scholarly journals Vitamin B12 in HIV-Infected Patients with Insulin Resistance and Visceral Adiposity in a Randomized Trial of Recombinant Human Growth Hormone and Rosiglitazone (OR12-05-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Heather Guetterman ◽  
Bryan Gannon ◽  
Saurabh Mehta ◽  
Marshall Glesby ◽  
Julia Finkelstein
Keyword(s):  
Insulin Resistance ◽  
Growth Hormone ◽  
Vitamin B12 ◽  
Randomized Trial ◽  
Recombinant Human Growth Hormone ◽  
Vitamin B12 Deficiency ◽  
Visceral Adiposity ◽  
Serum Folate ◽  
Recombinant Growth Hormone ◽  
B12 Deficiency

Abstract Objectives To 1) examine the burden of vitamin B12 deficiency, 2) determine the effects of recombinant growth hormone and rosiglitazone on vitamin B12 status, and 3) investigate vitamin B12 status as a risk factor for changes in insulin sensitivity (SI) and visceral adipose tissue (VAT), among HIV-infected patients with insulin resistance and visceral adiposity participating in a randomized controlled trial. Methods Participants were 72 HIV-infected adults (median [IQR]: 48 [43, 53] y) with insulin resistance and visceral adiposity who participated in a 12-week randomized trial of recombinant growth hormone (GH) and rosiglitazone (R). Venous blood samples were collected at baseline, 4, and 12 weeks, and samples were centrifuged, processed, and stored <−80°C until analysis. Total vitamin B12, methylmalonic acid (MMA), homocysteine, and serum folate were measured in a subset. Vitamin B12 deficiency and insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L, respectively. Elevated MMA was defined as >0.26 µmol/L.Generalized estimating equations were used to evaluate the effects of treatment on vitamin B12 status. Generalized linear models were used to assess the associations of vitamin B12 concentrations with SI and VAT. Results A total of 2.3% of patients were vitamin B12 deficient and 13.6% were vitamin B12insufficient at baseline (median [IQR]: 419.8 [287.0, 538.6] pmol/L); 5.4% had elevated MMA concentrations. The GH + R intervention significantly lowered vitamin B12 concentrations at 4 (β: −66.6, 95% CI: −119.6, −13.6, P = 0.01) and 12 (β: −73.3, 95% CI: −117.8, −28.7, P = 0.001) weeks, compared to placebo. The GH-only intervention significantly lowered vitamin B12concentrations at 12 weeks (β: −89.1, 95% CI: −143.0, −35.3, P = 0.001), compared to placebo. Vitamin B12 concentrations did not significantly change in the R-only group. There were no significant changes in MMA concentrations. Vitamin B12 concentrations at baseline were not significantly associated with changes in SI or VAT (P > 0.05). Conclusions The prevalence of vitamin B12 deficiency was low in HIV-infected individuals with insulin resistance and visceral adiposity. However, interventions containing recombinant growth hormone decreased vitamin B12 status during follow-up. Funding Sources BG was supported by NIH/NCATS Grant # TL1-TR-002386; Division of Nutritional Sciences, Cornell University.

scholarly journals Vitamin B12 deficiency: metabolic effects, clinical evaluation, and treatment

2019 ◽  
Vol 59 (2) ◽  
pp. 40 ◽  
Author(s):  
Synara Cavalcante Lopes ◽  
Daniel Duarte Gadelha ◽  
Manuela Dias de Carvalho ◽  
Virgínia Oliveira Fernandes ◽  
Renan Magalhães Montenegro Junior
Keyword(s):  
Insulin Resistance ◽  
Vitamin B12 ◽  
Neurological Disorders ◽  
Vitamin B12 Deficiency ◽  
The Body ◽  
Water Soluble ◽  
Metabolic Effects ◽  
Pharmacological Treatments ◽  
B12 Deficiency ◽  
Composition Changes

Vitamin B12 is a water-soluble essential micronutrient, required by all the body cells. Its deficiency has been implicated not only in hematological and neurological disorders, but also in many metabolic processes, such as insulin resistance and body composition changes, which have aroused particular interest in recent years. This study reviews the physiology of vitamin B12 from its digestion and absorption to its distribution in tissues, metabolic effects and controversies regarding the diagnosis of deficiency, and to dietary and pharmacological treatments.

scholarly journals Estimating the Serum Folate Concentration Associated With the Red Blood Cell Folate Threshold for Optimal Neural Tube Defects Prevention: A Population Based Biomarker Survey

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 644-644
Author(s):  
Amy Fothergill ◽  
Charles Rose ◽  
Krista Crider ◽  
Beena Bose ◽  
Heather Guetterman ◽  
...  
Keyword(s):  
Blood Cell ◽  
Vitamin B12 ◽  
Neural Tube ◽  
Red Blood Cell ◽  
Vitamin B12 Deficiency ◽  
Population Based ◽  
World Health ◽  
Serum Folate ◽  
Total Vitamin ◽  
B12 Deficiency

Abstract Objectives To estimate the serum folate insufficiency threshold (sf-IT) corresponding to the red blood cell (RBC) folate insufficiency threshold for optimal neural tube defect (NTD) prevention. Methods Participants were 977 women of reproductive age (WRA; 15–40y; not pregnant or lactating) from a population-based biomarker survey in Southern India. Venous blood samples were collected at enrollment. Plasma, serum, and red blood cells were centrifuged, processed, and stored &lt; -80°C until batch analysis. Total vitamin B12 concentrations were measured via chemiluminescence; RBC and serum folate concentrations were measured using the World Health Organization-recommended microbiological assay. Vitamin B12 deficiency was defined as total vitamin B12 &lt; 148 pmol/L. Folate insufficiency was defined as RBC folate &lt; 748 nmol/L, the recommended calibrator-adjusted equivalent of the threshold for population optimal NTD prevention. A previously developed Bayesian model and the RBC and serum folate distributions in this population were used to estimate the sf-IT corresponding to the RBC folate insufficiency threshold for optimal NTD prevention, overall and by age, body mass index (BMI) category, HbA1c, anemia, and vitamin B12 status. Results The overall estimated median sf-IT was 37.8 nmol/L (95% credible interval [33.8–43.3]). This threshold was lower in overweight WRA (BMI: ≥25.0 kg/m2: 32.0 nmol/L [27.3–40.2] vs. BMI &lt; 25.0 kg/m2: 36.2 nmol/L [32.2–43.3]), and varied by age (&lt; 25y: 61.3 nmol/L [44.3–111.8]; 25 to 35y: 35.7 nmol/L [30.8–43.5]; ≥35y: 30.8 nmol/L [26.9–37.2]). The sf-IT was lower in anemic WRA (32.9 nmol/L [28.5–40.1]) compared to non-anemic WRA (42.0 nmol/L [36.1–51.3]), and lower in WRA with elevated HbA1c (≥5.7% to &lt; 6.5: 32.4 nmol/L [27.3–41.6]; ≥6.5%: 20.9 nmol/L [17.8–25.6]) vs. WRA with HbA1c &lt; 5.7% (43.8 nmol/L, [37.5–53.7]). The median sf-IT was higher in WRA with vitamin B12 deficiency (72.1 nmol/L [52.0–126.0]), compared to women who were not vitamin B12 deficient (28.1 nmol/L [25.6–31.5]). Conclusions The estimated sf-IT is dependent on anemia, elevated HbA1c, BMI, age, and vitamin B12 status. Funding Sources Centers for Disease Control and Prevention; AF was supported by the National Institutes of Health #5 T32 HD087137.

scholarly journals Low vitamin B12 diet increases liver homocysteine levels and leads to liver steatosis in rats

2019 ◽  
Vol 38 (3) ◽  
pp. 194
Author(s):  
Imelda Rosalyn Sianipar ◽  
Irena Ujianti ◽  
Sophie Yolanda ◽  
Ahmad Aulia Jusuf ◽  
Neng Tine Kartinah ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin B12 ◽  
Insulin Signaling ◽  
Liver Steatosis ◽  
Vitamin B12 Deficiency ◽  
Dietary Vitamin ◽  
Control Group ◽  
Treatment Groups ◽  
Treatment Standard ◽  
B12 Deficiency

Background <br />Nonalcoholic fatty liver disease (NAFLD) is one of the most widespread chronic liver diseases, caused by the development of insulin resistance. One of the mechanisms involved is a disturbance in insulin signaling by certain toxic substances that interact with one of the proteins responsible for the insulin signaling pathway. Increased homocysteine level, upon disruption of the methionine pathway, is associated with insulin resistance. The aim of this study was to evaluate the effect of hyperhomocysteinemia and insulin resistance (HOMA-IR level) induced by dietary vitamin B12 restriction on liver steatosis. <br /><br />Methods <br />A study of laboratory experimental design was conducted involving 18 male Sprague Dawley rats (age 36-40 weeks, BW 300-350 g), that were randomly divided into 3 groups: control, 8-week treatment, and 16-week treatment. Standard AIN-93 diet was administered to the control group, whereas rats in the treatment groups were fed vitamin B12 deficiency-AIN-93M. At the end of treatment, liver homocysteine levels were determined by ELISA, HOMA-IR values were calculated, and steatosis degree of the liver was determined histologically. Statistical analysis was performed using independent t-test. <br /><br />Results <br />A significant increase in liver homocysteine levels was found between the control and both the 8- and 16-week treatment groups (p&lt;0.001). HOMA-IR levels were significantly higher in both treatment groups compared to controls (p&lt;0.001). The area of liver steatosis in both treatment groups was significantly larger than that of the control group (p&lt;0.001). <br /><br />Conclusion <br />Increased homocysteine levels due to dietary vitamin B12 deficiency induces liver steatosis due to insulin resistance in rats.

scholarly journals Anaemia in the Hospitalized Elderly in Tanzania: Prevalence, Severity, and Micronutrient Deficiency Status

Anemia ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Clara Chamba ◽  
Ahlam Nasser ◽  
William F. Mawalla ◽  
Upendo Masamu ◽  
Neema Budodi Lubuva ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Elderly Population ◽  
Vitamin B12 Deficiency ◽  
The Elderly ◽  
Micronutrient Deficiency ◽  
Sub Saharan Africa ◽  
Serum Folate ◽  
Deficiency Anaemia ◽  
Hospitalized Elderly ◽  
B12 Deficiency

Introduction. Anaemia is a common problem in sub-Saharan Africa. While most literature has focused on children, women of childbearing age, and pregnant women, data for the elderly population are relatively scarce. Anaemia exhorts negative consequences to functional ability of elderly patients, both physically and cognitively. The purpose of this study was to determine the prevalence of anaemia, severity, and micronutrient deficiency status in the elderly hospitalized patients in Tanzania. Methods. A total of 156 hospitalized adults aged 60 years and above were enrolled in this study. A structured questionnaire was used to capture sociodemographic and clinical characteristics. Blood samples were collected, and a complete blood count, serum cobalamin, serum ferritin, and serum folate levels were measured to assess anaemia and micronutrient deficiency status in all participants who had anaemia. Results. The prevalence of anaemia was 79.5% (124/156) with severe anaemia in 33.9% (42/124) of participants, moderate anaemia in 42.7% (53/124) of participants, and 23.4% (29/124) of all participants had mild anaemia. Micronutrient deficiency was found in 14.5% (18/124) of all participants with anaemia. Combined deficiency (either iron and vitamin B12 deficiency or iron and folate deficiency) was the most common micronutrient deficiency anaemia with a frequency of 33.3% (6/18), followed by isolated iron and folate deficiencies at equal frequency of 27.8% (5/18) and vitamin B12 deficiency at 11.1% (2/18). Conclusion. The prevalence of anaemia in the hospitalized elderly population is high warranting public health attention and mostly present in moderate and severe forms. Micro-nutrient deficiency anaemia is common in this age group and is mostly due to combined micronutrient deficiency.

scholarly journals Holotranscobalamin Is a Useful Marker of Vitamin B12 Deficiency in Alcoholics

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Alberto Fragasso ◽  
Clara Mannarella ◽  
Angela Ciancio ◽  
Oronzo Scarciolla ◽  
Nicoletta Nuzzolese ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Serum Levels ◽  
Normal Serum ◽  
Serum Folate ◽  
Gamma Glutamyl Transpeptidase ◽  
B12 Deficiency ◽  
Male Patients ◽  
Positive Correlations ◽  
Glutamyl Transpeptidase

Background. Measurement of serum cobalamin (Cbl) levels is the standard investigation for assessing vitamin B12 deficiency. Falsely increased values of Cbl can be caused by alcoholic liver disease. Measurement of total vitamin B12 serum levels might be misleading in alcoholics, because a tissue metabolic deficiency is possible even with normal serum Cbl levels. Holotranscobalamin (HoloTC), the Cbl metabolically active fraction, is considered as a better index of vitamin B12 deficiency.Methods. For assessing vitamin B12 status, we evaluated 22 adult alcoholic male patients by measuring in parallel serum Cbl, serum folate and red blood cell folate levels, HoloTC levels by the AxSYM assay.Results. HoloTC values were reduced in 3 alcoholics with borderline-low Cbl values. Significant positive correlations were found between serum Cbl and HoloTC levels, serum Cbl and gamma-glutamyl transpeptidase (GGT).Conclusion. HoloTC measurement is a useful option for assessing vitamin B12 status in alcoholics, particularly in the subjects with borderline Cbl values and may be considered an early marker of vitamin B12 deficiency.

Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women

2008 ◽  
Vol 46 (9) ◽  
Author(s):  
Ulrich Hübner ◽  
Ahmad Alwan ◽  
Muhidin Jouma ◽  
Mohammad Tabbaa ◽  
Heike Schorr ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Methylmalonic Acid ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Serum Folate ◽  
Functional Markers ◽  
Unexpected Result ◽  
Recurrent Abortion ◽  
B12 Deficiency ◽  
Low Serum

Abstract: Hyperhomocysteinemia and B-vitamin deficiency are associated with recurrent abortion. Recent studies have not investigated functional markers of vitamin B12 deficiency, such as methylmalonic acid.: A total of 43 consecutive Syrian women with unexplained recurrent abortion and 32 pregnant controls were enrolled in the study. Serum folate, vitamin B12, methylmalonic acid and plasma homocysteine were determined.: Vitamin B12 was significantly decreased in patients with recurrent abortion compared to controls (mean concentrations 197 vs. 300 pg/mL, p=0.004). The lowest mean serum vitamin B12 (172 pg/mL) was observed in primary aborters. Homocysteine was elevated in aborters in comparison to controls (8.3 vs. 7.1 μmol/L, p=0.093). Folate and methylmalonic acid did not differ significantly between the study groups. A highly significant correlation between homocysteine and methylmalonic acid and vitamin B12 was observed only in patients but not in controls (p<0.001 and p=0.002, respectively). In the logistic regression model, only serum vitamin B12 emerged with a significant odds ratio.: The results confirm low serum vitamin B12 in recurrent abortion patients. However, methylmalonic acid did not support that functional vitamin B12 plays a role in this group. This unexpected result might be due to a decrease of the metabolically inert vitamin B12 fraction (holohaptocorrin) or confounding factors. Further studies are necessary to investigate the role of vitamin B12 deficiency in recurrent abortion.Clin Chem Lab Med 2008;46:1265–9.

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