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Fernandes S, Oliveira L, Pereira A, Costa MDC, Raposo A, Saraiva A, Magalhães B. Exploring Vitamin B12 Supplementation in the Vegan Population: A Scoping Review of the Evidence. Nutrients 2024; 16:1442. [PMID: 38794680 PMCID: PMC11124153 DOI: 10.3390/nu16101442] [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: 04/01/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
With a significant portion of the population adopting veganism and conflicting views among nutrition professionals regarding the necessity of vitamin B12 supplementation, this review aims to explore existing studies evaluating interventions through food supplementation. It focuses on the impact of vitamin B12 deficiency across different demographics. The present study seeks to understand how research has addressed the relationship between the rise in veganism and vitamin B12 deficiency over the past decade. A scoping review was conducted following the PRISMA flow diagram. Studies from 2010 to 2023 were identified using Boolean operators and key terms in electronic databases such as PubMed/MEDLINE, Web of Science, and EBSCO (Library, Information Science & Technology Abstracts, and Academic Search Complete). Out of 217 articles identified, 70 studies were included. The topical analysis categorized the studies into three groups: those associating vitamin B12 deficiency with diseases (n = 14), those analyzing the dietary habits of vegetarian individuals (vegan or not) without a specific focus on vitamin B12 (n = 49), and those addressing food guides and nutrition institution positions (n = 7). The authors concluded that vitamin B12 deficiency is prevalent among vegans due to limited consumption of animal products. For vegetarians, supplementation is an efficient means of treating and preventing deficiency; a daily dose of 50 to 100 micrograms is advised. There are still significant gaps in the research, nevertheless, such as the absence of randomized controlled trials evaluating various forms or dosages of vitamin B12 among vegetarians and the requirement for more information and awareness of the vitamin's significance in vegan diets.
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Affiliation(s)
- Sávio Fernandes
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal; (S.F.); (L.O.)
| | - Leandro Oliveira
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal; (S.F.); (L.O.)
- Coimbra Health School, Polytechnic Institute of Coimbra, Rua 5 de Outubro—S. Martinho do Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Alda Pereira
- Institute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, 1649-028 Lisboa, Portugal;
- University Clinic of General and Family Medicine, Ecogenetics and Human Health Unity, Institute for Environmental Health, Instituto de Saúde Ambiental (ISAMB), 1649-028 Lisboa, Portugal
| | - Maria do Céu Costa
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal; (S.F.); (L.O.)
- Núcleo de Investigação em Ciências e Tecnologias da Saúde (NICiTeS), Polytechnic Institute of Lusophony, ERISA—Escola Superior de Saúde Ribeiro Sanches, 1900-693 Lisboa, Portugal
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal; (S.F.); (L.O.)
| | - Ariana Saraiva
- Department of Animal Pathology and Production, Bromatology and Food Technology, Faculty of Veterinary, Universidad de Las Palmas de Gran Canaria, Trasmontaña s/n, 35413 Arucas, Spain;
| | - Bruno Magalhães
- School of Health, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal;
- RISE—Health Research Network, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal
- Clinical Academic Centre of Trás-os-Montes and Alto Douro (CACTMAD), 5000-801 Vila Real, Portugal
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Zhou L, Bai X, Wu B, Tan Y, Li M, Yang Q. Characterizing Vitamin B12 Deficiency in Neurology Outpatients: A Retrospective Observational Study. Clin Neuropharmacol 2024; 47:87-96. [PMID: 38743602 DOI: 10.1097/wnf.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVES Clinical manifestations of vitamin B12 deficiency are varied and may result in missed or delayed diagnosis. This investigation explores the diverse clinical manifestations and demographic characteristics of vitamin B12 deficiency in neurology outpatients, aiming to enhance timely diagnosis and outcomes. METHODS The severity of vitamin B12 deficiency was classified as absolute (≤150 pg/mL) or borderline deficiency (150-300 pg/mL). We conducted a retrospective analysis of 165 outpatients with vitamin B12 deficiency at the department of neurology between May 2020 and May 2021. RESULT Absolute vitamin B12 deficiency was found in 23.0% of the patients. The most common age range was 50-60 years, the most common cause was vegetarianism, and the most common symptom was headache. Epileptiform symptoms were more likely to occur in younger patients (<20 years old) with vitamin B12 deficiency, whereas psychiatric symptoms were more likely to occur in older patients (>70 years old). Vegetarians, salivation, and nonmegaloblastic anemia were more obvious in patients with absolute vitamin B12 deficiency, whereas headaches often showed borderline B12 deficiency. CONCLUSIONS The clinical characteristics of vitamin B12 deficiency are complex and nonspecific. The diagnosis should be based on multiple factors.
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Affiliation(s)
- Li Zhou
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | | | - Bowen Wu
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongjun Tan
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mengxia Li
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qin Yang
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Şen S. Vitamin B12 deficiency in pregnant women. Lancet 2024; 403:1449-1450. [PMID: 38614485 DOI: 10.1016/s0140-6736(24)00186-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 01/29/2024] [Indexed: 04/15/2024]
Affiliation(s)
- Selçuk Şen
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Türkiye.
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Alvernaz SA, Wenzel ES, Nagelli U, Pezley LB, LaBomascus B, Gilbert JA, Maki PM, Tussing-Humphreys L, Peñalver Bernabé B. Inflammatory Dietary Potential Is Associated with Vitamin Depletion and Gut Microbial Dysbiosis in Early Pregnancy. Nutrients 2024; 16:935. [PMID: 38612969 PMCID: PMC11013194 DOI: 10.3390/nu16070935] [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: 02/20/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
Pregnancy alters many physiological systems, including the maternal gut microbiota. Diet is a key regulator of this system and can alter the host immune system to promote inflammation. Multiple perinatal disorders have been associated with inflammation, maternal metabolic alterations, and gut microbial dysbiosis, including gestational diabetes mellitus, pre-eclampsia, preterm birth, and mood disorders. However, the effects of high-inflammatory diets on the gut microbiota during pregnancy have yet to be fully explored. We aimed to address this gap using a system-based approach to characterize associations among dietary inflammatory potential, a measure of diet quality, and the gut microbiome during pregnancy. Forty-seven pregnant persons were recruited prior to 16 weeks of gestation. Participants completed a food frequency questionnaire (FFQ) and provided fecal samples. Dietary inflammatory potential was assessed using the Dietary Inflammatory Index (DII) from the FFQ data. Fecal samples were analyzed using 16S rRNA amplicon sequencing. Differential taxon abundances with respect to the DII score were identified, and the microbial metabolic potential was predicted using PICRUSt2. Inflammatory diets were associated with decreased vitamin and mineral intake and a dysbiotic gut microbiota structure and predicted metabolism. Gut microbial compositional differences revealed a decrease in short-chain fatty acid producers such as Faecalibacterium, and an increase in predicted vitamin B12 synthesis, methylglyoxal detoxification, galactose metabolism, and multidrug efflux systems in pregnant individuals with increased DII scores. Dietary inflammatory potential was associated with a reduction in the consumption of vitamins and minerals and predicted gut microbiota metabolic dysregulation.
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Affiliation(s)
- Suzanne A. Alvernaz
- Department of Biomedical Engineering, University of Illinois, Chicago, IL 60607, USA; (S.A.A.); (U.N.)
| | - Elizabeth S. Wenzel
- Department of Psychology, University of Illinois, Chicago, IL 60607, USA; (E.S.W.); (P.M.M.)
| | - Unnathi Nagelli
- Department of Biomedical Engineering, University of Illinois, Chicago, IL 60607, USA; (S.A.A.); (U.N.)
| | - Lacey B. Pezley
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL 60612, USA; (L.B.P.); (B.L.); (L.T.-H.)
| | - Bazil LaBomascus
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL 60612, USA; (L.B.P.); (B.L.); (L.T.-H.)
| | - Jack A. Gilbert
- Department of Pediatrics, University of California, San Diego, CA 92093, USA;
- Scripps Oceanographic Institute, University of California, San Diego, CA 92037, USA
| | - Pauline M. Maki
- Department of Psychology, University of Illinois, Chicago, IL 60607, USA; (E.S.W.); (P.M.M.)
- Department of Psychiatry, University of Illinois, Chicago, IL 60612, USA
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, IL 60612, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL 60612, USA; (L.B.P.); (B.L.); (L.T.-H.)
| | - Beatriz Peñalver Bernabé
- Department of Biomedical Engineering, University of Illinois, Chicago, IL 60607, USA; (S.A.A.); (U.N.)
- Center for Bioinformatics and Quantitative Biology, University of Illinois, Chicago, IL 60612, USA
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Alvernaz SA, Wenzel ES, Nagelli U, Pezley LB, LaBomascus B, Gilbert JA, Maki PM, Tussing-Humphreys L, Peñalver Bernabé B. Inflammatory dietary potential is associated with vitamin depletion and gut microbial dysbiosis in early pregnancy. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.12.02.23299325. [PMID: 38076865 PMCID: PMC10705629 DOI: 10.1101/2023.12.02.23299325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Background Pregnancy alters many physiological systems, including the maternal gut microbiota. Diet is a key regulator of this system and can alter the host immune system to promote inflammation. Multiple perinatal disorders have been associated with inflammation, maternal metabolic alterations, and gut microbial dysbiosis, including gestational diabetes mellitus, preeclampsia, preterm birth, and mood disorders. However, the effects of high inflammatory diets on the gut microbiota during pregnancy have yet to be fully explored. Objective To use a systems-based approach to characterize associations among dietary inflammatory potential, a measure of diet quality, and the gut microbiome during pregnancy. Methods Forty-nine pregnant persons were recruited prior to 16 weeks of gestation. Participants completed a food frequency questionnaire (FFQ) and provided fecal samples. Dietary inflammatory potential was assessed using the Dietary Inflammatory Index (DII) from FFQ data. Fecal samples were analyzed using 16S rRNA amplicon sequencing. Differential taxon abundance with respect to DII score were identified, and microbial metabolic potential was predicted using PICRUSt2. Results Inflammatory diets were associated with decreased vitamin and mineral intake and dysbiotic gut microbiota structure and predicted metabolism. Gut microbial compositional differences revealed a decrease in short chain fatty acid producers such as Faecalibacterium, and an increase in predicted vitamin B12 synthesis, methylglyoxal detoxification, galactose metabolism and multi drug efflux systems in pregnant individuals with increased DII scores. Conclusions Dietary inflammatory potential was associated with a reduction in the consumption of vitamins & minerals and predicted gut microbiota metabolic dysregulation.
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Affiliation(s)
- Suzanne A. Alvernaz
- Department of Biomedical Engineering, University of Illinois, Chicago, IL, USA
| | | | - Unnathi Nagelli
- Department of Biomedical Engineering, University of Illinois, Chicago, IL, USA
| | - Lacey B. Pezley
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
| | - Bazil LaBomascus
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
| | - Jack A. Gilbert
- Department of Pediatrics, University of California, San Diego, CA, USA
- Scripps Oceanographic Institute, University of California, San Diego, CA, USA
| | - Pauline M. Maki
- Department of Psychology, University of Illinois, Chicago, IL, USA
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, IL, USA
| | | | - Beatriz Peñalver Bernabé
- Department of Biomedical Engineering, University of Illinois, Chicago, IL, USA
- Center for Bioinformatics and Quantitative Biology, University of Illinois, Chicago, IL, USA
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Mathew AR, Di Matteo G, La Rosa P, Barbati SA, Mannina L, Moreno S, Tata AM, Cavallucci V, Fidaleo M. Vitamin B12 Deficiency and the Nervous System: Beyond Metabolic Decompensation-Comparing Biological Models and Gaining New Insights into Molecular and Cellular Mechanisms. Int J Mol Sci 2024; 25:590. [PMID: 38203763 PMCID: PMC10778862 DOI: 10.3390/ijms25010590] [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: 11/27/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Vitamin B12 (VitB12) is a micronutrient and acts as a cofactor for fundamental biochemical reactions: the synthesis of succinyl-CoA from methylmalonyl-CoA and biotin, and the synthesis of methionine from folic acid and homocysteine. VitB12 deficiency can determine a wide range of diseases, including nervous system impairments. Although clinical evidence shows a direct role of VitB12 in neuronal homeostasis, the molecular mechanisms are yet to be characterized in depth. Earlier investigations focused on exploring the biochemical shifts resulting from a deficiency in the function of VitB12 as a coenzyme, while more recent studies propose a broader mechanism, encompassing changes at the molecular/cellular levels. Here, we explore existing study models employed to investigate the role of VitB12 in the nervous system, including the challenges inherent in replicating deficiency/supplementation in experimental settings. Moreover, we discuss the potential biochemical alterations and ensuing mechanisms that might be modified at the molecular/cellular level (such as epigenetic modifications or changes in lysosomal activity). We also address the role of VitB12 deficiency in initiating processes that contribute to nervous system deterioration, including ROS accumulation, inflammation, and demyelination. Consequently, a complex biological landscape emerges, requiring further investigative efforts to grasp the intricacies involved and identify potential therapeutic targets.
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Affiliation(s)
- Aimee Rachel Mathew
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (A.M.T.)
| | - Giacomo Di Matteo
- Department of Chemistry and Technology of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (L.M.)
| | - Piergiorgio La Rosa
- Division of Neuroscience, Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- European Center for Brain Research, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Saviana Antonella Barbati
- Departmental Faculty of Medicine and Surgery, UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy;
| | - Luisa Mannina
- Department of Chemistry and Technology of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (L.M.)
| | - Sandra Moreno
- Department of Science, University Roma Tre, 00146 Rome, Italy;
- Laboratory of Neurodevelopment, Neurogenetics and Neuromolecular Biology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Ada Maria Tata
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (A.M.T.)
- Research Centre of Neurobiology “Daniel Bovet”, Sapienza University of Rome, 00185 Rome, Italy
| | - Virve Cavallucci
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Marco Fidaleo
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (A.M.T.)
- Research Center for Nanotechnology Applied to Engineering (CNIS), Sapienza University of Rome, 00185 Rome, Italy
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Cruz‐Rodríguez J, Canals‐Sans J, Hernández‐Martínez C, Voltas‐Moreso N, Arija V. Prenatal vitamin B12 status and cognitive functioning in children at 4 years of age: The ECLIPSES Study. MATERNAL & CHILD NUTRITION 2024; 20:e13580. [PMID: 37938197 PMCID: PMC10750008 DOI: 10.1111/mcn.13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
Maternal vitamin B12 deficiency has been associated with disturbed cognitive functioning in offspring at different ages during childhood. However, this association has not been explored in pre-school-age children. The objective of this study was to examine the association between maternal vitamin B12 levels at the beginning and end of pregnancy and cognitive functioning in their children at 4 years of age. This longitudinal prospective study included a subsample of pregnant women and their children aged 4 years (n = 249) who participated in the ECLIPSES Study conducted in the province of Tarragona, Spain, from 2013 to 2017. Maternal vitamin B12 concentrations were determined in the first and third trimesters, and sociodemographic, nutritional and psychological data were collected. The children's cognitive functioning was assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) and subtests of the Neuropsychological Assessment of Development (NEPSY-II). The multivariable models showed a significant relationship between vitamin B12 and the working memory index in the first trimester of the pregnancy but not in the third trimester. Children of mothers in the second vitamin B12 level tertile (314-413 pg/mL) (β = 6.468, 95% confidence interval [CI]: = 2.054, 10.882, p = 0.004) and third vitamin B12 level tertile (≥414 pg/mL) (β = 4.703, 95% CI: = 0.292, 9.114, p = 0.037) scored higher in the working memory index of the WPPSI-IV than the children of mothers with vitamin B12 levels in the first tertile (<314 pg/mL). Maintaining an adequate level of maternal vitamin B12 during early pregnancy contributes to improved performance in childhood working memory at 4 years of age.
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Affiliation(s)
- Josué Cruz‐Rodríguez
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
| | - Josefa Canals‐Sans
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - Carmen Hernández‐Martínez
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - Núria Voltas‐Moreso
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - Victoria Arija
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Institut d'Investigació en Atenció Primària IDIAP Jordi GolInstitut Català de la Salut (ICS)BarcelonaSpain
- Collaborative Research Group on Lifestyles, Nutrition and Smoking (CENIT)IDIAP Jordi GolReusSpain
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Wirthensohn M, Wehrli S, Ljungblad UW, Huemer M. Biochemical, Nutritional, and Clinical Parameters of Vitamin B12 Deficiency in Infants: A Systematic Review and Analysis of 292 Cases Published between 1962 and 2022. Nutrients 2023; 15:4960. [PMID: 38068819 PMCID: PMC10708449 DOI: 10.3390/nu15234960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Pooled data from published reports on infants with clinically diagnosed vitamin B12 (B12) deficiency were analyzed with the purpose of describing the presentation, diagnostic approaches, and risk factors for the condition to inform prevention strategies. An electronic (PubMed database) and manual literature search following the PRISMA approach was conducted (preregistration with the Open Science Framework, accessed on 15 February 2023). Data were described and analyzed using correlation analyses, Chi-square tests, ANOVAs, and regression analyses, and 102 publications (292 cases) were analyzed. The mean age at first symptoms (anemia, various neurological symptoms) was four months; the mean time to diagnosis was 2.6 months. Maternal B12 at diagnosis, exclusive breastfeeding, and a maternal diet low in B12 predicted infant B12, methylmalonic acid, and total homocysteine. Infant B12 deficiency is still not easily diagnosed. Methylmalonic acid and total homocysteine are useful diagnostic parameters in addition to B12 levels. Since maternal B12 status predicts infant B12 status, it would probably be advantageous to target women in early pregnancy or even preconceptionally to prevent infant B12 deficiency, rather than to rely on newborn screening that often does not reliably identify high-risk children.
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Affiliation(s)
- Miriam Wirthensohn
- Department of Pediatrics, Landeskrankenhaus Bregenz, 6900 Bregenz, Austria
| | - Susanne Wehrli
- Department of Psychosomatics and Psychiatry, University Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- University Research Priority Program “ITINERARE—Innovative Therapies in Rare Diseases”, University of Zurich, 8032 Zurich, Switzerland
| | - Ulf Wike Ljungblad
- Department of Pediatrics, Vestfold Hospital Trust, NO-3168 Tønsberg, Norway
| | - Martina Huemer
- Department of Pediatrics, Landeskrankenhaus Bregenz, 6900 Bregenz, Austria
- Division of Metabolism and Children’s Research Center, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- Vorarlberg University of Applied Sciences, Competence Area Healthcare and Nursing, 6850 Dornbirn, Austria
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Gharibzahedi SMT, Moghadam M, Amft J, Tolun A, Hasabnis G, Altintas Z. Recent Advances in Dietary Sources, Health Benefits, Emerging Encapsulation Methods, Food Fortification, and New Sensor-Based Monitoring of Vitamin B 12: A Critical Review. Molecules 2023; 28:7469. [PMID: 38005191 PMCID: PMC10673454 DOI: 10.3390/molecules28227469] [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: 10/10/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
In this overview, the latest achievements in dietary origins, absorption mechanism, bioavailability assay, health advantages, cutting-edge encapsulation techniques, fortification approaches, and innovative highly sensitive sensor-based detection methods of vitamin B12 (VB12) were addressed. The cobalt-centered vitamin B is mainly found in animal products, posing challenges for strict vegetarians and vegans. Its bioavailability is highly influenced by intrinsic factor, absorption in the ileum, and liver reabsorption. VB12 mainly contributes to blood cell synthesis, cognitive function, and cardiovascular health, and potentially reduces anemia and optic neuropathy. Microencapsulation techniques improve the stability and controlled release of VB12. Co-microencapsulation of VB12 with other vitamins and bioactive compounds enhances bioavailability and controlled release, providing versatile initiatives for improving bio-functionality. Nanotechnology, including nanovesicles, nanoemulsions, and nanoparticles can enhance the delivery, stability, and bioavailability of VB12 in diverse applications, ranging from antimicrobial agents to skincare and oral insulin delivery. Staple food fortification with encapsulated and free VB12 emerges as a prominent strategy to combat deficiency and promote nutritional value. Biosensing technologies, such as electrochemical and optical biosensors, offer rapid, portable, and sensitive VB12 assessment. Carbon dot-based fluorescent nanosensors, nanocluster-based fluorescent probes, and electrochemical sensors show promise for precise detection, especially in pharmaceutical and biomedical applications.
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Affiliation(s)
| | - Maryam Moghadam
- Institute of Human Nutrition and Food Science, Division of Food Technology, Kiel University, 24118 Kiel, Germany
| | - Jonas Amft
- Institute of Human Nutrition and Food Science, Division of Food Technology, Kiel University, 24118 Kiel, Germany
| | - Aysu Tolun
- Institute of Materials Science, Faculty of Engineering, Kiel University, 24143 Kiel, Germany
| | - Gauri Hasabnis
- Institute of Materials Science, Faculty of Engineering, Kiel University, 24143 Kiel, Germany
| | - Zeynep Altintas
- Institute of Materials Science, Faculty of Engineering, Kiel University, 24143 Kiel, Germany
- Kiel Nano, Surface and Interface Science-KiNSIS, Kiel University, 24118 Kiel, Germany
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10
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Goraya JS, Kaur S. Vitamin B 12 deficiency in mothers and children: risk of neuro-regression. Paediatr Int Child Health 2023; 43:50-56. [PMID: 36755398 DOI: 10.1080/20469047.2023.2171767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/17/2022] [Indexed: 02/10/2023]
Affiliation(s)
- Jatinder Singh Goraya
- Department of Pediatrics, Division of Pediatric Neurology, Dayanand Medical College and Hospital Ludhiana, Punjab, India
| | - Sukhjot Kaur
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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11
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Nair M, Choudhury SS, Rani A, Solomi C, Kakoty SD, Medhi R, Rao S, Mahanta P, Zahir F, Roy I, Chhabra S, Deka G, Minz B, Deka R, Opondo C, Churchill D, Lakhal-Littleton S, Nemeth E. The complex relationship between iron status and anemia in pregnant and postpartum women in India: Analysis of two Indian study cohorts of uncomplicated pregnancies. Am J Hematol 2023; 98:1721-1731. [PMID: 37651649 DOI: 10.1002/ajh.27059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023]
Abstract
Low hemoglobin is widely used as an indicator of iron deficiency anemia in India and other low-and-middle income counties, but anemia need not accurately reflect iron deficiency. We examined the relationship between hemoglobin and biomarkers of iron status in antenatal and postnatal period. Secondary analysis of uncomplicated singleton pregnancies in two Indian study cohorts: 1132 antenatal women in third trimester and 837 postnatal women 12-72 h after childbirth. Associations of hemoglobin with ferritin in both data sets, and with sTfR, TSAT, and hepcidin in the postnatal cohort were examined using multivariable linear regression. Multinomial logistic regression was used to examine the association between severity of anemia and iron status. Regression models were adjusted for potential confounders. Over 55% of the women were anemic; 34% of antenatal and 40% of postnatal women had low ferritin, but 4% antenatal and 6% postnatal women had high ferritin. No evidence of association between hemoglobin and ferritin was observed (antenatal: adjusted coefficient [aCoef] -0.0004, 95% confidence interval [CI] -0.001, 0.001; postnatal: aCoef -0.0001, 95% CI -0.001, 0.001). We found a significant linear association of hemoglobin with sTfR (aCoef -0.04, 95% CI -0.07, -0.01), TSAT (aCoef -0.005, 95% CI -0.008, -0.002), and hepcidin (aCoef 0.02, 95% CI 0.02, 0.03) in postnatal women. Likelihood of low ferritin was more common in anemic than non-anemic women, but high ferritin was also more common in women with severe anemia in both cohorts. Causes of anemia in pregnant and postpartum women in India are multifactorial; low hemoglobin alone is not be a useful marker of iron deficiency.
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Affiliation(s)
- Manisha Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Saswati S Choudhury
- Department of Obstetrics and Gynaecology, Gauhati Medical College and Hospital, Guwahati, India
| | - Anjali Rani
- Institute of Medical Sciences, Banaras Hindu University, Banaras Hindu University Campus, Varanasi, India
| | - Carolin Solomi
- Makunda Christian Leprosy and General Hospital, Karimganj, India
| | - Swapna D Kakoty
- Department of Obstetrics and Gynaecology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, India
| | - Robin Medhi
- Department of Obstetrics and Gynaecology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, India
| | - Sereesha Rao
- Department of Obstetrics and Gynaecology, Silchar Medical College and Hospital, Silchar, India
| | - Pranabika Mahanta
- Department of Obstetrics and Gynaecology, Jorhat Medical College and Hospital, Jorhat, India
| | - Farzana Zahir
- Department of Obstetrics and Gynaecology, Assam Medical College, Dibrugarh, India
| | | | - Shakuntala Chhabra
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
| | - Gitanjali Deka
- Department of Obstetrics and Gynaecology, Tezpur Medical College, Tezpur, India
| | - Bina Minz
- Sewa Bhawan Hospital Society, Basna, India
| | - Rupanjali Deka
- MaatHRI, Srimanta Sankaradeva University of Health Sciences, Guwahati, India
| | - Charles Opondo
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - David Churchill
- The Royal Wolverhampton Hospitals NHS Trust, University of Wolverhampton, Wolverhampton, UK
| | | | - Elizabeta Nemeth
- David Geffen School of Medicine & the UCLA Center for Iron Disorders, University of California, Los Angeles, California, USA
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Světnička M, Heniková M, Selinger E, Ouřadová A, Potočková J, Kuhn T, Gojda J, El-Lababidi E. Prevalence of iodine deficiency among vegan compared to vegetarian and omnivore children in the Czech Republic: cross-sectional study. Eur J Clin Nutr 2023; 77:1061-1070. [PMID: 37488261 PMCID: PMC10630131 DOI: 10.1038/s41430-023-01312-9] [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: 01/31/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The intake and homeostasis of iodine, an essential micronutrient that plays a vital role in thyroid physiology, is of particular concern with the increasing popularity of vegetarian (VG) and vegan (VN) diets. Children on these restrictive diets may be at risk of possible adverse effects on growth and development, but there is currently a lack of recent epidemiological studies on this topic. METHODS We gathered clinical, anthropometric, and blood/urine data on iodine status and thyroid function from children aged 0-18 years who followed either a VG diet (n = 91), VN diet (n = 75), or omnivore diet (OM, n = 52). Cross-sectional comparison of the groups and linear regression was used. Stratified analyses were performed based on age (according to WHO): 0-5 years and 6-18 years. RESULTS Our study revealed no significant differences in levels of thyroid-stimulating hormone (TSH), triiodothyronine (fT3), thyroglobulin (TG) or anti-thyroid peroxidase antibody (ATPOc) between the VG, VN, and OM groups. However, thyroxine (fT4) levels were found to be higher in the VN group compared to the OM group (15.00 ± 1.73 vs. 16.17 ± 1.82 pmol/l, p < 0.001). The presence of anti-thyroglobulin antibodies (AhTGc) was notably more common in the VG (18.2%)/VN (35.0%) groups than in the OM group (2.1%) (p < 0.001). Regarding iodine status, the concentration of iodine in spot urine (UIC) was found to be highest in the OM group (197.28 ± 105.35 vs. VG: 177.95 ± 155.88 vs. VN: 162.97 ± 164.51 µg/l, p < 0.001). Notably, the lowest (5.99 µg/l) and highest (991.80 µg/l) levels were measured in the VN group. Of the participants, 31 VN, 31 VG and 10 OM children met the criteria for iodine deficiency (i.e., UIC < 100 µg/l). We found that children with regular iodine supplementation had higher UIC (p < 0.001). Importantly, the median UIC was above 100 µg/l in all three groups, through the recommended intake (RDI) of iodine was rarely met throughout the groups. CONCLUSION We have observed a trend to lower UIC values in VN as compared to OM. This trend is also reflected in the median UIC values, even though the median UIC values were above the WHO cut-off (e.g., 100 µg/l) for iodine deficiency in all dietary groups. These results suggest that VN and VG children may be more at higher risk of iodine deficiency, this theory is also supported by higher prevalence of AhTGc positivity. Further research is needed to investigate the long-term impact of these dietary patterns on iodine status and thyroid function in children. Given our findings, it may also be necessary to consider new guidelines for supplementing children following VG and VN diets to ensure their iodine needs are met.
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Affiliation(s)
- Martin Světnička
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic.
- Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic.
- Department of Paediatrics, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Marina Heniková
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eliška Selinger
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
- The National Institute of Public Health, Centre for Public Health Promotion, Prague, Czech Republic
| | - Anna Ouřadová
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Potočková
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tilman Kuhn
- The Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg, Germany
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- Medical University of Vienna, Centre for Public Health, Vienna, Austria
| | - Jan Gojda
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eva El-Lababidi
- Centre for Research on Diabetes Metabolism, and Nutrition of Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Paediatrics, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Genchi G, Lauria G, Catalano A, Carocci A, Sinicropi MS. Prevalence of Cobalt in the Environment and Its Role in Biological Processes. BIOLOGY 2023; 12:1335. [PMID: 37887045 PMCID: PMC10604320 DOI: 10.3390/biology12101335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/08/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023]
Abstract
Cobalt (Co) is an essential trace element for humans and other animals, but high doses can be harmful to human health. It is present in some foods such as green vegetables, various spices, meat, milk products, seafood, and eggs, and in drinking water. Co is necessary for the metabolism of human beings and animals due to its key role in the formation of vitamin B12, also known as cobalamin, the biological reservoir of Co. In high concentrations, Co may cause some health issues such as vomiting, nausea, diarrhea, bleeding, low blood pressure, heart diseases, thyroid damage, hair loss, bone defects, and the inhibition of some enzyme activities. Conversely, Co deficiency can lead to anorexia, chronic swelling, and detrimental anemia. Co nanoparticles have different and various biomedical applications thanks to their antioxidant, antimicrobial, anticancer, and antidiabetic properties. In addition, Co and cobalt oxide nanoparticles can be used in lithium-ion batteries, as a catalyst, a carrier for targeted drug delivery, a gas sensor, an electronic thin film, and in energy storage. Accumulation of Co in agriculture and humans, due to natural and anthropogenic factors, represents a global problem affecting water quality and human and animal health. Besides the common chelating agents used for Co intoxication, phytoremediation is an interesting environmental technology for cleaning up soil contaminated with Co. The occurrence of Co in the environment is discussed and its involvement in biological processes is underlined. Toxicological aspects related to Co are also examined in this review.
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Affiliation(s)
- Giuseppe Genchi
- Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (G.G.); (G.L.); (M.S.S.)
| | - Graziantonio Lauria
- Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (G.G.); (G.L.); (M.S.S.)
| | - Alessia Catalano
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari “A. Moro”, 70125 Bari, Italy;
| | - Alessia Carocci
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari “A. Moro”, 70125 Bari, Italy;
| | - Maria Stefania Sinicropi
- Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Arcavacata di Rende, 87036 Cosenza, Italy; (G.G.); (G.L.); (M.S.S.)
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14
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da Fonseca-Pereira P, Monteiro-Batista RDC, Araújo WL, Nunes-Nesi A. Harnessing enzyme cofactors and plant metabolism: an essential partnership. THE PLANT JOURNAL : FOR CELL AND MOLECULAR BIOLOGY 2023; 114:1014-1036. [PMID: 36861364 DOI: 10.1111/tpj.16167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 05/31/2023]
Abstract
Cofactors are fundamental to the catalytic activity of enzymes. Additionally, because plants are a critical source of several cofactors (i.e., including their vitamin precursors) within the context of human nutrition, there have been several studies aiming to understand the metabolism of coenzymes and vitamins in plants in detail. For example, compelling evidence has been brought forth regarding the role of cofactors in plants; specifically, it is becoming increasingly clear that an adequate supply of cofactors in plants directly affects their development, metabolism, and stress responses. Here, we review the state-of-the-art knowledge on the significance of coenzymes and their precursors with regard to general plant physiology and discuss the emerging functions attributed to them. Furthermore, we discuss how our understanding of the complex relationship between cofactors and plant metabolism can be used for crop improvement.
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Affiliation(s)
- Paula da Fonseca-Pereira
- National Institute of Science and Technology on Plant Physiology under Stress Conditions, Departamento de Biologia Vegetal, Universidade Federal de Viçosa, 36570-900, Viçosa, Minas Gerais, Brazil
| | - Rita de Cássia Monteiro-Batista
- National Institute of Science and Technology on Plant Physiology under Stress Conditions, Departamento de Biologia Vegetal, Universidade Federal de Viçosa, 36570-900, Viçosa, Minas Gerais, Brazil
| | - Wagner L Araújo
- National Institute of Science and Technology on Plant Physiology under Stress Conditions, Departamento de Biologia Vegetal, Universidade Federal de Viçosa, 36570-900, Viçosa, Minas Gerais, Brazil
| | - Adriano Nunes-Nesi
- National Institute of Science and Technology on Plant Physiology under Stress Conditions, Departamento de Biologia Vegetal, Universidade Federal de Viçosa, 36570-900, Viçosa, Minas Gerais, Brazil
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15
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Tangeraas T, Ljungblad UW, Lutvica E, Kristensen E, Rowe AD, Bjørke-Monsen AL, Rootwelt-Revheim T, Sæves I, Pettersen RD. Vitamin B12 Deficiency (Un-)Detected Using Newborn Screening in Norway. Int J Neonatal Screen 2023; 9:ijns9010003. [PMID: 36648770 PMCID: PMC9844471 DOI: 10.3390/ijns9010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/26/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023] Open
Abstract
Untreated vitamin B12 (B12) deficiency may cause delayed development in infants. Several newborn screening (NBS) programs have reported an increased detection rate of B12 deficiency when second-tier dried blood spot (DBS) analyses of total homocysteine (tHcy) and methylmalonic acid (MMA) are included. This is a retrospective study of newborns reported from NBS during 2012−2021 with confirmed B12 deficiency. DBSs were retrieved from the NBS biobank for second-tier MMA and tHcy analysis. Thirty-one newborns were diagnosed with B12 deficiency out of 552970 screened. Twenty-five were ascertained from sixty-one false positive (FP) cases of methylmalonic acidemia and propionic acidemia (PA), and six infants screened positive for other NBS metabolic diseases with propionylcarnitine (C3) in the normal range. In the original DBS, 7/23 (30%) and 12/23 (52%) of B12-deficient newborns with FP methylmalonic acidemia/PA had MMA and tHcy > 99th percentile. B12 deficiency was a common differential diagnosis of screening positive for methylmalonic and PA. C3 failed to identify a subset of newborns with B12 deficiency. Second-tier MMA and tHcy analyses in the DBS showed suboptimal sensitivity for identifying infants with B12 deficiency. The shortcomings of NBS should be acknowledged when considering B12 deficiency as a primary target of NBS panels.
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Affiliation(s)
- Trine Tangeraas
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway
- European Reference Network for Hereditary Metabolic Disorders (MetabERN), 0424 Oslo, Norway
- Correspondence:
| | - Ulf W. Ljungblad
- Institute of Clinical Medicine, University of Oslo, Mailbox 1171 Blindern, 0318 Oslo, Norway
- Department of Pediatrics, Vestfold Hospital Trust, Mailbox 1068, 3103 Tønsberg, Norway
| | - Elma Lutvica
- Medical Faculty, University of Oslo, Mailbox 1171 Blindern, 0318 Oslo, Norway
| | - Erle Kristensen
- Department of Medical Biochemistry, Oslo University Hospital, 0424 Oslo, Norway
| | - Alex D. Rowe
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Anne-Lise Bjørke-Monsen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5007 Bergen, Norway
| | - Terje Rootwelt-Revheim
- European Reference Network for Hereditary Metabolic Disorders (MetabERN), 0424 Oslo, Norway
| | - Ingjerd Sæves
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Rolf D. Pettersen
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway
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Temova Rakuša Ž, Roškar R, Hickey N, Geremia S. Vitamin B 12 in Foods, Food Supplements, and Medicines-A Review of Its Role and Properties with a Focus on Its Stability. MOLECULES (BASEL, SWITZERLAND) 2022; 28:molecules28010240. [PMID: 36615431 PMCID: PMC9822362 DOI: 10.3390/molecules28010240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
Vitamin B12, also known as the anti-pernicious anemia factor, is an essential micronutrient totally dependent on dietary sources that is commonly integrated with food supplements. Four vitamin B12 forms-cyanocobalamin, hydroxocobalamin, 5'-deoxyadenosylcobalamin, and methylcobalamin-are currently used for supplementation and, here, we provide an overview of their biochemical role, bioavailability, and efficacy in different dosage forms. Since the effective quantity of vitamin B12 depends on the stability of the different forms, we further provide a review of their main reactivity and stability under exposure to various environmental factors (e.g., temperature, pH, light) and the presence of some typical interacting compounds (oxidants, reductants, and other water-soluble vitamins). Further, we explore how the manufacturing process and storage affect B12 stability in foods, food supplements, and medicines and provide a summary of the data published to date on the content-related quality of vitamin B12 products on the market. We also provide an overview of the approaches toward their stabilization, including minimization of the destabilizing factors, addition of proper stabilizers, or application of some (innovative) technological processes that could be implemented and contribute to the production of high-quality vitamin B12 products.
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Affiliation(s)
| | - Robert Roškar
- Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Neal Hickey
- Department of Chemical and Pharmaceutical Sciences, Centre of Excellence in Biocrystallography, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy
| | - Silvano Geremia
- Department of Chemical and Pharmaceutical Sciences, Centre of Excellence in Biocrystallography, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy
- Correspondence:
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Vitamin B12 (Cobalamin): Its Fate from Ingestion to Metabolism with Particular Emphasis on Diagnostic Approaches of Acquired Neonatal/Infantile Deficiency Detected by Newborn Screening. Metabolites 2022; 12:metabo12111104. [DOI: 10.3390/metabo12111104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Acquired vitamin B12 (vB12) deficiency (vB12D) of newborns is relatively frequent as compared with the incidence of inherited diseases included in newborn screening (NBS) of different countries across the globe. Infants may present signs of vB12D before 6 months of age with anemia and/or neurologic symptoms when not diagnosed in asymptomatic state. The possibility of identifying vitamin deficient mothers after their pregnancy during the breastfeeding period could be an additional benefit of the newborn screening. Vitamin supplementation is widely available and easy to administer. However, in many laboratories, vB12D is not included in the national screening program. Optimized screening requires either second-tier testing or analysis of new urine and blood samples combined with multiple clinical and laboratory follow ups. Our scope was to review the physiologic fate of vB12 and the pathobiochemical consequences of vB12D in the human body. Particular emphasis was put on the latest approaches for diagnosis and treatment of vB12D in NBS.
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Güitrón Leal CE, Palma Molina XE, Williams JL, Venkatramanan S, Finkelstein JL, Kuriyan R, Crider KS. Vitamin B 12
supplementation for growth, development, and cognition in children. Hippokratia 2022. [DOI: 10.1002/14651858.cd015264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Jennifer L Williams
- National Center on Birth Defects and Developmental Disabilities; Centers for Disease Control and Prevention; Atlanta GA USA
| | | | | | - Rebecca Kuriyan
- Division of Nutrition; St John's Research Institute; Bengaluru India
| | - Krista S Crider
- National Center on Birth Defects and Developmental Disabilities; Centers for Disease Control and Prevention; Atlanta GA USA
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Dib MJ, Gumban-Marasigan M, Yoxall R, Andrew T, Harrington DJ, Sobczyńska-Malefora A, Ahmadi KR. Evaluating the Diagnostic Value of a Combined Indicator of Vitamin B12 Status (cB12) Throughout Pregnancy. Front Nutr 2022; 8:789357. [PMID: 35155515 PMCID: PMC8825834 DOI: 10.3389/fnut.2021.789357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 11/15/2022] Open
Abstract
Background Inadequate provision of vitamin B12 during pregnancy is associated with a number of adverse maternal and fetal outcomes. We set out to (1) suggest pregnancy-specific reference ranges for a range of biomarkers of vitamin B12; (2) assess the temporal behaviors of these markers over the course of pregnancy; and (3) test whether any biomarkers, including the genetic marker HIBCH rs291466 strongly associated with MMA measured early in pregnancy could reliably and significantly predict future B12 status within a healthy UK population of pregnant women. Materials and Methods We used existing biobank samples from the placebo arm of the UK Selenium in PRegnancy Intervention (SPRINT) study, to generate biochemical data for serum folate, B12, holotranscobalamin (HoloTC), total homocysteine (tHcy), and MMA, calculate cB12, and genotyped the polymorphism rs291466 in gene HIBCH on a total of n=114 women across trimesters 1–3 of their pregnancy. We performed a series of exploratory cross-sectional and longitudinal analyses to investigate levels at each trimester, suggest references ranges, evaluate changes and correlations between the B12 biomarkers, and assess the predictive capabilities of each biomarker from 12-weeks to 35-weeks of gestation. Results Significant changes in all vitamin B12 biomarker values were observed over the three trimesters (P < 0.05). Our study shows that cB12 values were largely constant and stable throughout trimester 1 (T1) and T2 (i.e., up to week 20), but declined significantly in T3 (−66% | P < 0.001). Yet, cB12 generally remained within the normal boundaries. We identified pregnancy and trimester-specific reference ranges for each biomarker at each trimester, notably for total serum B12. This marker fell below the recommended cut-offs in 1/3 of the cohort at the third trimester, contrasting other markers (mostly normal). Our multivariate analyses indicated that none of the biomarkers could reliably and accurately predict any other biomarkers than themselves later in pregnancy. Yet, HoloTC seems to be a promising predictor within the limitations of our cohort, constituted of B12-replete individuals. Most notably, cB12 did not significantly predict itself between trimesters. Finally, we show that the HIBCH variant has little predictive power for MMA or cB12 as it does not explain the significant increase in MMA concentrations nor the decline of cB12 throughout pregnancy. Conclusion Trimester-specific reference ranges for biomarkers of vitamin B12 in normal pregnancy are suggested. However, these biomarkers have limited predictive value in identifying mothers at elevated risk of vitamin B12 insufficiency/deficiency during pregnancy.
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Affiliation(s)
- Marie-Joe Dib
- Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College, London, United Kingdom
- *Correspondence: Marie-Joe Dib
| | | | - Rozzie Yoxall
- Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Toby Andrew
- Department of Genomics of Common Disease, Imperial College, London, United Kingdom
| | - Dominic J. Harrington
- The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, United Kingdom
- Division of Women's Health, School of Medicine, King's College London, London, United Kingdom
| | - Agata Sobczyńska-Malefora
- The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, United Kingdom
- Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Kourosh R. Ahmadi
- Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
- Kourosh R. Ahmadi
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Světnička M, Sigal A, Selinger E, Heniková M, El-Lababidi E, Gojda J. Cross-Sectional Study of the Prevalence of Cobalamin Deficiency and Vitamin B12 Supplementation Habits among Vegetarian and Vegan Children in the Czech Republic. Nutrients 2022; 14:nu14030535. [PMID: 35276893 PMCID: PMC8838497 DOI: 10.3390/nu14030535] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
Vegetarian (VG) and vegan (VN) diets in childhood are of growing interest due to their perceived health and environmental benefits. Concerns remain due to the possible disruption of healthy growth and development of children because of the scarcity of evidence-based studies. Among the nutrients of special concern is vitamin B12. Therefore, the Czech Vegan Children Study (CAROTS) decided to examine the relationship between B12 metabolism parameters and B12 intake through diet and supplementation. We analyzed laboratory parameters within n = 79 VG, n = 69 VN, and n = 52 omnivores (OM) children (0−18 years old). There were no significant differences in levels of holotranscobalamin (aB12), folate, homocysteine (hcys), or mean corpuscular volume. However, there was a significant difference in levels of cyanocobalamin (B12) (p = 0.018), even though we identified only n = 1 VG and n = 2 VN children as B12 deficient. On the other hand, we identified n = 35 VG, n = 28 VN, and n = 9 OM children with vitamin B12 hypervitaminosis (p = 0.004). This finding was related to a high prevalence of over-supplementation in the group (mean dose for VG 178.19 ± 238.5 µg per day; VN 278.35 ± 394.63 µg per day). Additionally, we found a significant (p < 0.05) difference between B12, aB12, and hcys levels of supplemented vs. non-supplemented VG/VN children. This can show that the intake of vitamin B12 via diet in the VG group might not be sufficient. Secondly, we analyzed a relation between supplement use in pregnancy and breastfeeding and its impact on vitamin B12 levels of children aged 0−3 years. Out of n = 46 mothers, only n = 3 (e.g., 6.5%) were not supplemented at all. We have not identified any clinical manifestation of B12 deficiency and only n = 1 child with low serum cobalamin, a child who did not receive vitamin B12 supplementation and whose mother took only low doses of vitamin B12 (25/µg/day).To conclude, we did not observe any life-threatening or severe consequences of laboratory-stated vitamin B12 deficiency; thus, our group was well supplemented. On the other hand, we have identified many subjects with vitamin B12 hypervitaminosis of unknown impact on their health. Further research and new guidelines for B12 supplementation among VG and VN children are needed.
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Affiliation(s)
- Martin Světnička
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
- Department of Pediatrics, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
- Correspondence: ; Tel.: +420-725-569-697
| | - Anat Sigal
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Pediatrics, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
| | - Eliška Selinger
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
- Centre for Public Health Promotion, The National Institute of Public Health, 10000 Prague, Czech Republic
| | - Marina Heniková
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
| | - Eva El-Lababidi
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Pediatrics, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
| | - Jan Gojda
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
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Benefits and risks of vegetarian diets. NUTR HOSP 2022; 39:26-29. [DOI: 10.20960/nh.04306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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