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Yu J, Xue R, Wang Q, Yu H, Liu X. The Effects of Plasma Homocysteine Level on the Risk of Three Major Psychiatric Disorders: A Mendelian Randomization Study. Front Psychiatry 2022; 13:841429. [PMID: 35386526 PMCID: PMC8977462 DOI: 10.3389/fpsyt.2022.841429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Higher homocysteine (Hcy) level has been suggested to be associated with major psychiatric disorders (MPDs), such as schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). We investigated the causal relationships between plasma Hcy level and MPDs risks using the Mendelian randomization (MR) method. METHODS We selected 18 loci associated with plasma Hcy level from a large-scale genome-wide association study (GWAS) as genetic instruments. Genetic associations with SCZ, MDD, BD and BD subtypes (BD-I and BD-II) were extracted from several GWAS datasets from the Psychiatric Genomics Consortium. We used the Generalized Summary-data-based Mendelian Randomization (GSMR) method to estimate the associations of genetically predicted plasma Hcy levels with MPDs risks. We also performed inverse variance-weighted (IVW) analysis to verify the GSMR results and used MR-Egger regression and leave-one-out analysis to test the assumptions for a valid MR analysis. RESULTS Genetically predicted plasma Hcy levels were associated with risks of SCZ (odds ratio [OR] = 1.12, P GSMR = 1.73 × 10-3) and BD-I (OR = 1.14, P IVW = 5.23 × 10-3) after Bonferroni correction. These associations were statistically significant when using IVW analysis (SCZ: OR = 1.11, P IVW = 2.74 × 10-3; BD-I: OR = 1.13, P IVW = 9.44 × 10-3). Furthermore, no significant horizontal pleiotropy was found by sensitivity analysis, and leave-one-out analyses showed no specific SNP affected the overall estimate. However, genetically determined plasma Hcy levels were not causally associated with MDD, BD, or BD-II risks. CONCLUSION Our results suggest that elevated plasma Hcy levels may increase the risk of SCZ or BD-I. Further randomized clinical trials are warranted to validate the MR findings in our study.
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Affiliation(s)
- Jing Yu
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Ranran Xue
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Qiuling Wang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Hao Yu
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Xia Liu
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
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2
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Supakul S, Chabrun F, Genebrier S, N’Guyen M, Valarche G, Derieppe A, Villoteau A, Lacombe V, Urbanski G. Diagnostic Performances of Urinary Methylmalonic Acid/Creatinine Ratio in Vitamin B12 Deficiency. J Clin Med 2020; 9:jcm9082335. [PMID: 32707915 PMCID: PMC7466029 DOI: 10.3390/jcm9082335] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 11/28/2022] Open
Abstract
Sole measurement of plasma vitamin B12 is no longer enough to identify vitamin B12 (B12) deficiency. When plasma vitamin B12 is in the low-normal range, especially between 201 and 350 ng/L, B12 deficiency should be assessed by measurements of plasma homocysteine and/or plasma methylmalonic acid (MMA). However, these biomarkers also accumulate during renal impairment, leading to a decreased specificity for B12 deficiency. In such cases, urinary methylmalonic acid/creatinine ratio (uMMA/C) could be of interest, due to the stable urinary excretion of MMA. The objectives were to evaluate the influence of renal impairment on uMMA/C compared to plasma homocysteine and plasma methylmalonic acid, and to determine the diagnostic performances of uMMA/C in the diagnosis of B12 deficiency. We prospectively studied 127 patients with a plasma B12 between 201 and 350 ng/L. We noticed that uMMA/C was not dependent on renal function (p = 0.34), contrary to plasma homocysteine and plasma methylmalonic acid. uMMA/C showed a perspective diagnostic performance (AUC 0.71 [95% CI: 0.62–0.80]) and the threshold of 1.45 umol/mmol presented a high degree of specificity (87.9% [95% CI: 72.0–98.9]). In conclusion, uMMA/C is a promising biomarker to assess vitamin B12 status in doubtful cases, notably during renal impairment.
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Affiliation(s)
- Sopak Supakul
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
| | - Floris Chabrun
- Department of Biochemistry, University Hospital, 49000 Angers, France; (F.C.); (S.G.)
| | - Steve Genebrier
- Department of Biochemistry, University Hospital, 49000 Angers, France; (F.C.); (S.G.)
- Department of Immunology, University Hospital, 35000 Rennes, France
| | - Maximilien N’Guyen
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
| | - Guillaume Valarche
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
| | - Arthur Derieppe
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
| | - Adeline Villoteau
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
| | - Valentin Lacombe
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
| | - Geoffrey Urbanski
- Department of Internal Medicine, University Hospital, 49000 Angers, France; (S.S.); (M.N.); (G.V.); (A.D.); (A.V.); (V.L.)
- Correspondence:
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Salagre E, Vizuete A, Leite M, Brownstein D, McGuinness A, Jacka F, Dodd S, Stubbs B, Köhler C, Vieta E, Carvalho A, Berk M, Fernandes B. Homocysteine as a peripheral biomarker in bipolar disorder: A meta-analysis. Eur Psychiatry 2020; 43:81-91. [DOI: 10.1016/j.eurpsy.2017.02.482] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/13/2022] Open
Abstract
AbstractBackground:Bipolar disorder (BD) is a psychiatric disorder with an uncertain aetiology. Recently, special attention has been given to homocysteine (Hcy), as it has been suggested that alterations in 1-carbon metabolism might be implicated in diverse psychiatric disorders. However, there is uncertainty regarding possible alterations in peripheral Hcy levels in BD.Methods:This study comprises a meta-analysis comparing serum and plasma Hcy levels in persons with BD and healthy controls. We conducted a systematic search for all eligible English and non-English peer-reviewed articles.Results:Nine cross-sectional studies were included in the meta-analyses, providing data on 1547 participants. Random-effects meta-analysis showed that serum and plasma levels of Hcy were increased in subjects with BD in either mania or euthymia when compared to healthy controls, with a large effect size in the mania group (g= 0.98, 95% CI: 0.8–1.17,P< 0.001,n= 495) and a small effect in the euthymia group (g= 0.3, 95% CI: 0.11–0.48,P= 0.002,n= 1052).Conclusions:Our meta-analysis provides evidence that Hcy levels are elevated in persons with BD during mania and euthymia. Peripheral Hcy could be considered as a potential biomarker in BD, both of trait (since it is increased in euthymia), and also of state (since its increase is more accentuated in mania). Longitudinal studies are needed to clarify the relationship between bipolar disorder and Hcy, as well as the usefulness of peripheral Hcy as both a trait and state biomarker in BD.
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4
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Liu Y, Tao H, Yang X, Huang K, Zhang X, Li C. Decreased Serum Oxytocin and Increased Homocysteine in First-Episode Schizophrenia Patients. Front Psychiatry 2019; 10:217. [PMID: 31024366 PMCID: PMC6469488 DOI: 10.3389/fpsyt.2019.00217] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 03/25/2019] [Indexed: 01/28/2023] Open
Abstract
Schizophrenia (SZ) is a debilitating and heterogeneous disease. We hypothesized that the oxytocin (OXT) system, inflammation and one-carbon metabolism would have a link with SZ. In this study, serum OXT, OXT receptor (OXTR), interleukin-6 (IL-6), high sensitivity CRP (hsCRP) and homocysteine (Hcy) levels were measured in 52 first-episode schizophrenia (FES) patients and 41 healthy controls (HC) from the Second Xiangya Hospital of Central South University. Meanwhile, the mRNA expressions of OXT and OXTR genes were determined by real-time quantitative PCR. Serum OXT and OXTR levels were significantly lower in FES patients (518.96 ± 22.22 and 174.60 ± 17.11 pg/ml) than the HC group (711.58 ± 40.57 and 252.15 ± 20.62 pg/ml). Serum IL-6 and hsCRP levels showed no difference between the two groups (1.82 ± 0.30 vs. 1.69 ± 0.36 pg/ml, 0.66 (0.22, 1.07) vs. 0.31 (0.13, 0.91) mg/L), but serum Hcy levels were significantly higher in FES patients (20.18 ± 1.83 vs. 15.24 ± 0.82 μmol/ml). The FES patients (0.27 ± 0.02 and 0.20 ± 0.02) have relatively higher mRNA expressions of OXT and OXTR genes than the HC group (0.16 ± 0.01 and 0.14 ± 0.01). In summary, our results suggested the possible function of the OXT system and Hcy in the pathogenesis of SZ.
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Affiliation(s)
- Yong Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya) and China National Technology Institute on Mental Disorders, Changsha, China.,Mental Health Institute of Central South University and Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Huai Tao
- Department of Biochemistry and Molecular Biology, Hunan University of Chinese Medicine, Changsha, China
| | - Xiudeng Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Shaoyang University, Shaoyang, China
| | - Kai Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya) and China National Technology Institute on Mental Disorders, Changsha, China.,Mental Health Institute of Central South University and Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xianghui Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya) and China National Technology Institute on Mental Disorders, Changsha, China.,Mental Health Institute of Central South University and Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Cunyan Li
- Department of Laboratory Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
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5
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Karademir F, Suleymanoglu S, Ersen A, Aydinoz S, Gultepe M, Meral C, Ozkaya H, Gocmen I. Vitamin B12, Folate, Homocysteine and Urinary Methylmalonic Acid Levels in Infants. J Int Med Res 2016; 35:384-8. [PMID: 17593867 DOI: 10.1177/147323000703500313] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Serum vitamin B12 and folate, and their functional markers, plasma homocysteine and urinary methylmalonate (uMMA) were measured in 204 healthy, term infants at birth, and at 2 and 6 months. Compared with infants receiving formula food, those fed mother's milk had lower vitamin B12 and folate at 2 and 6 months. In infants receiving mother's milk, vitamin B12 levels were similar at birth (238 pg/ml) and 2 months (243 pg/ml), whereas with formula milk the level was significantly higher at 2 months (558 pg/ml) than at birth (257 pg/ml). Vitamin B12 was negatively correlated with homocysteine at birth and 6 months. The level of uMMA (mmol/mol creatinine) was higher at 2 (mother's milk, 25.5; formula, 23.97) and 6 months (19.77; 15) than at birth (11.97; 10.88), and was not correlated with vitamin B12 levels. Homocysteine may be a reliable marker of vitamin B12 status in neonates and infants; however, uMMA is not suitable as a marker of vitamin B12 status.
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Affiliation(s)
- F Karademir
- Department of Paediatrics, GATA Haydarpasa Teaching Hospital, Uskudar, Istanbul, Turkey.
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Impact of HIV Infection and Zidovudine Therapy on RBC Parameters and Urine Methylmalonic Acid Levels. Interdiscip Perspect Infect Dis 2016; 2016:5210963. [PMID: 26989408 PMCID: PMC4773552 DOI: 10.1155/2016/5210963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/05/2016] [Accepted: 01/13/2016] [Indexed: 11/25/2022] Open
Abstract
Background. Anaemia is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid (UMMA) levels in patients with HIV infection. Material and Methods. A cross-sectional study involving 114 subjects, 94 of which are HIV-infected nonanaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid (UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics where appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL) and ART-naïve (85.9 fL) subjects and the highest mean RDW. Mean UMMA level, which reflects vitamin B12 level status, was high in all HIV-infected groups but was significantly higher in ART-naïve subjects than in ART-experienced subjects. Conclusion. Although non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may not. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-naïve subjects was common in all HIV-infected subjects.
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7
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Ozcan O, Cosar A. Are vitamin B(12) levels really increased in women delivering preterm? ANNALS OF NUTRITION AND METABOLISM 2013; 62:310. [PMID: 23774762 DOI: 10.1159/000348819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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8
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Hill MH, Flatley JE, Barker ME, Garner CM, Manning NJ, Olpin SE, Moat SJ, Russell J, Powers HJ. A vitamin B-12 supplement of 500 μg/d for eight weeks does not normalize urinary methylmalonic acid or other biomarkers of vitamin B-12 status in elderly people with moderately poor vitamin B-12 status. J Nutr 2013; 143:142-7. [PMID: 23236022 DOI: 10.3945/jn.112.169193] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Plasma vitamin B-12 is the most commonly used biomarker of vitamin B-12 status, but the predictive value for low vitamin B-12 status is poor. The urinary methylmalonic acid (uMMA) concentration has potential as a functional biomarker of vitamin B-12 status, but the response to supplemental vitamin B-12 is uncertain. A study was conducted to investigate the responsiveness of uMMA to supplemental vitamin B-12 in comparison with other biomarkers of vitamin B-12 status [plasma vitamin B-12, serum holotranscobalamin (holoTC), plasma MMA] in elderly people with moderately poor vitamin B-12 status. A double-blind, placebo-controlled, randomized 8-wk intervention study was carried out using vitamin B-12 supplements (500 μg/d, 100 μg/d, and 10 μg/d cyanocobalamin) in 100 elderly people with a combined plasma vitamin B-12 <250 pmol/L and uMMA ratio (μmol MMA/mmol creatinine) >1.5. All biomarkers had a dose response to supplemental vitamin B-12. Improvements in plasma vitamin B-12 and serum holoTC were achieved at cobalamin supplements of 10 μg/d, but even 500 μg/d for 8 wk did not normalize plasma vitamin B-12 in 8% and serum holoTC in 12% of people. The response in uMMA was comparable with plasma MMA; 15-25% of people still showed evidence of metabolic deficiency after 500 μg/d cobalamin for 8 wk. There was a differential response in urinary and plasma MMA according to smoking behavior; the response was enhanced in ex-smokers compared with never-smokers. uMMA offers an alternative marker of metabolic vitamin-B12 status, obviating the need for blood sampling.
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Affiliation(s)
- Marilyn H Hill
- Human Nutrition Unit, Department of Oncology, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK
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9
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Abstract
The cost of psychiatric illness to the UK economy was recently estimated at pound77 billion annually. Despite years of research no firm aetiological explanation exists, and with no physiological or biochemical markers diagnosis is made entirely on a behavioural basis. All current pharmacological therapies are associated with serious long-term side effects. Substantial evidence supports the involvement of one-carbon cycle dysregulation in psychiatric illness, but this is not currently used as a basis for diagnosis or treatment. The present paper reviews the evidence for one-carbon cycle dysregulation in schizophrenic, bipolar, depressed and autistic patients. Also presented are novel findings from the field of epigenetics, which demonstrate how the one-carbon cycle-derived methyl donor S-adenosylmethionine influences the expression of key genes in the brain affecting memory, learning, cognition and behaviour, genes whose expression is reduced to varying degrees in these patient groups. Clinical evidence that nutritional supplements can rectify one-carbon cycle activity, and restore normal gene expression, suggests a novel approach to the development of biochemical tests and simple, non-harmful treatments for some psychiatric patients. Conversely, evidence from animal studies highlights the dangers of exposing the unborn fetus to very high dietary levels of folic acid, a one-carbon cycle cofactor. Fetal adaptations to a high-folate environment may interfere with folate metabolism postnatally, with serious consequences for the epigenetic regulation of gene expression. The public health implications of these diverse scenarios indicate an urgent need for further research in this field.
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Affiliation(s)
- C Sugden
- Centre for Nutrition and Food Safety, School of Biomedical and Molecular Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
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10
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Vieira C, Cosmo C, Lucena R. The importance of methylmalonic acid dosage on the assessment of patients with neurological manifestations following bariatric surgery. Obes Surg 2012; 21:1971-4. [PMID: 21688116 DOI: 10.1007/s11695-011-0449-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Vitamin B12 or cyanocobalamin is an important substance that is included in several metabolic pathways. Its deficiency is a common event after bariatric surgery, decreasing the vitamin B12 absorption after almost all of the stomach and duodenum are eliminated from the digestion process. Neurological manifestations of cyanocobalamin deficiency are not uncommon. We report a case of a young woman who developed ataxia, weakness and peripheral neuropathy after bariatric surgery, but with normal value of vitamin B12 dosage. For the diagnosis, it was necessary to dose methylmalonic acid. We discuss the importance of methylmalonic acid dosage after bariatric surgery in patients who present suspect of cyanocobalamin deficiency with normal values of this vitamin and the role of proton pump inhibitor use and vitamin supplementation in patients with early neurological presentation.
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Affiliation(s)
- Camilo Vieira
- Clinic of Neuromuscular Diseases, DINEP-Neurology and Epidemiology Division, University Complex Professor Edgar Santos, Federal University of Bahia, Salvador, Bahia, Brazil.
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Flatley JE, Garner CM, Al-Turki M, Manning NJ, Olpin SE, Barker ME, Powers HJ. Determinants of urinary methylmalonic acid concentration in an elderly population in the United Kingdom. Am J Clin Nutr 2012; 95:686-93. [PMID: 22301932 DOI: 10.3945/ajcn.111.024133] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An age-related deterioration of vitamin B-12 status has been well documented. The early detection of deficiency may prevent the development of serious clinical symptoms, but plasma vitamin B-12 concentration is known to be an imperfect measure of vitamin B-12 status. Urinary methylmalonic acid (MMA) may be a more informative biomarker of vitamin B-12 status; however, biochemical, dietary, and other lifestyle determinants are not known. OBJECTIVE We identified determinants of urinary MMA concentrations in free-living men and women aged ≥65 y in the United Kingdom. DESIGN A cross-sectional study in 591 men and women aged 65-85 y, with no clinical evidence of vitamin B-12 deficiency, was conducted to determine the demographic, clinical, and lifestyle determinants of urinary MMA concentration expressed as the ratio of micromoles of MMA to millimoles of creatinine (uMMA ratio). RESULTS Twenty percent of subjects had plasma vitamin B-12 concentrations <200 pmol/L. Seventeen percent of the variation in the uMMA ratio could be explained by plasma holotranscobalamin and sex; total vitamin B-12 intake and measures of renal function and gastric function made only a small contribution to the model. The uMMA ratio was lower in people with moderately impaired renal function. CONCLUSIONS Plasma holotranscobalamin and sex were the most important determinants of uMMA ratio in elderly people with no clinical diagnosis of renal impairment. This biomarker might underestimate vitamin B-12 deficiency in a population in which renal impairment is prevalent. This trial was registered at www.controlled-trials.com as ISRCJN83921062.
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Affiliation(s)
- Janet E Flatley
- Human Nutrition Unit, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
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12
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Ipcioglu OM, Ozcan O, Gultepe M, Ates A, Basoglu C, Cakir E. Reduced urinary excretion of homocysteine could be the reason of elevated plasma homocysteine in patients with psychiatric illnesses. Clin Biochem 2008; 41:831-5. [DOI: 10.1016/j.clinbiochem.2008.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 04/01/2008] [Accepted: 04/08/2008] [Indexed: 12/18/2022]
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13
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Kim JM, Stewart R, Kim SW, Yang SJ, Shin IS, Yoon JS. Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression. Br J Psychiatry 2008; 192:268-74. [PMID: 18378986 DOI: 10.1192/bjp.bp.107.039511] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The role of folate, vitamin B(12) and homocysteine levels in depression is not clear. AIMS To investigate cross-sectional and prospective associations between folate, B(12) and homocysteine levels and late-life depression. METHOD A total of 732 Korean people aged 65 years or over were evaluated at baseline. Of the 631 persons who were not depressed, 521 (83%) were followed over a period of 2-3 years and incident depression was ascertained with the Geriatric Mental State schedule. Serum folate, serum vitamin B(12) and plasma homocysteine levels were assayed at both baseline and follow-up. RESULTS Lower levels of folate and vitamin B(12) and higher homocysteine levels at baseline were associated with a higher risk of incident depression at follow-up. Incident depression was associated with a decline in vitamin B(12) and an increase in homocysteine levels over the follow-up period. CONCLUSIONS Lower folate, lower vitamin B(12) and raised homocysteine levels may be risk factors for late-life depression.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry and Depression Clinical Research Centre, Chonnam National University Medical School, Kwangju, Republic of Korea
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14
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Özcan Ö, İpçioğlu OM, Gültepe M, Başoğlu C. Altered red cell membrane compositions related to functional vitamin B12 deficiency manifested by elevated urine methylmalonic acid concentrations in patients with schizophrenia. Ann Clin Biochem 2008; 45:44-9. [DOI: 10.1258/acb.2007.007057] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Abnormal cell membrane composition and functional cobalamin (vitamin B12) deficiency was reported in schizophrenic individuals. We aimed to investigate the relationship between cobalamin state and cell membrane composition in patients with schizophrenia. Methods Malondialdehyde (MDA), cholesterol, and phospholipid classes in the erythrocyte membranes of 18 schizophrenic and 20 healthy individuals of the same age and sex distribution were determined. Serum vitamin B12, plasma total homocysteine, serum folate, and urine methylmalonic acid (uMMA) concentrations were measured in both groups. Results In the schizophrenic group, uMMA, membrane MDA, membrane cholesterol, membrane phosphatidylinositol concentrations were significantly higher and the membrane phosphatidylserine concentrations were lower than the control group values. In schizophrenic individuals, uMMA concentrations have a significant positive correlation with membrane MDA and a negative correlation with membrane cholesterol concentrations ( P < 0.05). The negative correlation of uMMA with membrane cholesterol concentrations may be a biological response to the increased membrane rigidity. Also, a free radical elevation related to the elevated uMMA concentrations in the erythrocyte membrane, might reflect the role of methylmalonic acid (MMA) in membrane damage. Conclusion Our present findings suggest that, functional vitamin B12 deficiency representing itself by MMA elevations in schizophrenic individuals could damage cell membrane.
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Affiliation(s)
| | | | | | - Cengiz Başoğlu
- Department of Psychiatry, GATA Haydarpasa Training Hospital, 81327 Üsküdar, İstanbul, Turkey
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15
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Mössner R, Mikova O, Koutsilieri E, Saoud M, Ehlis AC, Müller N, Fallgatter AJ, Riederer P. Consensus paper of the WFSBP Task Force on Biological Markers: biological markers in depression. World J Biol Psychiatry 2007; 8:141-74. [PMID: 17654407 DOI: 10.1080/15622970701263303] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Biological markers for depression are of great interest to aid in elucidating the causes of major depression. We assess currently available biological markers to query their validity for aiding in the diagnosis of major depression. We specifically focus on neurotrophic factors, serotonergic markers, biochemical markers, immunological markers, neuroimaging, neurophysiological findings, and neuropsychological markers. We delineate the most robust biological markers of major depression. These include decreased platelet imipramine binding, decreased 5-HT1A receptor expression, increase of soluble interleukin-2 receptor and interleukin-6 in serum, decreased brain-derived neurotrophic factor in serum, hypocholesterolemia, low blood folate levels, and impaired suppression of the dexamethasone suppression test. To date, however, none of these markers are sufficiently specific to contribute to the diagnosis of major depression. Thus, with regard to new diagnostic manuals such as DSM-V and ICD-11 which are currently assessing whether biological markers may be included in diagnostic criteria, no biological markers for major depression are currently available for inclusion in the diagnostic criteria.
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Affiliation(s)
- Rainald Mössner
- Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
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