ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1512410
This article is part of the Research TopicDietary Influences on White and Brown Adipose Tissue: Mechanisms and Health ImplicationsView all 4 articles
Red blood cell folate and visceral adipose tissue among young and middle-aged American adults
Provisionally accepted
- 1Jiangmen Central Hospital, Jiangmen, China
- 2The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
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The relationship between red blood cell (RBC) folate levels and visceral adipose tissue (VAT) accumulation has not been well-explored. This study investigates the association between RBC folate and VAT in young and middle-aged adults in the United States.Methods: A cross-sectional analysis was conducted using data from 7,591 individuals aged 20 to 59 years, drawn from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. VAT was measured using dual-energy X-ray absorptiometry (DXA). RBC folate levels were quantified using a multi-step process combining microbiologic assays and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Multivariate linear regression models were applied to assess the relationship between RBC folate and VAT mass.Results: After adjusting for potential confounders, RBC folate levels were positively associated with VAT mass, with a β coefficient (95% CI) of 0.05 (0.03, 0.07). A J-shaped dose-response relationship was observed (nonlinear, p < 0.001), with a threshold effect identified at an RBC folate level of 397.18 ng/mL. Below this threshold, the association was negative [β (95% CI): -0.10 (-0.20, -0.01)], while above the threshold, the association became positive [β (95% CI): 0.06 (0.03, 0.09)].Conclusions: The association between RBC folate and VAT mass in young and middle-aged American adults follows a J-shaped curve, with a threshold effect observed at an RBC folate level of 397.18 ng/mL. Further research is needed to explore the underlying mechanisms of this association.
Keywords: visceral adipose tissue, Folate status, Red blood cell folate, Cross-sectional study, National Health and Nutrition Examination Survey
Received: 22 Oct 2024; Accepted: 11 Jun 2025.
Copyright: © 2025 Jiang, Li, Yu, Luo, Wu, Long and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bin Zhang, Jiangmen Central Hospital, Jiangmen, China
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