Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K

Taverner, Tom; Crowe, Francesca L.; Thomas, G. Neil; Gokhale, Krishna; Thayakaran, Rasiah; Nirantharakumar, Krishnarajah; Rajabally, Yusuf A.

doi:10.3390/nu11102443

Open AccessArticle

Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K

by

Tom Taverner

^1,†,

Francesca L. Crowe

^1,*,†

,

G. Neil Thomas

¹,

Krishna Gokhale

¹,

Rasiah Thayakaran

¹

,

Krishnarajah Nirantharakumar

^1,*,‡ and

Yusuf A. Rajabally

^2,‡

¹

Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Prichatts Road, Birmingham B15 2TT, UK

²

Aston Brain Centre, Aston University, Aston Triangle, Birmingham B4 7ET, UK

^*

Authors to whom correspondence should be addressed.

^†

Joint first authors.

^‡

Equal contribution.

Nutrients 2019, 11(10), 2443; https://doi.org/10.3390/nu11102443

Submission received: 6 September 2019 / Revised: 9 October 2019 / Accepted: 10 October 2019 / Published: 14 October 2019

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Abstract

Background: Folate deficiency may increase the risk of peripheral neuropathy but there is a paucity of data from large prospective studies examining this association. Methods: Longitudinal analysis of electronic health records in The Health Improvement Network (THIN), a U.K. primary care database including 594,338 patients aged 18–70 years with a folate measurement and without a history of peripheral neuropathy. Results: After a mean follow-up of 3.71 (standard deviation (SD) = 3.14) years, 1949 patients were diagnosed with peripheral neuropathy and 20,679 patients died. In those <40 years, compared to patients with folate ≥13.6 nmol/L, those with folate <6.8 (deficient) and 6.8–13.5 nmol/L (insufficient) had a hazard ratio (HR) for peripheral neuropathy of 1.83 (95% confidence intervals (CI) = 1.16–2.91) and 1.48 (95% CI = 1.04–2.08), respectively. There was no significant association between folate and peripheral neuropathy among those aged 41–70 years. Compared to patients with folate ≥ 13.6 nmol/L, folate <6.8 nmol/L was associated with a greater risk of death among all ages. Conclusion: Folate deficiency and insufficiency was associated with a greater risk of peripheral neuropathy among younger patients. This investigation should be replicated in other large datasets and it may be important to monitor peripheral neuropathy incidence after the introduction of mandatory folic acid fortification of flour in the U.K.

Keywords: electronic health records; epidemiology; folate; nutrition; peripheral neuropathy

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MDPI and ACS Style

Taverner, T.; Crowe, F.L.; Thomas, G.N.; Gokhale, K.; Thayakaran, R.; Nirantharakumar, K.; Rajabally, Y.A. Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K. Nutrients 2019, 11, 2443. https://doi.org/10.3390/nu11102443

AMA Style

Taverner T, Crowe FL, Thomas GN, Gokhale K, Thayakaran R, Nirantharakumar K, Rajabally YA. Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K. Nutrients. 2019; 11(10):2443. https://doi.org/10.3390/nu11102443

Chicago/Turabian Style

Taverner, Tom, Francesca L. Crowe, G. Neil Thomas, Krishna Gokhale, Rasiah Thayakaran, Krishnarajah Nirantharakumar, and Yusuf A. Rajabally. 2019. "Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K" Nutrients 11, no. 10: 2443. https://doi.org/10.3390/nu11102443

APA Style

Taverner, T., Crowe, F. L., Thomas, G. N., Gokhale, K., Thayakaran, R., Nirantharakumar, K., & Rajabally, Y. A. (2019). Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K. Nutrients, 11(10), 2443. https://doi.org/10.3390/nu11102443

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Circulating Folate Concentrations and Risk of Peripheral Neuropathy and Mortality: A Retrospective Cohort Study in the U.K

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