Vitamin B12 absorption judged by measurement of holotranscobalamin, active vitamin B12: evaluation of a commercially available EIA kit

Greibe, Eva; Nexø, Ebba

doi:10.1515/cclm.2011.754

Cited by 8 publications

(6 citation statements)

References 9 publications

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“…The mean holoTC values for the low, intermediate, and high controls were 40, 70, and 114 pmol/L, respectively [ 12 ]. The in-house TC ELISA is routinely employed at our department, and had earlier proven to agree with the Active B12 (holoTC) EIA kit (Axis-Shield Diagnostics, Dundee, Scotland, UK) that is available on the AxSYM platform from Abbott [ 13 ]. The samples were also measured for totalTC using the above-mentioned TC ELISA.…”

Section: Methodsmentioning

confidence: 99%

Increase in circulating holotranscobalamin after oral administration of cyanocobalamin or hydroxocobalamin in healthy adults with low and normal cobalamin status

et al. 2017

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PurposeTo investigate the absorption of synthetic cyanocobalamin and natural occurring hydroxocobalamin in populations with low and normal cobalamin (vitamin B12) status.MethodsWe included adults with low (n = 59) and normal (n = 42) cobalamin status and measured the change in serum holotranscobalamin (ΔholoTC) before and after 2 day administration of different doses of cyanocobalamin and hydroxocobalamin (CobaSorb test). In the low status group, the test was performed using a cross-over design with identical doses of both cobalamin forms (1.5, 3, and 6 µg, respectively). In the normal status group, the test was performed with either 3, 6, and 9 µg cyanocobalamin (n = 28), or with 9 µg cyanocobalamin and 9 µg hydroxocobalamin (n = 14).ResultsIn both groups, median ΔholoTC (pmol/L) was higher after intake of cyanocobalamin compared to (hydroxocobalamin) [low status: 1.5 µg: 19 (6); 3 µg: 23 (7); 6 µg: 30 (14); normal status: 9 µg: 30 (13) pmol/L]. Independent of B12 form, no difference was observed in ΔholoTC between those receiving 1.5 and 3 µg in the low status group or 6 and 9 µg cyanocobalamin in the normal status group. However, in both groups, administration of 6 µg cobalamin resulted in a significant higher ΔholoTC than did 3 µg [low status: p = 0.02 (0.009) for cyanocobalamin (hydroxocobalamin); normal status: p = 0.03 for cyanocobalamin].ConclusionsAdministration of cyanocobalamin resulted in a more than twofold increase in holoTC in comparison with hydroxocobalamin. The absorptive capacity was reached only by doses above 3 µg cobalamin. Our results underscore the importance of using the same form of cobalamin when comparing uptake under different conditions.Clinical trial registry numberNCT02832726 at https://clinicaltrials.gov and 2016/09/012147 at Clinical Trials Registry India.Electronic supplementary materialThe online version of this article (doi:10.1007/s00394-017-1553-5) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Increase in circulating holotranscobalamin after oral administration of cyanocobalamin or hydroxocobalamin in healthy adults with low and normal cobalamin status

et al. 2017

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“…5,90 Although measurement of these metabolites may be used in population screening for B 12 deficiency, the finding of an isolated elevation of plasma MMA should not be taken as proof of clinically attributable B 12 92 One possible test that shows promise, the Cobasorb test, is based on the measurement of the change in holoTC following oral administration of nonradiolabeled cobalamin. 82,93,94 An alternative approach has been described using accelerator mass spectrometry to quantify 14 C in the blood following an orally administered dose of [ 14 C]-cyanocobalamin. 95 In absence of any test for B 12 absorption, definitive diagnosis of pernicious anemia is problematic and depends on the demonstration of circulating antibodies to intrinsic factor and gastric parietal cells.…”

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confidence: 99%

Vitamin B12 deficiency from the perspective of a practicing hematologist

Green

2017

Blood

262

197

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B12 deficiency is the leading cause of megaloblastic anemia, and although more common in the elderly, can occur at any age. Clinical disease caused by B12 deficiency usually connotes severe deficiency, resulting from a failure of the gastric or ileal phase of physiological B12 absorption, best exemplified by the autoimmune disease pernicious anemia. There are many other causes of B12 deficiency, which range from severe to mild. Mild deficiency usually results from failure to render food B12 bioavailable or from dietary inadequacy. Although rarely resulting in megaloblastic anemia, mild deficiency may be associated with neurocognitive and other consequences. B12 deficiency is best diagnosed using a combination of tests because none alone is completely reliable. The features of B12 deficiency are variable and may be atypical. Timely diagnosis is important, and treatment is gratifying. Failure to diagnose B12 deficiency can have dire consequences, usually neurological. This review is written from the perspective of a practicing hematologist.

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“…However, it carries several advantages, one of which is to be more reliable in pregnancy, as total plasma cobalamin levels decrease with increasing gestation, despite a constant level of active holotranscobalamin. This is explained by a demonstrable reduction in haptocorrin levels (Greibe & Nexo, ), and a 30% drop in total cobalamin is expected by the third trimester (Devalia et al, ), such that levels of 110–148 pmol L −1 (150–200 ng L −1 ) constitute a low probability of B12 deficiency in pregnant women.…”

Section: Case 3 – Low B12 Levelsmentioning

confidence: 99%

The management of anaemia and haematinic deficiencies in pregnancy and post‐partum

Roy

Pavord

2018

Transfusion Medicine

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Anaemia is one of the most common disorders in the world (24·8% of the world population) (de Benoist 2008) and affects patients of all ages and ethnic origins. Underlying causes and prevalences vary by age group and socioeconomic background, but pregnant women everywhere are at high risk of anaemia, the vast majority of cases being due to iron deficiency. One in four pregnant women in Europe are thought to have iron deficiency anaemia (Daru et al., March 2016), whereas in parts of Africa, where hookworm infestation is common, this has been estimated to be as high as 38% (Stevens et al., 2013) to 50% (Bah et al., June 2017). Women of menstruating age are rarely iron replete (Low et al., 18 April 2016) and then enter pregnancy, which carries a major negative iron balance (Bentley, October 1985). Despite a good understanding of the causes of anaemia in pregnancy, there is still uncertainty about how best this should be investigated, prevented and managed. This reflects the limitations of laboratory tests, as well as the poor understanding of how best to replace iron, given the complex physiological mechanisms of iron absorption and distribution. A strategy for iron replacement in a population of anaemic pregnant women needs to be developed not only based on what is biologically and clinically most appropriate but also in the context of each organisation's delivery of care structure, taking into consideration aspects of cost effectiveness. For this reason, management algorithms must be adapted locally, ensuring they meet basic clinical imperatives.

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Vitamin B12 absorption judged by measurement of holotranscobalamin, active vitamin B12: evaluation of a commercially available EIA kit

Cited by 8 publications

References 9 publications

Increase in circulating holotranscobalamin after oral administration of cyanocobalamin or hydroxocobalamin in healthy adults with low and normal cobalamin status

Increase in circulating holotranscobalamin after oral administration of cyanocobalamin or hydroxocobalamin in healthy adults with low and normal cobalamin status

Vitamin B12 deficiency from the perspective of a practicing hematologist

The management of anaemia and haematinic deficiencies in pregnancy and post‐partum

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