folat (LH Indholdsside)

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  <Item Id="{A6D2AA89-9D74-465D-B69B-D29C9190D8BB}" Name="folat" Type="LHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{954990FB-BCA1-4322-A1A9-62D3FD4B2E07}" SortOrder="4300" PublishDate="2011-01-31T13:14:00" DeleteDate="2999-12-31T00:00:00" PotItemType="">
    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>
    Folat unders&oslash;ges ved makrocyt&aelig;r an&aelig;mi eller mistanke om andre tilstande med <a href="https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/blod/tilstande-og-sygdomme/anaemier/folsyremangel/">folatmangel</a>, herunder d&aring;rlig&nbsp;ern&aelig;ring og malabsorption<a href="%20" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S;; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH|Lyngbyes laboratoriemedicin. 2. udg|København|Nyt Nordisk Forlag Arnold Busck A/S;|2010" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S;; 2010" data-type="book-reference">1</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7BA6D2AA89-9D74-465D-B69B-D29C9190D8BB%7D&amp;ed=FIELD2201678544&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H2201678608&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Martin J, Radeke HH, Dignass A, Stein J, Current evaluation and management of anemia in patients with inflammatory bowel disease.. Expert Rev Gastroenterol Hepatol 2017;11: 19-32" data-value-piped="Martin J, Radeke HH, Dignass A, Stein J|Current evaluation and management of anemia in patients with inflammatory bowel disease.|Expert Rev Gastroenterol Hepatol|2017|11|19-32|27885843" data-url="reference-link" data-pubmedid="27885843" title="Martin J, Radeke HH, Dignass A, Stein J, Current evaluation and management of anemia in patients with inflammatory bowel disease.. Expert Rev Gastroenterol Hepatol 2017;11: 19-32">2</a></li>
    <li>
    Hovedparten af patienter med kronisk&nbsp;<a href="~/link.aspx?_id=C080DD40EC4E4DAEAEDF4AC362930D12&amp;_z=z">alkoholisme</a>&nbsp;har folatmangel
    </li>
    <li>
    Folat er et B-vitamin som skal tilf&oslash;res via kosten eller som kosttilskud</li>
    <li>
    Sundhedsstyrelsen anbefaler folattilskud til gravide og kvinder der planl&aelig;gger graviditet, da folatmangel giver &oslash;get risiko for neuralr&oslash;rsdefekt hos fosteret<a href="https://www.sst.dk/da/viden/foraeldreskab/graviditet-og-foedsel/information-til-gravide/kost-og-kosttilskud" data-type="other-reference" data-value="SST, anbefaling kosttilskud" data-url="https://www.sst.dk/da/viden/foraeldreskab/graviditet-og-foedsel/information-til-gravide/kost-og-kosttilskud" title="SST, anbefaling kosttilskud">3</a>
    </li>
</ul>
<h2>Definition</h2>
<ul>
    <li>Koncentrationen af folat i plasma, m&aring;lt i nanomol per liter (nmol/L)</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>Synonymer: Folinsyre; Folsyre; Vitamin B<sub>9</sub></li>
</ul>
<h2>Indikationer</h2>
<ul>
    <li>Mistanke om&nbsp;<a href="~/link.aspx?_id=D034F70CE577455C82B08497E96CFB0A&amp;_z=z">folatmangel</a>, fx hos patienter med:
    <ul>
        <li>Makrocyt&aelig;r an&aelig;mi som ikke skyldes&nbsp;<a href="~/link.aspx?_id=607B515C63D64C2483609169CD92CE8E&amp;_z=z">vitamin B12-mangel</a><a href="EditorPage.aspx?da=core&amp;id=%7BA6D2AA89-9D74-465D-B69B-D29C9190D8BB%7D&amp;ed=FIELD2032587957&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H2032588387&amp;us=sitecore%5Cneho&amp;mo&amp;pe=0&amp;fbd=1" title="Green R, Datta Mitra A, Megaloblastic Anemias: Nutritional and Other Causes. Med Clin North Am. 2017;101: 297-317" data-url="reference-link" data-value-piped="Green R, Datta Mitra A|Megaloblastic Anemias: Nutritional and Other Causes|Med Clin North Am.|2017|101|297-317" data-value="Green R, Datta Mitra A, Megaloblastic Anemias: Nutritional and Other Causes. Med Clin North Am. 2017;101: 297-317" data-type="journal-reference">4</a></li>
        <li>D&aring;rlige kostvaner, is&aelig;r med et lavt indtag af gr&oslash;ntsager
        <ul>
            <li><a href="~/link.aspx?_id=450DBE8CC2A44436A03F430880A0CA3F&amp;_z=z">Anoreksi</a></li>
            <li><a href="~/link.aspx?_id=C080DD40EC4E4DAEAEDF4AC362930D12&amp;_z=z">Alkoholisme</a></li>
            <li>&AElig;ldre</li>
        </ul>
        </li>
        <li>Sygdomstilstande med malabsorption, fx&nbsp;<a href="~/link.aspx?_id=7C3C6EF3B3BE4C7AA66DC32DA809FE83&amp;_z=z">Mb. Crohn</a>&nbsp;eller&nbsp;<a href="~/link.aspx?_id=935A845E8C8643229D937C40DCE2A30F&amp;_z=z">c&oslash;liaki</a>, genestiske tilstande<a href="EditorPage.aspx?da=core&amp;id=%7BA6D2AA89-9D74-465D-B69B-D29C9190D8BB%7D&amp;ed=FIELD537356730&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H537356885&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Martin J, Radeke HH, Dignass A, Stein J, Current evaluation and management of anemia in patients with inflammatory bowel disease.. Expert Rev Gastroenterol Hepatol 2017;11: 19-32" data-value-piped="Martin J, Radeke HH, Dignass A, Stein J|Current evaluation and management of anemia in patients with inflammatory bowel disease.|Expert Rev Gastroenterol Hepatol|2017|11|19-32|27885843" data-url="reference-link" data-pubmedid="27885843" title="Martin J, Radeke HH, Dignass A, Stein J, Current evaluation and management of anemia in patients with inflammatory bowel disease.. Expert Rev Gastroenterol Hepatol 2017;11: 19-32">2</a></li>
        <li>Tilstande og sygdomme med et &oslash;get forbrug af folat
        <ul>
            <li>Graviditet<a href="EditorPage.aspx?da=core&amp;id=%7BA6D2AA89-9D74-465D-B69B-D29C9190D8BB%7D&amp;ed=FIELD537356730&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H537356885&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Annamraju H, Pavord S, Anaemia in pregnancy.. Br J Hosp Med (Lond) 2016;77: 584-588" data-value-piped="Annamraju H, Pavord S|Anaemia in pregnancy.|Br J Hosp Med (Lond)|2016|77|584-588|27723395" data-url="reference-link" data-pubmedid="27723395" title="Annamraju H, Pavord S, Anaemia in pregnancy.. Br J Hosp Med (Lond) 2016;77: 584-588">5</a></li>
            <li>Pr&aelig;maturitet</li>
            <li><a href="~/link.aspx?_id=1A0F3F20CA1848F595B1118E358DED41&amp;_z=z">H&aelig;molytisk an&aelig;mi</a></li>
            <li>Dialysekr&aelig;vende nyresygdom</li>
            <li><a href="~/link.aspx?_id=6F8C67265AD4418CBB1BA4514AE6EA53&amp;_z=z">Hyperthyreose</a></li>
            <li>Cancer, og is&aelig;r&nbsp;<a href="~/link.aspx?_id=6F8C67265AD4418CBB1BA4514AE6EA53&amp;_z=z">leuk&aelig;mi</a></li>
            <li>Eksfoliative hudsygdomme, og is&aelig;r&nbsp;<a href="~/link.aspx?_id=01B73EDAEA6749029D805E9C5B9E687E&amp;_z=z">psoriasis</a></li>
        </ul>
        </li>
    </ul>
    </li>
</ul>
<h2>Fortolkninger<a href=" " data-type="journal-reference" data-value="Shulpekova Y, Nechaev V, Kardasheva S, Sedova A, Kurbatova A, Bueverova E, Kopylov A, Malsagova K, Dlamini JC, Ivashkin V, The Concept of Folic Acid in Health and Disease. Molecules 2021;26: " data-value-piped="Shulpekova Y, Nechaev V, Kardasheva S, Sedova A, Kurbatova A, Bueverova E, Kopylov A, Malsagova K, Dlamini JC, Ivashkin V|The Concept of Folic Acid in Health and Disease.|Molecules|2021|26||34207319" data-url="reference-link" data-pubmedid="34207319" title="Shulpekova Y, Nechaev V, Kardasheva S, Sedova A, Kurbatova A, Bueverova E, Kopylov A, Malsagova K, Dlamini JC, Ivashkin V, The Concept of Folic Acid in Health and Disease. Molecules 2021;26: ">6</a></h2>
<ul>
    <li>Lave v&aelig;rdier:&nbsp;
    <ul>
        <li>Da folat- og vitamin B12-mangel giver ensartede h&aelig;matologiske symptomer, kan tilstandene v&aelig;re vanskelige at skelne fra hinanden.&nbsp;<a href="~/link.aspx?_id=D04A9CDA27624A36946213C381814AEA&amp;_z=z">Homocystein</a>&nbsp;er forh&oslash;jet ved begge tilstande, hvorimod&nbsp;<a href="~/link.aspx?_id=A045C13E28B5473BBEE18AADDB31AADE&amp;_z=z">metylmalonat</a>&nbsp;kun er forh&oslash;jet ved B12-vitanin-mangel</li>
        <li>Methotrexat behandling s&aelig;nker folat-niveauet, og der b&oslash;r derfor suppleres med&nbsp;<a href="https://pro.medicin.dk/laege/middelgrupper/grupper/213095">folattilskud</a></li>
    </ul>
    </li>
    <li>Forh&oslash;jede v&aelig;rdier
    <ul>
        <li> kan ses ved hepatitis</li>
    </ul>
    </li>
    <li>Personer med polymorfi (677 C til T)&nbsp;i metylen tetrahydrofolatreduktase genet har &oslash;get risiko for folat-mangel. Forekommer hos ca. 8 % af befolkningen, har brug for h&oslash;jere folat koncentration i plasma (&gt; 15 nmol/L)&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7BA6D2AA89-9D74-465D-B69B-D29C9190D8BB%7D&amp;ed=FIELD537356730&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H537356885&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Annamraju H, Pavord S, Anaemia in pregnancy.. Br J Hosp Med (Lond) 2016;77: 584-588" data-value-piped="Annamraju H, Pavord S|Anaemia in pregnancy.|Br J Hosp Med (Lond)|2016|77|584-588|27723395" data-url="reference-link" data-pubmedid="27723395" title="Annamraju H, Pavord S, Anaemia in pregnancy.. Br J Hosp Med (Lond) 2016;77: 584-588">5</a></li>
    <li>Mangel p&aring; folater hos gravide giver &oslash;get risiko for neuralr&oslash;rsdefekt hos fosteret, hvorfor Sundhedsstyrelsen anbefaler tilskud til gravide og til kvinder der p&aring;t&aelig;nker graviditet<a href="https://www.sst.dk/da/viden/foraeldreskab/graviditet-og-foedsel/information-til-gravide/kost-og-kosttilskud" data-type="other-reference" data-value="SST, anbefaling kosttilskud" data-url="https://www.sst.dk/da/viden/foraeldreskab/graviditet-og-foedsel/information-til-gravide/kost-og-kosttilskud" title="SST, anbefaling kosttilskud">3</a></li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)</h2>
<ul>
    <li>H&aelig;molyse giver falsk forh&oslash;jede v&aelig;rdier</li>
    <li>V&aelig;rdien stiger i forbindelse med indtagelse af et folatholdigt m&aring;ltid eller en vitaminpille</li>
    <li>Niveauet falder under transport fra praksis til laboratoriet</li>
    <li>Begr&aelig;nset holdbarhed f&oslash;r pr&oslash;ven bliver centrifugeret</li>
</ul>
<h2>Biokemisk baggrund<a href="%20" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S;; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH|Lyngbyes laboratoriemedicin. 2. udg|København|Nyt Nordisk Forlag Arnold Busck A/S;|2010" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S;; 2010" data-type="book-reference">1</a><sup>,</sup>
<a href="%20" title="Saini RK, Nile SH, Keum YS, Folates: Chemistry, analysis, occurrence, biofortification and bioavailability.. Food Res Int. 2016;89: 1-13" data-url="reference-link" data-value-piped="Saini RK, Nile SH, Keum YS|Folates: Chemistry, analysis, occurrence, biofortification and bioavailability.|Food Res Int.|2016|89|1-13" data-value="Saini RK, Nile SH, Keum YS, Folates: Chemistry, analysis, occurrence, biofortification and bioavailability.. Food Res Int. 2016;89: 1-13" data-type="journal-reference">7</a><sup>,
<a href=" " data-type="journal-reference" data-value="Kaye AD, Jeha GM, Pham AD, Fuller MC, Lerner ZI, Sibley GT, Cornett EM, Urits I, Viswanath O, Kevil CG, Folic Acid Supplementation in Patients with Elevated Homocysteine Levels. Adv Ther 2020;37: 4149-4164" data-value-piped="Kaye AD, Jeha GM, Pham AD, Fuller MC, Lerner ZI, Sibley GT, Cornett EM, Urits I, Viswanath O, Kevil CG|Folic Acid Supplementation in Patients with Elevated Homocysteine Levels.|Adv Ther|2020|37|4149-4164|32845472" data-url="reference-link" data-pubmedid="32845472" title="Kaye AD, Jeha GM, Pham AD, Fuller MC, Lerner ZI, Sibley GT, Cornett EM, Urits I, Viswanath O, Kevil CG, Folic Acid Supplementation in Patients with Elevated Homocysteine Levels. Adv Ther 2020;37: 4149-4164"></a></sup><a href=" " data-type="journal-reference" data-value="Kaye AD, Jeha GM, Pham AD, Fuller MC, Lerner ZI, Sibley GT, Cornett EM, Urits I, Viswanath O, Kevil CG, Folic Acid Supplementation in Patients with Elevated Homocysteine Levels. Adv Ther 2020;37: 4149-4164" data-value-piped="Kaye AD, Jeha GM, Pham AD, Fuller MC, Lerner ZI, Sibley GT, Cornett EM, Urits I, Viswanath O, Kevil CG|Folic Acid Supplementation in Patients with Elevated Homocysteine Levels.|Adv Ther|2020|37|4149-4164|32845472" data-url="reference-link" data-pubmedid="32845472" title="Kaye AD, Jeha GM, Pham AD, Fuller MC, Lerner ZI, Sibley GT, Cornett EM, Urits I, Viswanath O, Kevil CG, Folic Acid Supplementation in Patients with Elevated Homocysteine Levels. Adv Ther 2020;37: 4149-4164">8</a></h2>
<ul>
    <li>Folat er et B-vitamin, som findes i lever, b&aelig;lgfrugter og gr&oslash;nne gr&oslash;ntsager&nbsp;</li>
    <li>Folater optages i duodenum og proximale jejunum&nbsp;og transporteres til leveren, der regulerer folat-homeostasen&nbsp;</li>
    <li>I forbindelse med optagelsen i tarmen reduceres og methyleres folaterne til 5-methyl-tetrahydrofolat (5-methyl-THF)</li>
    <li>En stor del af&nbsp;blodbanens 5-methyl-THF er proteinbundet</li>
    <li>5-methyl-THF afgiver sin methylgruppe til homocystein, der herved omdannes til methionin (derfor stiger homocystein ved folatmangel). </li>
    <li>Herefter kan THF indg&aring; i DNA og RNA syntesen og aminosyremetabolismen</li>
    <li>Tilstedev&aelig;relse af Cobalamin&nbsp; er n&oslash;dvendig for flere funktioner af 5-methyl-THF&nbsp; &nbsp;&nbsp;</li>
    <li>Voksnes kost indeholder en m&aelig;ngde nogenlunde svarende til anbefalingerne p&aring; 300 mikrogram per dag.&nbsp;For kvinder i den fertile alder, gravide og ammende er anbefalingen 400 mikrogram per dag, en m&aelig;ngde, som n&aelig;sten altid vil kr&aelig;ve tilskud </li>
    <li>Ved folatfattig kost vil niveauet falde i blodet i l&oslash;bet af nogle f&aring; uger og endnu hurtigere ved samtidig alkoholoverforbrug. Alkohol h&aelig;mmer dels metylering og del optagelsen i tarmen. </li>
    <li>Man vil f&aring; an&aelig;mi efter nogle m&aring;neder uden folat i kosten og pancytopeni ved l&aelig;ngere varende mangel<a href="%20" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S;; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH|Lyngbyes laboratoriemedicin. 2. udg|København|Nyt Nordisk Forlag Arnold Busck A/S;|2010" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S;; 2010" data-type="book-reference">1</a></li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Veneblodpr&oslash;ve i r&oslash;r uden antikoagulans (t&oslash;rglas)</li>
    <li>Afpipetteret serum er holdbart 1-2 d&oslash;gn ved stuetemperatur eller ved 4<sup>o</sup>C</li>
</ul>
<h2>Referenceintervaller</h2>
<ul>
    <li>Der kan v&aelig;re forskelle i de angivne v&aelig;rdier fra laboratorium til laboratorium, b&aring;de afh&aelig;ngigt af de anvendte m&aring;lemetoder og referencepopulationen</li>
</ul>
<ul>
    <li>0
    &aring;r - 1 &aring;r: 15-50 nmol/L</li>
    <li>1 &aring;r - 18 &aring;r: 6-35 nmol/L</li>
    <li>18 &aring;r - 200 &aring;r: &gt; 9 nmol/L
    </li>
</ul>
<h2>Patientinformation</h2>
<ul>
    <li><a href="~/link.aspx?_id=FFD7E719F1D84F6BB1778DA53416DB0D&amp;_z=z">Folater</a></li>
</ul>
<h2>NPU-kode</h2>
<ul>
    <li>NPU02070</li>
</ul>
<h2>Navn</h2>
<ul>
    <li><strong>Langt navn</strong>
    <ul>
        <li>P&mdash;Folat; stofk. = ? nmol/L</li>
    </ul>
    </li>
    <li><strong>Kort navn</strong>
    <ul>
        <li>Folat;P</li>
    </ul>
    </li>
</ul>]]></HtmlField>
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