scholarly journals Population reference values for methylmalonic acid (MMA) and its relation with age, race, supplements use, serum creatinine and serum vitamin B‐12 in the post‐folic acid fortification era

2009 ◽  
Vol 23 (S1) ◽  
Author(s):  
Vijay Ganji ◽  
Mohammad R Kafai
Keyword(s):  
Folic Acid ◽  
Serum Creatinine ◽  
Reference Values ◽  
Methylmalonic Acid ◽  
Serum Vitamin ◽  
Vitamin B ◽  
Folic Acid Fortification ◽  
Vitamin B 12

scholarly journals The Prevalence of Low Serum Vitamin B-12 Status in the Absence of Anemia or Macrocytosis Did Not Increase among Older U.S. Adults after Mandatory Folic Acid Fortification

2013 ◽  
Vol 144 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Yan Ping Qi ◽  
Ann N. Do ◽  
Heather C. Hamner ◽  
Christine M. Pfeiffer ◽  
Robert J. Berry
Keyword(s):  
Folic Acid ◽  
Serum Vitamin ◽  
Vitamin B ◽  
Folic Acid Fortification ◽  
Vitamin B 12 ◽  
Low Serum

scholarly journals Low vitamin B-12 concentrations in patients without anemia: the effect of folic acid fortification of grain

2003 ◽  
Vol 77 (6) ◽  
pp. 1474-1477 ◽  
Author(s):  
James L Mills ◽  
Isabelle Von Kohorn ◽  
Mary R Conley ◽  
Jack A Zeller ◽  
Christopher Cox ◽  
...  
Keyword(s):  
Folic Acid ◽  
Vitamin B ◽  
Folic Acid Fortification ◽  
Vitamin B 12

scholarly journals Monitoring of vitamin B-12 nutritional status in the United States by using plasma methylmalonic acid and serum vitamin B-12

2011 ◽  
Vol 94 (2) ◽  
pp. 552-561 ◽  
Author(s):  
Regan L Bailey ◽  
Ralph Carmel ◽  
Ralph Green ◽  
Christine M Pfeiffer ◽  
Mary E Cogswell ◽  
...  
Keyword(s):  
United States ◽  
Nutritional Status ◽  
Methylmalonic Acid ◽  
Serum Vitamin ◽  
The United States ◽  
Vitamin B ◽  
Vitamin B 12

scholarly journals Associations of Circulating Methylmalonic Acid and Vitamin B-12 Biomarkers Are Modified by Vegan Dietary Pattern in Adult and Elderly Participants of the Adventist Health Study 2 Calibration Study

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ella H Haddad ◽  
Karen Jaceldo-Siegl ◽  
Keiji Oda ◽  
Gary E Fraser
Keyword(s):  
Dietary Pattern ◽  
Methylmalonic Acid ◽  
Serum Vitamin ◽  
Health Study ◽  
Vitamin B ◽  
Limited Information ◽  
Cross Sectional ◽  
Fortified Food ◽  
Vitamin B 12 ◽  
Adventist Health Study

ABSTRACT Background Elevated plasma methylmalonic acid (MMA) is a functional biomarker of vitamin B-12 status but limited information is available on its prevalence in US vegetarians. Objectives The study examines the prevalence of plasma MMA ≥0.27 µmol/L in those consuming vegetarian diets, its associations with vitamin B-12 intake and biomarkers, and the modifying effect of vegetarian patterns on these associations. Methods In this cross-sectional study (n = 785), concentrations of MMA, vitamin B-12, holotranscobalamin (holoTC), and homocysteine (Hcy) were determined in participants of the calibration substudy of the Adventist Health Study 2 (AHS-2). Vitamin B-12 intake from food, fortified food, and supplements was assessed by six 24-h recalls. Regression models were used to estimate ORs of having high MMA as related to vitamin B-12 status biomarkers, vitamin B-12 intake, and dietary pattern. Results The prevalence of low vitamin B-12 status defined by serum vitamin B-12 <148 pmol/L, holoTC <35 pmol/L, MMA ≥0.27 and ≥0.37 μmol/L, or Hcy ≥15 μmol/L, and the OR of having high MMA did not differ by dietary pattern, possibly due to intake from fortified food and supplements. Total daily vitamin B-12 intake in the second tertile range of 4.4–14.5 μg/d reduced the likelihood of elevated MMA by 69%; and a doubling of vitamin B-12 intake was associated with a 4.3% decrease in plasma MMA. The association between log plasma MMA and biomarkers was modified by diet, with the vegan pattern showing an ∼3-fold stronger association with log serum vitamin B-12 and Hcy than did the nonvegetarian pattern. Conclusions The prevalence of vitamin B-12 intake <2.0 μg/d was 15.2% in vegans, 10.6% in lacto-ovo-vegetarians, and 6.5% in nonvegetarians. Given the irreversible neurological consequences of vitamin B-12 inadequacy, the importance of regular supplemental vitamin B-12 intake in adult and elderly individuals is stressed.

scholarly journals Age-specific Serum Methylmalonic Acid Reference Ranges for More Accurate Interpretation of Vitamin B-12 Status in U.S. Adults (P24-030-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ekaterina Mineva ◽  
Maya Sternberg ◽  
Renee Storandt ◽  
Regan Bailey ◽  
Christine Pfeiffer
Keyword(s):  
Renal Function ◽  
Normal Renal Function ◽  
Impaired Renal Function ◽  
Methylmalonic Acid ◽  
Age Groups ◽  
Serum Vitamin ◽  
Reference Intervals ◽  
Vitamin B ◽  
Younger Age ◽  
Vitamin B 12

Abstract Objectives To evaluate vitamin B-12 status of U.S. adults. High serum methylmalonic acid (MMA) is a specific functional indicator of low vitamin B-12 status, but it is not sensitive because concentrations also increase with impaired renal function. Our goal was to describe the distribution of serum vitamin B-12 and MMA in U.S. adults, and estimate age-specific reference intervals for serum MMA in a subpopulation with replete vitamin B-12 status and normal renal function. Methods We examined cross-sectional data for serum vitamin B-12 and MMA in U.S. adults participating in the National Health and Nutrition Examination Survey from 2011–2014. Vitamin B-12 was assessed by electrochemiluminescence assay and MMA by isotope-dilution LC-MS/MS. Results In both bivariate and multivariate analysis age, race/Hispanic origin, and vitamin B-12 supplementation were generally significantly associated with serum vitamin B-12 and MMA concentrations before and after controlling for additional covariates. We observed higher serum vitamin B-12 and MMA concentrations in persons ≥60 y compared with younger age groups. Non-Hispanic white persons had lower vitamin B-12 and higher MMA concentrations compared with non-Hispanic black persons. Shorter fasting times and impaired renal function were significantly associated with higher serum MMA concentrations, but not with serum vitamin B-12 concentrations after controlling for covariates. The central 95% reference intervals for serum vitamin B-12 and MMA concentrations were wider for persons ≥60 y compared with younger age groups. Compared with the overall population, the central 95% reference interval for serum MMA concentrations was considerably narrower for a vitamin B-12 replete subpopulation with normal renal function, but still age-dependent. Serum vitamin B-12 showed little, while serum MMA showed notable increases with impaired renal function. Conclusions The higher serum MMA concentrations throughout the entire distribution in older persons who are vitamin B-12 replete and have normal renal function indicate the need for age-specific MMA reference intervals to better interpret the vitamin B-12 status in clinical and epidemiologic research. Funding Sources This work was supported by direct appropriations from U.S. Congress.

scholarly journals Age-specific reference ranges are needed to interpret serum methylmalonic acid concentrations in the US population

2019 ◽  
Vol 110 (1) ◽  
pp. 158-168 ◽  
Author(s):  
Ekaterina M Mineva ◽  
Maya R Sternberg ◽  
Mindy Zhang ◽  
Yutaka Aoki ◽  
Renee Storandt ◽  
...  
Keyword(s):  
Renal Function ◽  
Normal Renal Function ◽  
Impaired Renal Function ◽  
Methylmalonic Acid ◽  
Serum Vitamin ◽  
Reference Intervals ◽  
Specific Reference ◽  
Vitamin B ◽  
Reference Ranges ◽  
Vitamin B 12

ABSTRACTBackgroundSerum vitamin B-12 is measured to evaluate vitamin B-12 status. Serum methylmalonic acid (MMA) is a specific functional indicator of vitamin B-12 status; however, concentrations increase with impaired renal function.ObjectiveThe aim of this study was to describe the distribution of serum vitamin B-12 and MMA in US adults, and estimate age-specific reference intervals for serum MMA in a healthy subpopulation with replete vitamin B-12 status and normal renal function.MethodsWe examined cross-sectional data for serum vitamin B-12 and MMA in adults participating in the NHANES from 2011 to 2014. Vitamin B-12 was measured by electrochemiluminescence assay and MMA by isotope-dilution liquid chromatography–tandem mass spectrometry.ResultsIn both bivariate and multivariate analyses, age, race/Hispanic origin, and vitamin B-12 supplement use were generally significantly associated with serum vitamin B-12 and MMA concentrations. Serum MMA concentrations increased with age, particularly in persons aged ≥70 y. Non-Hispanic white persons had lower vitamin B-12 and higher MMA concentrations than non-Hispanic black persons. Shorter fasting times and impaired renal function were significantly associated with higher serum MMA concentrations, but not with serum vitamin B-12 concentrations after controlling for covariates. The central 95% reference intervals for serum vitamin B-12 and MMA concentrations were widest for persons aged ≥70 y compared with younger age groups. Compared with the overall population, the central 95% reference intervals for serum MMA concentrations were considerably narrower for a vitamin B-12–replete subpopulation with normal renal function, but still age-dependent. Serum vitamin B-12 showed little, whereas serum MMA showed notable, increases with impaired renal function.ConclusionsThe higher serum MMA concentrations throughout the entire distribution in older persons (especially persons aged ≥70 y) who are vitamin B-12–replete and have normal renal function indicate the need for age-specific MMA reference intervals to better interpret vitamin B-12 status in epidemiologic research.

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