High folic acid intake increases methylation-dependent expression of Lsr and dysregulates hepatic cholesterol homeostasis

J Nutr Biochem. 2021 Feb:88:108554. doi: 10.1016/j.jnutbio.2020.108554. Epub 2020 Nov 19.

Abstract

Food fortification with folic acid and increased use of vitamin supplements have raised concerns about high folic acid intake. We previously showed that high folic acid intake was associated with hepatic degeneration, decreased levels of methylenetetrahydrofolate reductase (MTHFR), lower methylation potential, and perturbations of lipid metabolism. MTHFR synthesizes the folate derivative for methylation reactions. In this study, we assessed the possibility that high folic acid diets, fed to wild-type and Mthfr+/- mice, could alter DNA methylation and/or deregulate hepatic cholesterol homeostasis. Digital restriction enzyme analysis of methylation in liver revealed DNA hypomethylation of a CpG in the lipolysis-stimulated lipoprotein receptor (Lsr) gene, which is involved in hepatic uptake of cholesterol. Pyrosequencing confirmed this methylation change and identified hypomethylation of several neighboring CpG dinucleotides. Lsr expression was increased and correlated negatively with DNA methylation and plasma cholesterol. A putative binding site for E2F1 was identified. ChIP-qPCR confirmed reduced E2F1 binding when methylation at this site was altered, suggesting that it could be involved in increasing Lsr expression. Expression of genes in cholesterol synthesis, transport or turnover (Abcg5, Abcg8, Abcc2, Cyp46a1, and Hmgcs1) was perturbed by high folic acid intake. We also observed increased hepatic cholesterol and increased expression of genes such as Sirt1, which might be involved in a rescue response to restore cholesterol homeostasis. Our work suggests that high folic acid consumption disturbs cholesterol homeostasis in liver. This finding may have particular relevance for MTHFR-deficient individuals, who represent ~10% of many populations.

Keywords: 1-Carbon metabolism; Folic acid; Liver; Methyl donor; Methylenetetrahydrofolate reductase; Mouse model.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cholesterol / metabolism*
  • Choline / metabolism
  • DNA Methylation / drug effects*
  • Diet
  • Folic Acid / administration & dosage
  • Folic Acid / pharmacology*
  • Food, Fortified
  • Homeostasis / drug effects
  • Humans
  • Lipid Metabolism
  • Liver / metabolism*
  • Male
  • Methylenetetrahydrofolate Reductase (NADPH2) / deficiency
  • Methylenetetrahydrofolate Reductase (NADPH2) / metabolism
  • Mice
  • Mice, Inbred BALB C
  • Multidrug Resistance-Associated Protein 2
  • Receptors, Lipoprotein / genetics
  • Receptors, Lipoprotein / metabolism*

Substances

  • ABCC2 protein, human
  • Multidrug Resistance-Associated Protein 2
  • Receptors, Lipoprotein
  • angulin-1 protein, mouse
  • Folic Acid
  • Cholesterol
  • Methylenetetrahydrofolate Reductase (NADPH2)
  • Choline

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