Examining Epidemiology of Folate Status Attributable to Adolescent Alcohol Use

青少年大量饮酒是一个基本的公共健康威胁。有证据表明 大量饮酒和酒精中毒损害叶酸（维生素B 9）的肠道吸收，并促进肾脏和 肝脏叶酸排泄。因此，少女可能面临大量饮酒的额外风险。 叶酸不足会导致一系列不良的出生结果和不良后果， 童年.拟定的前瞻性流行病学研究将招募白色分层配额样本， 非裔美国人和拉丁裔（N=455）14 - 18岁的青春期女孩。将对参与者进行监测， 为期4周的评估期，包括每周收集干血斑样本（以监测叶酸） 和血液酒精水平的连续透皮评估。收集的数据将用于实现三个 主要具体目标：1）描述酒精频率和强度的种族和民族差异 14-18岁女孩随着时间的推移而中毒，控制对酒精使用的重要家庭影响; 2） 描述叶酸水平随时间变化的种族和民族差异，控制饮食习惯和重要的家庭因素， 影响; 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 有色人种妇女在不良生育结果方面持续存在的种族和民族差异， 在这些差异中的酒精行为是模糊的。因此，该项目解决了 通过扩大对大量饮酒的潜在作用及其对以下方面的影响的认识， 叶酸的状况可能会在造成包括出生缺陷在内的不良出生结果的种族和民族不平等方面发挥作用。 拟议的研究在其前瞻性、以社区为基础的设计、对少女的关注、 通过持续的透皮评估客观评估酒精使用情况， 通过收集干血斑样本评估血清叶酸。实现以下目标： 这项研究将有助于有针对性地确定几种妊娠相关问题的潜在原因， 出生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.