The application and interpretation of laboratory biomarkers for the evaluation of vitamin B12 status

被引:0
作者
Harrington, Dominic J. [1 ,2 ]
Stevenson, Emma [3 ]
Sobczynska-Malefora, Agata [1 ,4 ]
机构
[1] St Thomas Hosp, Nutristasis Unit, 4th Floor North Wing,Westminster Bridge Rd, London SE1 7EH, England
[2] Univ Surrey, Sch Biosci & Med, Guildford, Surrey, England
[3] Gloucestershire Royal Hosp, Dept Clin Biochem, Pathol, Gloucester, England
[4] Kings Coll London, Fac Life Sci & Med, London, England
关键词
Vitamin B12; active B12; homocysteine; methylmalonic acid; serum B12; NICE; COBALAMIN DEFICIENCY; METHYLMALONIC ACID; BIOCHEMICAL MARKERS; HOLOTRANSCOBALAMIN; SERUM; DIAGNOSIS; RECOMMENDATIONS; REDUCTION; PREGNANCY; UTILITY;
D O I
暂无
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Vitamin B-12 (cobalamin; B-12) is an essential micronutrient, but deficiency is common. The prompt diagnosis and treatment of B-12 deficiency protects against megaloblastic anaemia, neuropathy and neuropsychiatric changes. Biomarkers of B-12 status include the measurement of serum B-12 (also known as total B-12 or serum cobalamin), holotranscobalamin (holoTC or 'active B12'), methylmalonic acid (MMA) and total plasma homocysteine (Hcy). There is no 'gold standard' test for deficiency and the sensitivity and specificity of each biomarker for the evaluation of B-12 status is affected by analytical and biological factors that may confer a high degree of diagnostic uncertainty. Limited access to technical and clinical expertise can lead to an over-reliance on the serum B-12 test, which is readily available and highly automated. In some cases, the sequential use of different B-12 status biomarkers or the calculation of a composite B-12 status score, derived from a panel of B-12 biomarkers and adjusted for folate status and age, can be used to detect deficient states that may otherwise be overlooked when using a single biomarker approach. This review summarizes the utility of B-12-related biomarkers and describes approaches to their application and interpretation.
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收藏
页码:22 / 33
页数:12
相关论文
共 46 条
[1]   Unexpected high plasma cobalamin [J].
Arendt, Johan F. B. ;
Nexo, Ebba .
CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2013, 51 (03) :489-496
[2]   Biomarkers of Nutrition for Development-Folate Review [J].
Bailey, Lynn B. ;
Stover, Patrick J. ;
McNulty, Helene ;
Fenech, Michael F. ;
Gregory, Jesse F., III ;
Mills, James L. ;
Pfeiffer, Christine M. ;
Fazili, Zia ;
Zhang, Mindy ;
Ueland, Per M. ;
Molloy, Anne M. ;
Caudill, Marie A. ;
Shane, Barry ;
Berry, Robert J. ;
Bailey, Regan L. ;
Hausman, Dorothy B. ;
Raghavan, Ramkripa ;
Raiten, Daniel J. .
JOURNAL OF NUTRITION, 2015, 145 (07) :1636-1680
[3]  
Bolann BJ, 2000, CLIN CHEM, V46, P1744
[4]   A genetic epidemiological study in British adults and older adults shows a high heritability of the combined indicator of vitamin B12 status (cB12) and connects B12 status with utilization of mitochondrial substrates and energy metabolism [J].
Dalmia, Anupriya ;
Dib, Marie-Joe ;
Maude, Hannah ;
Harrington, Dominic J. ;
Sobczynska-Malefor, Agata ;
Andrew, Toby ;
Ahmadi, Kourosh R. .
JOURNAL OF NUTRITIONAL BIOCHEMISTRY, 2019, 70 :156-163
[5]   Guidelines for the diagnosis and treatment of cobalamin and folate disorders [J].
Devalia, Vinod ;
Hamilton, Malcolm S. ;
Molloy, Anne M. .
BRITISH JOURNAL OF HAEMATOLOGY, 2014, 166 (04) :496-513
[6]   Combined indicator of vitamin B12 status: modification for missing biomarkers and folate status and recommendations for revised cut-points [J].
Fedosov, Sergey N. ;
Brito, Alex ;
Miller, Joshua W. ;
Green, Ralph ;
Allen, Lindsay H. .
CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2015, 53 (08) :1215-1225
[7]   Biochemical markers of vitamin B12 deficiency combined in one diagnostic parameter: The age-dependence and association with 'cognitive function and blood hemoglobin [J].
Fedosov, Sergey N. .
CLINICA CHIMICA ACTA, 2013, 422 :47-53
[8]   Vitamin B12 deficiency [J].
Green, Ralph ;
Allen, Lindsay H. ;
Bjorke-Monsen, Anne-Lise ;
Brito, Alex ;
Gueant, Jean-Louis ;
Miller, Joshua W. ;
Molloy, Anne M. ;
Nexo, Ebba ;
Stabler, Sally ;
Toh, Ban-Hock ;
Ueland, Per Magne ;
Yajnik, Chittaranjan .
NATURE REVIEWS DISEASE PRIMERS, 2017, 3
[9]   Comparison of biomarker for diagnosis of nitrous oxide abuse: challenge of cobalamin metabolic parameters, a retrospective study [J].
Grzych, Guillaume ;
Deheul, Sylvie ;
Gernez, Emeline ;
Davion, Jean-Baptiste ;
Dobbelaere, Dries ;
Carton, Louise ;
Kim, Isabelle ;
Guichard, Jean Claude ;
Girot, Marie ;
Humbert, Linda ;
Bennis, Anas ;
Joncquel, Marie ;
Chieux, Vincent ;
Joly, Audrey ;
Nasserdine, Phenicia ;
Trillot, Nathalie ;
Douillard, Claire ;
Pigny, Pascal ;
Tard, Celine .
JOURNAL OF NEUROLOGY, 2023, 270 (04) :2237-2245
[10]   Possible cause of false normal B-12 assays [J].
Hamilton, Malcolm S. ;
Blackmore, Sheena ;
Lee, Anne .
BRITISH MEDICAL JOURNAL, 2006, 333 (7569) :654-655