Folate and vitamin B12 work together when they enter the one-carbon metabolism where biochemical reactions occur that involve detoxification, energy production, immune function, maintenance, regulation of genes, mood stabilizing, and inflammation control (Medici & Halsted, 2012).
Non-Alcoholic Fatty Liver Disease has been found with many risk factors such as inflammation, obesity, fatty acid oxidation, insulin resistance, dietary factors, bacterial, and environmental toxins. There have been many nutrient deficiencies associated with NAFLD such as methyl donors such as folic acid, methionine, and choline (Sharifi et al., 2023). In th liver homocysteine is synthesized into methionine synthase and the methyl group of 5-methyl-tetrahydrofolate (5-MTHF) is transported to cobalamin (B12), for the formation of methyl-cobalamin which is then attached to the methionine synthase (MS); which causes this enzyme to be activated (Sharifi et al., 2023). The methionine is produces SAMe through the enzyme methionine adensyltransferase. When SAMe is available in the hepatocytes, phosphatidycholine (PC) is produced (Sharifi et al., 2023). Understanding this pathway is important when trying to understand the role of folic acid because folate deficiency has been associated with a decrease of storage of PC and SAMe within the liver.
Folic Acid plays important roles in the synthesis of purines, thymidylates, and the metabolism of amino acids such as glycine and methionine (both of these play an important part of live detoxification) and histidine. Folate monoglutamate is metabolized in the liver to 5-methyltetrahydrofolate which is necessary for the above pathway in the liver (Madkour, 2019). Folate deficiency is associated with the progression of liver disease due to its involvement with methionine metabolism and DNA synthsesis
Research
1. Sharifi, N., Molaqanbari, M., Zarringol, S., Talari, H., Taghizadeh, M., Bahmani, F., Mohtashamian, A., & Ebrahimzadeh, A. (2023). Effects of folic acid supplementation on liver enzymes, lipid profile, and insulin resistance in patients with non-alcoholic fatty liver disease: A randomized controlled trial. Advanced Biomedical Research, 12(1), 103. https://doi.org/10.4103/abr.abr_90_22Links to an external site.
2. Madkour, L. H. (2019). Nucleic acids as gene anticancer drug delivery therapy. Elsevier Science & Technology.
3. Medici, V., & Halsted, C. H. (2012). Folate, alcohol, and liver disease. Molecular Nutrition & Food Research, 57(4), 596–606. https://doi.org/10.1002/mnfr.201200077
