Assessment of folate status

Serum folate concentration is considered a sensitive indicator of recent dietary folate intake [7] in contrast to red blood cell folate concentration, which is considered an indicator of long-term status. Folate is not taken up by the mature red blood cell in the circulation; hence, red blood cell (RBC) folate concentration represents folate taken up in the developing reticulocyte early in the approximately 120-day erythrocyte lifespan [7]. This is especially relevant during pregnancy, when production of red cells increases by approximately 33% [32]. Based on associations with liver folate concentrations determined by biopsy, red blood cell folate concentration is considered representative of tissue folate stores [7]. The most commonly used cutoffs for defining low serum and red blood cell folate levels are 6.8 and 317 nmol/l, respectively [27].

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