Cobalamin Related Parameters and Disease Patterns in Patients with Increased Serum Cobalamin Levels

被引:76
作者
Arendt, Johan F. B. [1 ]
Nexo, Ebba [1 ]
机构
[1] Aarhus Univ Hosp, Dept Clin Biochem, DK-8000 Aarhus, Denmark
基金
英国医学研究理事会;
关键词
TRANSCOBALAMIN LEVELS; HOLO-TRANSCOBALAMIN; TRANSPORT PROTEINS; VITAMIN-B12; PLASMA; HAPTOCORRIN; FOLATE; QUANTIFICATION; ASSOCIATION; CELLS;
D O I
10.1371/journal.pone.0045979
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Measurement of serum cobalamin levels is routinely used to diagnose cobalamin deficiency. Surprisingly, approximately 15% of patients have high cobalamin levels and no consensus exists regarding the clinical implications. Methods: Hospital-treated patients above 18 years of age referred for serum cobalamin measurement were included in groups of patients [percentage cobalamin supplemented] with low (<200 pmol/L, n = 200 [6%]), normal (200-600, n = 202 [6%]) high (601-1000, n = 217 [27%]) and very high (>1000, n = 199 [53%]) cobalamin levels. Total and cobalamin-saturated (holo) transcobalamin, total haptocorrin, soluble TC receptor, sCD320, and methylmalonic acid were analyzed. Data on diagnoses and medical prescriptions was obtained through medical files and the Aarhus University Prescription Database. Results: Among patients not cobalamin supplemented median total haptocorrin and holo transcobalamin levels were markedly higher in the groups with high/very high cobalamin levels compared to groups with low/normal cobalamin levels. Median total transcobalamin and sCD320 levels were similar across the groups. A number of diagnoses were significantly associated to very high Cbl levels (odds ratio (95% confidence interval)): alcoholism (5.74 (2.76-11.96)), liver disease (8.53 (3.59-20.23)), and cancer (5.48 (2.85-10.55)). Elevated haptocorrin levels were seen in patients with alcoholism, cancer, liver-, renal-, autoimmune-, and bronchopulmonary disease. No clinical associations to sCD320 and total and holo transcobalamin levels were found. Conclusion: In non-supplemented patients, high cobalamin levels were associated to high haptocorrin levels, and several diagnoses, including alcoholism, liver disease and cancer. Our study emphasizes that clinicians should take high serum cobalamin levels into consideration in the diagnostic process.
引用
收藏
页数:8
相关论文
共 36 条
[1]  
AMAGASAKI T, 1990, BLOOD, V76, P1380
[2]   Soluble transcobalamin receptor, sCD320, is present in human serum and relates to serum cobalamin - establishment and validation of an ELISA [J].
Arendt, Johan Frederik Berg ;
Quadros, Edward V. ;
Nexo, Ebba .
CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2012, 50 (03) :515-519
[3]  
ARNALICH F, 1990, BRIT J RHEUMATOL, V29, P171
[4]  
ARNALICH F, 1990, J MED, V21, P277
[5]   Cobalamin (vitamin B12) and holotranscobalamin changes in plasma and liver tissue in alcoholics with liver disease [J].
Baker, H ;
Leevy, CB ;
DeAngelis, B ;
Frank, O ;
Baker, ER .
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION, 1998, 17 (03) :235-238
[6]   Human haptocorrin in hepatocellular carcinoma [J].
Boisson, F ;
Fremont, S ;
Migeon, C ;
Nodari, F ;
Droesch, S ;
Gerard, P ;
Parache, RM ;
Nicolas, JP .
CANCER DETECTION AND PREVENTION, 1999, 23 (02) :89-96
[7]   FOLATE, VITAMIN-B12, AND HIV-INFECTION [J].
BOUDES, P ;
ZITTOUN, J ;
SOBEL, A .
LANCET, 1990, 335 (8702) :1401-1402
[8]  
CARMEL R, 1977, CANCER-AM CANCER SOC, V40, P1348, DOI 10.1002/1097-0142(197709)40:3<1348::AID-CNCR2820400352>3.0.CO
[9]  
2-Q
[10]   High serum cobalamin levels in the clinical setting - clinical associations and holo-transcobalamin changes [J].
Carmel, R ;
Vasireddy, H ;
Aurangzeb, I ;
George, K .
CLINICAL AND LABORATORY HAEMATOLOGY, 2001, 23 (06) :365-371