Examining Epidemiology of Folate Status Attributable to Adolescent Alcohol Use

青少年酗酒是一个基本的公共健康威胁。有证据表明 大量饮酒和酗酒会损害肠道对叶酸(维生素B9)的吸收，并促进肾脏和 肝脏叶酸排泄。因此，青春期女孩可能面临大量饮酒的额外风险。 叶酸状态不足会导致一系列不良的出生结局和后来的不良后果 童年。拟议的前瞻性流行病学研究将招募怀特的分层配额样本， 非裔美国人和拉丁裔(N=455)14-18岁的少女。参赛者将在 为期4周的评估，包括每周采集干血斑样本(监测叶酸) 并持续经皮评估血液酒精水平。收集的数据将用于实现三个目标 主要具体目标：1)描述饮酒频率和强度的种族和民族差异 14-18岁女孩随时间醉酒，控制家庭对饮酒的重要影响；2) 描述随着时间的推移叶酸状况的种族和民族差异，控制饮食习惯和重要的家庭成员 影响；以及3)描述酒精中毒引起的叶酸状态的变化，并确定叶酸状态是否 在严重的间歇性饮酒事件后耗尽。实现这些目标意义重大，因为有 有色人种妇女在不良生育结果中持续存在的种族和民族差异，以及早期性别差异的作用 酒精行为在这些差异中是模棱两可的。因此，该项目解决了 通过扩展关于大量饮酒的潜在作用和随后对 叶酸状况可能会在包括出生缺陷在内的不良出生结局中造成种族和民族不平等。 拟议的研究在其前瞻性的、基于社区的设计方面具有创新性，其重点是青春期女孩，其 持续经皮评估酒精使用情况的客观评估及其严谨领域 通过采集干血斑样本来评估血清叶酸。实现以下目标 这项研究将有针对性地确定几个与怀孕有关的问题的潜在原因，并 先天缺陷。这些信息有助于减少与怀孕和分娩有关的健康差距。

Heavy alcohol consumption among adolescents is a fundamental public health threat. There is evidence that heavy alcohol use and alcoholism impair intestinal absorption of folate (vitamin B9), and promotes renal and hepatic folate excretion. Therefore, adolescent girls may face additional risks from heavy alcohol consumption. Inadequate folate status contributes to a host of poor birth outcomes and adverse consequences later in childhood. The proposed prospective epidemiological study will recruit a stratified quota sample of White, African American and Latina (N=455) adolescent girls aged 14 - 18 years. Participants will be monitored over a 4-week period with assessments including weekly collecting of dried blood spot samples (to monitor folate) and continuous transdermal assessment of blood alcohol level. Collected data will be used to achieve three primary specific aims: 1) delineate racial and ethnic variation in the frequency and intensity of alcohol intoxication over time among 14-18 year-old girls, controlling for important familial influences on alcohol use; 2) describe racial and ethnic variation in folate status over time, controlling for dietary habits and important familial influences; and 3) delineate variation in folate status by alcohol intoxication, and determine if folate status is depleted following heavy episodic drinking events. Accomplishing these aim is significant because there are persistent racial and ethnic disparities in poor birth outcomes among women of color, and the role of earlier alcohol behavior in these disparities is ambiguous. This project therefore addresses a critical gap in the literature by expanding knowledge about the potential role heavy alcohol use and subsequent implications for folate status may play in creating racial and ethnic inequities in poor birth outcomes including birth defects. The proposed study is innovative in its prospective, community-based design, its focus on adolescent girls, its objective assessment of alcohol use through continuous transdermal assessment, and its rigorous field assessments of serum folate through the collection of dried blood spot samples. Accomplishing the goals of this study will allow for targeted identification of potential causes of several pregnancy-related problems and birth defects. Such information can be helpful in reducing health disparities related to pregnancy and childbirth.