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Li T, Steibel JP, Willette AA. Vitamin B6, B12, and Folate's Influence on Neural Networks in the UK Biobank Cohort. Nutrients 2024; 16:2050. [PMID: 38999798 PMCID: PMC11243472 DOI: 10.3390/nu16132050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND One-carbon metabolism coenzymes may influence brain aging in cognitively unimpaired adults. METHODS Baseline data were used from the UK Biobank cohort. Estimated intake of vitamin B6, B12, and folate was regressed onto neural network functional connectivity in five resting-state neural networks. Linear mixed models tested coenzyme main effects and interactions with Alzheimer's disease (AD) risk factors. RESULTS Increased B6 and B12 estimated intake were linked with less functional connectivity in most networks, including the posterior portion of the Default Mode Network. Conversely, higher folate was related to more connectivity in similar networks. AD family history modulated these associations: Increased estimated intake was positively associated with stronger connectivity in the Primary Visual Network and Posterior Default Mode Network in participants with an AD family history. In contrast, increased vitamin B12 estimated intake was associated with less connectivity in the Primary Visual Network and the Cerebello-Thalamo-Cortical Network in those without an AD family history. CONCLUSIONS The differential patterns of association between B vitamins and resting-state brain activity may be important in understanding AD-related changes in the brain. Notably, AD family history appears to play a key role in modulating these relationships.
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Affiliation(s)
- Tianqi Li
- Genetics and Genomics Program, Iowa State University, Ames, IA 50011, USA
| | - Juan Pedro Steibel
- Department of Animal Science, Iowa State University, Ames, IA 50011, USA
| | - Auriel A Willette
- Department of Neurology, Rutgers University, New Brunswick, NJ 07101, USA
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Hu Y, Yu M, Wang Y, Wu H, Yang X, Chen X, Wu J. Exploring the Association between Serum B Vitamins, Homocysteine and Mental Disorders: Insights from Mendelian Randomization. Nutrients 2024; 16:1986. [PMID: 38999734 PMCID: PMC11243542 DOI: 10.3390/nu16131986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 07/14/2024] Open
Abstract
Previous studies show that B vitamins and homocysteine (Hcy) may be associated with mental disorders, but the accurate causal relationship remains unclear. This study aimed to elucidate the potential causal relationship of serum B vitamins and Hcy levels with five common mental disorders through a two-sample Mendelian randomization (MR) study. In this MR analysis, 50 single-nucleotide polymorphisms (SNPs)-13 related to folate, 17 to vitamin B6, 8 to vitamin B12 and 12 to Hcy-were obtained from a large-scale Genome-Wide Association Studies (GWAS) database and employed as instrumental variables (IVs). The MR analyses were conducted using the inverse variance weighted (IVW), weighted median (WM), MR-Egger methods and sensitivity analyses were further performed to test the robustness. This MR study found a suggestive causal relationships between serum vitamin B12 levels and the risk of anxiety disorders (odds ratio (OR): 1.34, 95% confidence interval (CI): 1.01-1.78, p = 0.046) and bipolar affective disorders (OR: 1.85, 95% CI: 1.16-2.96, p = 0.010). However, folate, vitamin B6 and Hcy levels may not be causally associated with the risk of mental disorders. In conclusion, this study reveals that elevated serum vitamin B12 levels might suggestively increase the risk of anxiety and bipolar affective disorders, even though horizontal pleiotropy cannot be completely eliminated. The potential implications of our results warrant validation in larger GWAS based on diverse populations.
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Affiliation(s)
- Yiming Hu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Miao Yu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, Inner Mongolia Medical University, Hohhot 010107, China
| | - Yaqiang Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, China Medical University, Shenyang 110122, China
| | - Haotian Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, Inner Mongolia Medical University, Hohhot 010107, China
| | - Xueqing Yang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiangxin Chen
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, Baotou Medical College, Baotou 014010, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Obeid R, Andrès E, Češka R, Hooshmand B, Guéant-Rodriguez RM, Prada GI, Sławek J, Traykov L, Ta Van B, Várkonyi T, Reiners K. Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus. J Clin Med 2024; 13:2176. [PMID: 38673453 PMCID: PMC11050313 DOI: 10.3390/jcm13082176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker and methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history, and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing the diagnosis of B12 deficiency. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency, and the treatment goals govern decisions regarding the route and dose of B12 therapy.
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Affiliation(s)
- Rima Obeid
- Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, 66421 Homburg, Germany
| | - Emmanuel Andrès
- Department of Internal Medicine, Diabetes and Metabolic Diseases, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France
| | - Richard Češka
- IIIrd Department of Internal Medicine, Center of Preventive Cardiology, University General Hospital, Charles University in Prague, 110 00 Prague, Czech Republic
| | - Babak Hooshmand
- Aging Research Center, Karolinska Institute, 171 65 Stockholm, Sweden
- Department of Neurology, Benedictus Klinikum Tutzing, 82327 Tutzing, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximillian University Hospital, 80539 Munich, Germany
| | - Rosa-Maria Guéant-Rodriguez
- INSERM, UMR_S1256, NGERE–Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54500 Vandoeuvre-lès-Nancy, France
- Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, 54000 Vandoeuvre-lès-Nancy, France
| | - Gabriel Ioan Prada
- Clinical Department of the National Institute of Gerontology and Geriatrics “Ana Aslan”, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania
| | - Jarosław Sławek
- Department of Neurology & Stroke, St. Adalbert Hospital, 80-462 Gdańsk, Poland
- Department of Neurological-Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Latchezar Traykov
- Department of Neurology, University Hospital “Alexandrovska”, Medical University, 1431 Sofia, Bulgaria
| | - Binh Ta Van
- Vietnam Institute of Diabetes and Metabolic Disorders, Hanoi Medical University, Hanoi 116001, Vietnam
| | - Tamás Várkonyi
- Department of Internal Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Karlheinz Reiners
- Consultant in Neurology and Clinical Neurophysiology, 41844 Wegberg, Germany
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Cobalamin Deficiency and Acute-Onset Auditory and Visual Hallucinations in an Elderly Man. J Acad Consult Liaison Psychiatry 2020; 62:131-139. [PMID: 33004220 DOI: 10.1016/j.psym.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/23/2022]
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Bruins MJ, Bird JK, Aebischer CP, Eggersdorfer M. Considerations for Secondary Prevention of Nutritional Deficiencies in High-Risk Groups in High-Income Countries. Nutrients 2018; 10:E47. [PMID: 29304025 PMCID: PMC5793275 DOI: 10.3390/nu10010047] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/22/2017] [Accepted: 12/28/2017] [Indexed: 12/26/2022] Open
Abstract
Surveys in high-income countries show that inadequacies and deficiencies can be common for some nutrients, particularly in vulnerable subgroups of the population. Inadequate intakes, high requirements for rapid growth and development, or age- or disease-related impairments in nutrient intake, digestion, absorption, or increased nutrient losses can lead to micronutrient deficiencies. The consequent subclinical conditions are difficult to recognize if not screened for and often go unnoticed. Nutrient deficiencies can be persistent despite primary nutrition interventions that are aimed at improving dietary intakes. Secondary prevention that targets groups at high risk of inadequacy or deficiency, such as in the primary care setting, can be a useful complementary approach to address persistent nutritional gaps. However, this strategy is often underestimated and overlooked as potentially cost-effective means to prevent future health care costs and to improve the health and quality of life of individuals. In this paper, the authors discuss key appraisal criteria to consider when evaluating the benefits and disadvantages of a secondary prevention of nutrient deficiencies through screening.
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Affiliation(s)
- Maaike J Bruins
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst CH-4303, Switzerland.
| | - Julia K Bird
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst CH-4303, Switzerland.
| | - Claude P Aebischer
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst CH-4303, Switzerland.
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Presse N, Perreault S, Kergoat MJ. Vitamin B12 Deficiency Induced by the Use of Gastric Acid Inhibitors: Calcium Supplements as a Potential Effect Modifier. J Nutr Health Aging 2016; 20:569-73. [PMID: 27102797 DOI: 10.1007/s12603-015-0605-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Use of gastric acid inhibitors has emerged as a risk factor of vitamin B12 deficiency, especially in older adults. Calcium supplements could be an effect modifier of this relationship by its role in the absorption process of vitamin B12. The aim of this study is to examine whether the use of calcium supplements could be an effect modifier of the association between gastric acid inhibitors and vitamin B12 deficiency. DESIGN Cross-sectional study based on medical chart reviews. SETTING Geriatric Assessment Unit (GAU) of a university-affiliated hospital. PARTICIPANTS The study included 172 patients discharged from the GAU between 2008 and 2012. MEASUREMENTS Cases of vitamin B12 deficiency were identified as those who had received a diagnosis of vitamin B12 deficiency, and/or were receiving a treatment for vitamin B12 deficiency. Use of gastric acid inhibitors and calcium supplements at admission was determined from the pharmacist report. Associations between medications and vitamin B12 status were investigated using logistic regression models. RESULTS Seventy-one patients (41%) had vitamin B12 deficiency. At admission, 42% were taking gastric acid inhibitors and 45% calcium supplements. After adjustment for covariates, analyses revealed that vitamin B12 deficiency was more likely among users of gastric acid inhibitors who did not concomitantly received calcium supplements [OR=3.12; P=0.01]. Conversely, no significant association was observed in patients using both, gastric acid inhibitors and calcium supplements [OR=1.30; P=0.59]. CONCLUSIONS The present study provides the very first evidence that the use of calcium supplements could be an effect modifier of the association between gastric acid inhibitors and vitamin B12 deficiency. Failure to consider calcium supplements as an effect modifier could have led to biased risk estimates in previous published studies.
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Affiliation(s)
- N Presse
- Marie-Jeanne Kergoat, MD, Centre de recherche, Institut universitaire de gériatrie de Montréal, 4565 Queen Mary, Montréal, QC Canada H3W 1W5, Telephone: 514-340-2800 #3246, Fax number: 514-340-2801, E-mail address:
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Risch M, Meier DW, Sakem B, Medina Escobar P, Risch C, Nydegger U, Risch L. Vitamin B12 and folate levels in healthy Swiss senior citizens: a prospective study evaluating reference intervals and decision limits. BMC Geriatr 2015; 15:82. [PMID: 26163013 PMCID: PMC4499201 DOI: 10.1186/s12877-015-0060-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 05/22/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The vitamin B12 and folate status in nonanaemic healthy older persons needs attention the more so as decrease in levels may be anticipated from reduced haematinic provision and/or impaired intestinal uptake. METHODS A total of 1143 subjectively healthy Swiss midlands participants (637 females and 506 males), ≥60 years of age were included in this study. Levels of vitamin B12, holotranscobalamin (holoTC), methylmalonic acid (MMA), homocysteine (Hcy), serum folate, red blood cell (RBC) folate were measured. Further, Fedosov's wellness score was determined. Associations of age, gender, and cystatin C/creatinine-based estimated kidney function, with the investigated parameters were assessed. Reference intervals were calculated. Further, ROC analysis was done to assess accuracy of the individual parameters in recognizing a deficient vitamin B12 status. Finally, decision limits for sensitive, specific and optimal recognition of vitamin B12 status with individual parameters were derived. RESULTS Three age groups: 60-69, 70-79 and ≥ 80 had median B12 (pmol/L) levels of 237, 228 and 231 respectively (p = 0.22), holoTC (pmol/L) of 52, 546 and 52 (p = 0.60) but Hcy (μmol/L) 12, 15 and 16 (p < 0.001), MMA (nmol/L) 207, 221 and 244 (p < 0.001). Hcy and MMA (both p < 0.001), but not holoTC (p = 0.12) and vitamin B12 (p = 0.44) were found to be affected by kidney function. In a linear regression model Fedosov's wellness score was independently associated with kidney function (p < 0.001) but not with age. Total serum folate and red blood cell (RBC) folate drift apart with increasing age: whereas the former decreases (p = 0.01) RBC folate remains in the same bandwidth across all age groups (p = 0.12) A common reference interval combining age and gender strata can be obtained for vitamin B12 and holoTC, whereas a more differentiated approach seems warranted for serum folate and RBC folate. CONCLUSION Whereas the vitamin B12 and holoTC levels remain steady after 60 years of age, we observed a significant increment in MMA levels accompanied by increments in Hcy; this is better explained by age-related reduced kidney function than by vitamin B12 insufficiency. Total serum folate levels but not RBC folate levels decreased with progressing age.
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Affiliation(s)
- Martin Risch
- Kantonsspital Graubünden, Zentrallabor, Loësstrasse 170, Chur, 7000, Switzerland.
| | - Dominik W Meier
- Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, 3097, Switzerland.
| | - Benjamin Sakem
- Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, 3097, Switzerland.
| | - Pedro Medina Escobar
- Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, 3097, Switzerland.
| | - Corina Risch
- Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, 3097, Switzerland.
| | - Urs Nydegger
- Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, 3097, Switzerland.
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, 3097, Switzerland. .,Private University Triesen, Triesen, 9495, Liechtenstein.
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