Age- and ethnicity-related reference intervals for serum vitamin B12

Sobczyńska‐Malefora, Agata; Katayev, Alexander; Steed, David L.; O'Logbon, Jessica; Crook, Martin; Harrington, Dominic J.

doi:10.1016/j.clinbiochem.2022.10.007

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…Long-term vitamin B12 supplementation has been shown to reduce weight gain in overweight or obese people ( 19 ). In the present study, a stronger association was observed in the studies conducted in the Asian continent, which suggests that ethnic, dietetic, or genetic factors may influence this association ( 108 , 109 ). Hence, future studies should control for these potential effect modifiers.…”

Section: Discussionsupporting

confidence: 44%

Vitamin B12, folate, and homocysteine in metabolic syndrome: a systematic review and meta-analysis

Ulloque-Badaracco,

Hernandez-Bustamante,

Alarcon-Braga

et al. 2023

Front. Endocrinol.

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Background & aimsMetabolic syndrome (MetS) is associated with life-threatening conditions. Several studies have reported an association of vitamin B12, folic acid, or homocysteine (Hcy) levels with MetS. This systematic review and meta-analysis assessed the association of vitamin B12, folic acid, and Hcy levels with MetS.MethodsPubMed, Scopus, Embase, Ovid/Medline, and Web of Science were searched up to February 13, 2023. Cross-sectional, case-control, or cohort studies were included. A random-effects model was performed using the DerSimonian and Laird method to estimate the between-study variance. Effect measures were expressed as odds ratios (OR) with their corresponding 95% confidence intervals (95% CI). Between-study heterogeneity was evaluated using Cochran’s Q test and the I2 statistic.ResultsSixty-six articles (n = 87,988 patients) were included. Higher vitamin B12 levels were inversely associated with MetS (OR = 0.87; 95% CI: 0.81–0.93; p < 0.01; I2 = 90%). Higher Hcy levels were associated with MetS (OR = 1.19; 95% CI: 1.14–1.24; p < 0.01; I2 = 90%). Folate levels were not associated with MetS (OR = 0.83; 95% CI: 0.66–1.03; p = 0.09; I2 = 90%).ConclusionHigher vitamin B12 levels were inversely associated with MetS, whereas higher Hcy levels were associated with MetS. Studies assessing the pathways underlying this association are required.

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Section: Discussionsupporting

confidence: 44%

Vitamin B12, folate, and homocysteine in metabolic syndrome: a systematic review and meta-analysis

Ulloque-Badaracco,

Hernandez-Bustamante,

Alarcon-Braga

et al. 2023

Front. Endocrinol.

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“…This issue is complicated by the fact that vitamin B12 concentrations vary with age, gender, ethnicity and cultural and regional dietary habits. 12,13 A recent Chinese study reported that a manufacturer's original reference interval from a population of European descent was quite different from the reference interval determined from a local population. 14 A recent study in North India found 47% prevalence of vitamin B12 deficiency using European derived reference interval.…”

Section: Discussionmentioning

confidence: 99%

Vitamin B12 reference intervals on Beckman, Roche and Siemens analytical platforms

Jassam,

Bancroft,

Luvai

et al. 2023

Ann Clin Biochem

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Background: Vitamin B12 status is assessed primarily by total serum B12 using competitive binding methods. The lack of availability of a standard material, and high-level reference measurement procedure affects the trueness of B12 results. This results in variation between methods. This study aimed to determine the reference intervals for vitamin B12 on three routine analytical platforms. Method: A prospective reference population of healthy individuals was recruited according to the IFCC CRIDL criteria. Vitamin B12 samples were measured on Roche, Beckman and Siemens analytical platforms. Results: In total, 300 adult subjects were recruited; the central 95th centile values for B12 for Roche (190-678 ng/ml) and Siemens (181-562 ng/ml) analytical platforms were in a close agreement. Beckman DXi however, showed a significantly lower reference limit (110-562 ng/ml). All reference intervals are in keeping with previously published data but some are not in agreement with manufacturer provided reference interval. Conclusion: As the quality of the reference intervals play a significant role in clinical outcome. It is of great importance that laboratories use method-specific reference interval and if possible locally derived reference intervals until further method standardisation occurs.

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“…Selecting a reference population of mostly white males and females aged 25–60 when the population served is composed of multiple ethnicities and a wider age range would be unsuitable. For example, people of Black ethnic origin are recognised to have higher vitamin B12 concentrations than other ethnicities yet RIs are mainly derived from white populations [ 15 ]. It is likely that this has historically led to underdiagnosis of B12 deficiency and a lack of identification of associated comorbidities.…”

Section: What Is the Reference Interval And How Is It Usually Establi...mentioning

confidence: 99%

“…However, they also influence other laboratory analytes such as creatinine, haemoglobin, and cholesterol [ 43 ]. Examples of other analytes which are affected by these individual characteristics include calcium, phosphate, albumin, total protein, globulins, creatinine, urea, urate, sex hormone binding globulins, ferritin, and vitamin B12 [ 15 , 44 , 45 ]. However, this list is not exhaustive and there are many more examples in the literature.…”

Section: Limitations Of the Standard Reference Intervalmentioning

confidence: 99%

The Role and Limitations of the Reference Interval Within Clinical Chemistry and Its Reliability for Disease Detection

Timbrell

2024

Br J Biomed Sci

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Reference intervals (RIs) are a range of values that are supplied alongside laboratory measurements for comparison to allow interpretation of this data. Historically, RIs were referred to as the normal range. However, the perception of what is normal can lead to confusion in clinicians and unnecessary emotional distress in patients. RIs can be acquired using several methods. Laboratories may quote published studies or derive their own using established direct or indirect methods. Alternatively, laboratories may verify RIs provided by assay manufacturers using in-house studies. RIs have several limitations that clinicians should be aware of. The statistical methodology associated with establishment of RIs means that approximately 5% of “disease free” individuals will fall outside the RI. Additionally, the higher the number of tests requested, the higher the probability that one will be abnormal, and repeat results in an individual may show regression to the mean. Completion of studies for establishment of RIs can be expensive, difficult, and time consuming. Method bias and differences in populations can greatly influence RIs and prevent them from being transferable between some laboratories. Differences in individual characteristics such as age, ethnicity, and sex can result in large variation in some analytes. Some patients, such as those whose gender differs from that which was presumed for them at birth, may require their own RIs. Alternatively, a decision will need to be made about which to use. Overall, the issue common to these factors lies within interpretation. As such, RIs can be improved with better training in their use, combined with a better understanding of influences that affect them, and more transparent communication from laboratories in how RIs were derived.

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Age- and ethnicity-related reference intervals for serum vitamin B12

Cited by 7 publications

References 23 publications

Vitamin B12, folate, and homocysteine in metabolic syndrome: a systematic review and meta-analysis

Vitamin B12, folate, and homocysteine in metabolic syndrome: a systematic review and meta-analysis

Vitamin B12 reference intervals on Beckman, Roche and Siemens analytical platforms

The Role and Limitations of the Reference Interval Within Clinical Chemistry and Its Reliability for Disease Detection

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