). FA was significantly correlated with elevated BP in children and adolescents (β=-0.353, P = 0.032), after adjusting VB12, and homocysteine (HCY), and the interaction effect of FA*HCY was significant. Both systolic and diastolic BP levels were statistically lower in the FA high exposure group than in the FA low exposure group in the cohort study. Conclusions This study found that FA deficiency in childhood was correlated with elevated BP levels, which may affect BP by regulating lipid levels, and confirmed the importance of FA supplementation in childhood.