Vitamin B12 deficiency: correction of P-methylmalonic acid for estimated glomerular filtration rate to improve diagnostic value – a confirmatory study

Nielsen, Sebastian; Parkner, Tina; Arendt, Johan Frederik Håkonsen

doi:10.1080/00365513.2022.2092898

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…B12 indicates total plasma B12; MMA, methylmalonic acid; eGFR, estimated glomerular filtration rate. The decision limits are based on studies by Abildgaard et al, 22 Hvas et al, 23 and Nielsen et al 24 For further details see: https://www.analysefortegnelsen.dk/AnalyselisteZoom.asp?Lok¼ AUH&Id¼AAA00281 (In Danish).…”

Section: Is the Patient B12 Deficient?mentioning

confidence: 99%

Vitamin B12-Related Biomarkers

Nexo,

Parkner

2024

Food Nutr Bull

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Background: Adult vitamin B12 (B12) deficiency may present itself with nonspecific mainly neurological symptoms, and thus plasma biomarkers are often judged to be of major importance in the further diagnostic process. Four biomarkers are of special relevance: total B12, holotranscobalamin (the part of B12 bound to the active transport protein, transcobalamin, also named holoTC or active B12) and the 2 so-called metabolic markers that accumulate if B12 is lacking, methylmalonic acid (MMA) and homocysteine. Objective: This article briefly reviews the inherent limitation of biomarkers, discusses its use in establishing the diagnosis and cause of B12 deficiency, and when following or discontinuing treatment with B12. Methods: The review is based on published papers, but also on knowledge gained from working within the area. Conclusion: It is concluded that a combination of a B12 and a metabolic marker, for example, total B12 and MMA, may prove most useful in daily practice. An unexpectedly high level of total B12 is most often of no clinical importance, though sometimes related to the presence of underlying cancer. Measurement of total B12 is of limited value in patients on treatment with pharmacological doses of B12 but may be helpful if B12 treatment is discontinued.

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Section: Is the Patient B12 Deficient?mentioning

confidence: 99%