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Jiang M, Guo S, Chen X, Wei Q, Wang M. Crystal structure of l-threonine-O-3-phosphate decarboxylase CobC from Sinorhizobium meliloti involved in vitamin B 12 biosynthesis. Biochem Biophys Res Commun 2024; 734:150767. [PMID: 39366178 DOI: 10.1016/j.bbrc.2024.150767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 09/28/2024] [Indexed: 10/06/2024]
Abstract
Vitamin B12 is involved in many important biochemical reactions for humans, and its deficiency can lead to serious diseases. The industrial production of vitamin B12 is achieved through microbial fermentation. In this work, we determine the crystal structures of the l-threonine-O-3-phosphate (Thr-P) decarboxylase CobC from Sinorhizobium meliloti (SmCobC), an industrial vitamin B12-producing bacterium, in apo form and in complex with a reaction intermediate. Our structures supported the Thr-P decarboxylase activity of SmCobC and revealed that the positively charged substrate-binding pocket between the large and small domains determines its substrate selectivity for Thr-P. Moreover, our results provided evidence for the proposition that the AP-P linker is formed by direct incorporation of AP-P in the biosynthetic pathway of vitamin B12 in S.meliloti.
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Affiliation(s)
- Meiyu Jiang
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, 230601, Anhui, China; School of Life Sciences, Anhui University, Hefei, 230601, Anhui, China
| | - Shuoxuan Guo
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, 230601, Anhui, China; School of Life Sciences, Anhui University, Hefei, 230601, Anhui, China
| | - Xi Chen
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, 230601, Anhui, China; School of Life Sciences, Anhui University, Hefei, 230601, Anhui, China
| | - Qinghao Wei
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, 230601, Anhui, China; School of Life Sciences, Anhui University, Hefei, 230601, Anhui, China
| | - Mingzhu Wang
- Institutes of Physical Science and Information Technology, Anhui University, Hefei, 230601, Anhui, China; School of Life Sciences, Anhui University, Hefei, 230601, Anhui, China; Key Laboratory of Human Microenvironment and Precision Medicine of Anhui Higher Education Institutes, Anhui University, Hefei, 230601, Anhui, China.
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2
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Balanč B, Salević-Jelić A, Đorđević V, Bugarski B, Nedović V, Petrović P, Knežević-Jugović Z. The Application of Protein Concentrate Obtained from Green Leaf Biomass in Structuring Nanofibers for Delivery of Vitamin B12. Foods 2024; 13:1576. [PMID: 38790876 PMCID: PMC11121456 DOI: 10.3390/foods13101576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Nanofibers made of natural proteins have caught the increasing attention of food scientists because of their edibility, renewability, and possibility for various applications. The objective of this study was to prepare nanofibers based on pumpkin leaf protein concentrate (LPC) as a by-product from some crops and gelatin as carriers for vitamin B12 using the electrospinning technique. The starting mixtures were analyzed in terms of viscosity, density, surface tension, and electrical conductivity. Scanning electron micrographs of the obtained nanofibers showed a slight increase in fiber average diameter with the addition of LPC and vitamin B12 (~81 nm to 109 nm). Fourier transform infrared spectroscopy verified the physical blending of gelatin and LPC without phase separation. Thermal analysis showed the fibers had good thermal stability up to 220 °C, highlighting their potential for food applications, regardless of the thermal processing. Additionally, the newly developed fibers have good storage stability, as detected by low water activity values ranging from 0.336 to 0.376. Finally, the release study illustrates the promising sustained release of vitamin B12 from gelatin-LPC nanofibers, mainly governed by the Fickian diffusion mechanism. The obtained results implied the potential of these nanofibers in the development of functional food products with improved nutritional profiles.
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Affiliation(s)
- Bojana Balanč
- Innovation Centre of Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia; (B.B.); (P.P.)
| | - Ana Salević-Jelić
- Faculty of Agriculture, University of Belgrade, Nemanjina 6, 11080 Beograd, Serbia; (A.S.-J.); (V.N.)
| | - Verica Đorđević
- Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia; (B.B.); (Z.K.-J.)
| | - Branko Bugarski
- Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia; (B.B.); (Z.K.-J.)
| | - Viktor Nedović
- Faculty of Agriculture, University of Belgrade, Nemanjina 6, 11080 Beograd, Serbia; (A.S.-J.); (V.N.)
| | - Predrag Petrović
- Innovation Centre of Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia; (B.B.); (P.P.)
| | - Zorica Knežević-Jugović
- Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia; (B.B.); (Z.K.-J.)
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Thewjitcharoen Y, Chongvoranond P, Nakasatien S, Krittiyawong S, Himathongkam T. Metformin-Associated Vitamin B12 Deficiency: An Underrecognized Complication. JCEM CASE REPORTS 2024; 2:luae029. [PMID: 38623534 PMCID: PMC11017106 DOI: 10.1210/jcemcr/luae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Indexed: 04/17/2024]
Abstract
Metformin-associated vitamin B12 deficiency is a well-established side effect, especially in patients taking higher doses of metformin or who have existing risk factors. Severe deficiency causes a wide range of systemic disorders. Gait instability, which leads to frequent falling, is usually an underrecognized side effect. Older patients are more likely to develop chronic subdural hematoma even with minor trauma. We present a case of 84-year-old man with type 2 diabetes mellitus with acute-on-chronic subdural hematoma from frequent falls. Metformin therapy at dose of 1700 mg/day was given for more than 25 years. He had been in his usual state of health until 10 months ago when he began to have frequent fallings and fatigue. Physical examination in this admission revealed new-onset impaired vibratory sensation and proprioception in both feet and positive Romberg test. Subsequent evaluations demonstrated undetectable plasma vitamin B12 level and elevated plasma homocysteine. Improvement in neurological symptoms occurred within 1 week of vitamin B12 replacement and surgical hematoma evacuation. This case highlights the importance of awareness and periodic monitoring of vitamin B12 status among older patients taking metformin.
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Affiliation(s)
| | | | | | | | - Thep Himathongkam
- Diabetes and Thyroid Center, Theptarin Hospital, Bangkok 10110, Thailand
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Mattavelli C, Willems A, Gomez Soto E, Chong SK. Hypocobalaminaemia in dogs with acute gastrointestinal diseases. J Small Anim Pract 2024; 65:104-112. [PMID: 38183171 DOI: 10.1111/jsap.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVES The objectives of this study were to investigate the prevalence of hypocobalaminaemia in dogs with acute gastrointestinal diseases and to evaluate its relationship with disease severity and outcome. MATERIALS AND METHODS Medical records of dogs presented for acute gastrointestinal signs that a serum cobalamin concentration measured between September 2019 and 2021 were included in this study. Hypocobalaminaemia was defined as serum cobalamin concentration <200 pmol/L, and low-normal cobalamin was defined as serum cobalamin concentration of 200 to 295 pmol/L. Duration of clinical signs prior to presentation, Acute Patient Physiologic and Laboratory Evaluation (APPLE) fast score, length of hospitalisation and outcome were recorded. RESULTS Thirty-three dogs were included. Seventeen dogs were diagnosed with acute gastrointestinal disease of unknown aetiology, seven dogs with parvoviral enteritis, three dogs with acute haemorrhagic diarrhoea syndrome and six dogs with miscellaneous diseases. The prevalence of hypocobalaminaemia in this population was 30.3% and low-normal cobalamin concentration was detected in 18.2% of dogs. There was no statistically significant relationship between the detection of hypocobalaminaemia or low-normal cobalamin and the duration of clinical signs before presentation, length of hospitalisation or Acute Patient Physiologic and Laboratory Evaluation fast score on admission. Mortality rate was 3%. CLINICAL SIGNIFICANCE Hypocobalaminaemia and low-normal cobalamin are common findings in dogs with acute gastrointestinal diseases. The therapeutic significance and potential implications for prognosis of hypocobalaminaemia in these patients requires further investigation.
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Affiliation(s)
- C Mattavelli
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - A Willems
- The Ralph Veterinary Referral Centre, Marlow, UK
| | - E Gomez Soto
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - S K Chong
- The Ralph Veterinary Referral Centre, Marlow, UK
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Hoteit M, Khadra R, Fadlallah Z, Mourad Y, Chahine M, Skaiki F, Al Manasfi E, Chahine A, Poh OBJ, Tzenios N. Prevalence and Time Trends of Low Serum B12 Levels and Inadequate B12 Dietary Intake in Lebanese Adults amidst the Food Insecurity Situation: Findings from a Nationally Representative Cross-Sectional Study. Nutrients 2024; 16:226. [PMID: 38257119 PMCID: PMC10818865 DOI: 10.3390/nu16020226] [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: 12/09/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Rising food insecurity (FI) and the increased prices of animal-based foods could compromise vitamin B12 (B12) intake and serum levels in food-insecure people. Our study aims to determine the prevalence of low levels of serum B12 and its inadequate dietary intake among a nationally representative sample of Lebanese adults aged 18 to 64 years, while exploring the impact of FI and identifying other potential predictors. The B12 intake was assessed using a food frequency questionnaire and the mean of two non-consecutive 24 h recalls. The B12 serum levels were also examined. To examine the time trends in the B12 serum levels and dietary intake, the data from a large representative digitized database of 6290 participants were collected, along with the examination of FAOSTAT food consumption data both before and during the economic crisis period. Our findings revealed that 47.3% of households in Lebanon experienced FI. The inadequate intake of B12 food sources was prevalent in 52.5% of participants, and 61.1% presented with low (23%) or intermediate (38.1%) levels of serum B12. The food-secure households had a higher proportion of B12 intake from meats (p = 0.004), while traditional foods contributed more to food-insecure households (p = 0.000). The participants who were female, unemployed, food-insecure, and had low dietary diversity were about two to three times more likely to have inadequate B12 intake. The predictors of low levels of serum B12 included residing in Beqaa (OR = 2.856 and 95% CI = 1.018-8.01) and having inadequate B12 intake (OR = 1.788 and 95% CI = 1.2-2.65). The findings from observing the time trends in the consumption and the serum levels of B12 indicate a considerable decline in the consumption of most animal-based foods compared to the pre-crisis period, associated with a decline in the serum levels of B12. In conclusion, an alarming prevalence of low dietary intake and low serum levels of B12 was revealed among Lebanese adults, and the indirect effect of FI on B12 serum levels mediated through B12 intake was inferred.
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Affiliation(s)
- Maha Hoteit
- Food Sciences Unit, National Council for Scientific Research-Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon (Z.F.)
- Faculty of Public Health, Section 1, Lebanese University, Beirut P.O. Box 6573, Lebanon
| | - Razan Khadra
- Food Sciences Unit, National Council for Scientific Research-Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon (Z.F.)
| | - Zahraa Fadlallah
- Food Sciences Unit, National Council for Scientific Research-Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon (Z.F.)
| | - Youmna Mourad
- Al Hadi Laboratory and IVF Center, Beirut 1103, Lebanon;
| | - Mohamad Chahine
- Biological and Chemical Technology, Kursk State Medical University, 305000 Kursk, Russia;
| | - Farouk Skaiki
- Department of Molecular Biology, General Management, Al Karim Medical Laboratories, Saida 1600, Lebanon;
| | | | | | | | - Nikolaos Tzenios
- Faculty of Public Health, Charisma University, London EC1V 7QE, UK
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Daiya V, Ahuja A, Kumar S, Acharya S. Methylcobalamin Deficiency Presenting as Thalamic Syndrome in the Elderly: Association or Chance? Cureus 2024; 16:e52761. [PMID: 38389590 PMCID: PMC10882257 DOI: 10.7759/cureus.52761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Vitamin deficiency is common in the geriatric population and is responsible for majorly imbalanced hematological, neurological, and neuropsychiatric functioning. Methylcobalamin deficiency or vitamin B12 deficiency can be underestimated in some cases and be misdiagnosed as other illnesses, such as thalamic syndrome. Timely diagnosis of this deficiency is essential, especially in the geriatric population, as it might cause irreversible structural brain damage. This is also presented as elevated levels of homocysteine and methylmalonic acid. Clinically, it presents with the following symptoms: lower sensitivity levels to touch and light, psychosis, paresthesia, anemia, imbalance, fatigue, cognitive disturbances, difficulty remembering, and confusion. Symptoms are usually progressive and worsen over a period of time. In this case report, we present the case of a 62-year-old male with clinical symptoms of numbness and tingling in the right side of the body. The neurological presentations resembled left thalamic infarct, but the underlying reason was methylcobalamin deficiency.
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Affiliation(s)
- Varun Daiya
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND
| | - Abhinav Ahuja
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND
| | - Sunil Kumar
- Internal Medicine, Geriatric Medicine, Critical Care, and Palliative Care, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND
| | - Sourya Acharya
- Internal Medicine and Endocrinology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND
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Yadav A, Jyoti S, Mehta RK, Parajuli SB. Vitamin B12 Deficiency among Metformin Treated Type 2 Diabetic Mellitus Patients Visiting the Department of Medicine of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:861-863. [PMID: 38289733 PMCID: PMC10725234 DOI: 10.31729/jnma.8340] [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: 11/01/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction About 424.9 million people worldwide are affected by Diabetes mellitus. Prevalence among people 20-79 years old in Nepal was 4% in 2017. It is associated with microvascular and macrovascular complications such as peripheral neuropathy leading to risk of foot ulcers and amputation, and impaired sensation in their feet. The study aimed to find the prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients visiting the Department of Medicine of a tertiary care centre. Methods A descriptive cross-sectional study was conducted in a tertiary care centre between 24 May 2021 to 24 May 2022 after obtaining ethical approval from the Institutional Review Committee. Patients who visited the Department of Medicine and gave informed consent were included in the study. Patients with underlying comorbidities were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 330 patients, vitamin B12 deficiency was seen in 33 (10%) (6.76-13.24, 95% Confidence Interval). Among them, 27 (81.82%) were male and 6 (18.18%) were female. Conclusions The prevalence of vitamin B12 deficiency was found to be higher than other studies done in similar settings. Keywords diabetic neuropathy; metformin; type 2 diabetes; vitamin B12.
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Affiliation(s)
- Anil Yadav
- Department of Medicine, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal
| | - Sabita Jyoti
- Department of Community Medicine, Nepalgunj Medical College, Nepalgunj, Banke
| | - Ram Kumar Mehta
- Department of Medicine, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal
| | - Surya Bahadur Parajuli
- Department of Community Medicine, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal
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Hurley-Kim K, Vu CH, Dao NM, Tran LC, McBane S, Lee J, Sepassi A. Effect of Metformin Use on Vitamin B12 Deficiency Over Time (EMBER): A Real-World Evidence Database Study. Endocr Pract 2023; 29:862-867. [PMID: 37611751 DOI: 10.1016/j.eprac.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE To examine the extent to which metformin increases the risk of vitamin B12 deficiency and borderline deficiency over time in participants with type 2 diabetes mellitus (T2DM). METHODS Using the All of Us database, adults aged ≥18 years with T2DM and a documented history of metformin use were included for the evaluation of B12 deficiency. Those with B12 deficiency before metformin use were excluded. Adjusted logistic regression models were used to evaluate the association between metformin use and long-term metformin use (≥4 years) and the risk of B12 deficiency. We conducted a subgroup analysis comparing differences in borderline B12 deficiency in metformin and non-metformin users. RESULTS Of 36 740 participants with T2DM, 6221 (16.9%) had documented metformin use. The mean age of metformin users was 65.3 years. B12 deficiency was confirmed in 464 (7.5%) metformin users, and 1919 of 30 519 participants (6.3%) did not use metformin. Metformin users had a 4.7% increased risk of developing B12 deficiency compared with nonmetformin users (P = .44). Each additional year of metformin use was associated with 5% increased likelihood of deficiency (P < .05). Metformin use for ≥4 years resulted in a 41.0% increased odds of B12 deficiency, compared with those who used <4 years of metformin (P < .05). Metformin use increased the odds of borderline B12 deficiency by 27.0% (P < .05). CONCLUSION Long-term metformin use was associated with an increased risk of B12 deficiency in patients with T2DM, with compounding risk over time.
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Affiliation(s)
- Keri Hurley-Kim
- Department of Clinical Pharmacy Practice, University of California, Irvine School of Pharmacy & Pharmaceutical Sciences, Irvine, California
| | | | | | | | - Sarah McBane
- Department of Clinical Pharmacy Practice, University of California, Irvine School of Pharmacy & Pharmaceutical Sciences, Irvine, California
| | - Joyce Lee
- Department of Clinical Pharmacy Practice, University of California, Irvine School of Pharmacy & Pharmaceutical Sciences, Irvine, California
| | - Aryana Sepassi
- Department of Clinical Pharmacy Practice, University of California, Irvine School of Pharmacy & Pharmaceutical Sciences, Irvine, California.
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9
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Tiwari A, Kumar Singh R, Satone PD, Meshram RJ. Metformin-Induced Vitamin B12 Deficiency in Patients With Type-2 Diabetes Mellitus. Cureus 2023; 15:e47771. [PMID: 38034222 PMCID: PMC10688235 DOI: 10.7759/cureus.47771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Diabetes mellitus (DM) is the most common metabolic disease worldwide. Hence, the prevalence of the disease continues to increase across the globe. Metformin is used as a first-line oral hypoglycemic drug to keep control of type-2 DM (T2DM) in adults. Diabetic patients on metformin have been largely seen to be suffering from a deficiency of vitamin B12. It is a water-soluble vitamin mainly obtained from animal food like meat. At the basic cell level, it acts as a cofactor for enzymes essential for DNA synthesis and neuroprotection. As a result, vitamin B12 deficiency can show clinical effects such as progressive demyelination, peripheral neuropathy and haematological abnormalities (such as macrocytic anaemia and neutrophil hypersegmentation). Various studies also show a relation between vitamin B12 insufficiency and metformin-treated T2DM patients as decreased absorption of vitamin B12. There could be a severe complication of vitamin B12 deficiency in T2DM patients. The use of proton pump inhibitors, gastric bypass surgery, older patients and patients with a higher red blood cell turnover are factors that hasten the depletion of vitamin B12 reserves in the liver. Methylmalonic acid and homocysteine levels can be measured to identify vitamin B12 insufficiency at its early stage if blood vitamin B12 levels are borderline. The action of metformin on vitamin B12 absorption and its potential mechanisms of inhibition will be the main topics of discussion in this review. The review will also discuss how vitamin B12 deficiencies in T2DM patients using metformin affect their clinical results.
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Affiliation(s)
- Aakriti Tiwari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rakshit Kumar Singh
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prasiddhi D Satone
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Revat J Meshram
- Paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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10
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Henjum S. A response to 'Highlights of the importance of vitamin B 12 for neurological and cognitive function: from pregnancy to childhood'. Br J Nutr 2023; 130:1013-1014. [PMID: 36620948 PMCID: PMC10442790 DOI: 10.1017/s0007114522004020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Affiliation(s)
- Sigrun Henjum
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Postboks 4, St. Olavs plass 0130Oslo, Norway
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Yıldız O, Erdem Tilki H. Visual Evoked Potentials in Patients With Vitamin B12 Deficiency. J Clin Neurophysiol 2023; 40:535-540. [PMID: 35349545 DOI: 10.1097/wnp.0000000000000920] [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: 11/26/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the subclinical involvement of the optic nerve in asymptomatic patients with vitamin B12 deficiency using visual evoked potentials. METHODS This study included 40 asymptomatic patients diagnosed with vitamin B12 deficiency (considered as serum levels below 150 pg/mL) and a control group of 40 healthy individuals. All participants underwent a visual evoked potential examination. Routine screening for homocysteine was performed for patients with vitamin B12 deficiency. The levels of vitamin B12 and homocysteine and the presence of megaloblastic anemia were analyzed statistically compared with P100, N75, and N135 latencies and amplitudes. RESULTS The mean vitamin B12 level was 96 pg/mL in the patient group and 374 pg/mL in the control group. In the patient group, 24 (60%) patients had hyperhomocysteinemia and 8 (20%) patients had megaloblastic anemia. The P100 wave latency of patients with vitamin B12 deficiency was significantly prolonged compared with the control group ( P < 0.01). There was no significant difference in the P100 amplitude between the patient group and the control group. P100 latencies were significantly longer in patients with hyperhomocysteinemia ( P = 0.002). CONCLUSIONS Our study showed that patients with vitamin B12 deficiency may have visual evoked potential abnormalities without visual symptoms or examination findings. In addition, high homocysteine levels led to a prolonged P100 latency in the patient group independent of vitamin B12 levels.
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Affiliation(s)
- Onur Yıldız
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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12
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Craig WJ, Messina V, Rowland I, Frankowska A, Bradbury J, Smetana S, Medici E. Plant-Based Dairy Alternatives Contribute to a Healthy and Sustainable Diet. Nutrients 2023; 15:3393. [PMID: 37571331 PMCID: PMC10421454 DOI: 10.3390/nu15153393] [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: 06/30/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Plant-based foods are increasing in popularity as more and more people are concerned about personal and planetary health. The consumption of plant-based dairy alternatives (PBDAs) has assumed a more significant dietary role in populations shifting to more sustainable eating habits. Plant-based drinks (PBDs) made from soya and other legumes have ample protein levels. PBDs that are appropriately fortified have adequate levels of important vitamins and minerals comparable to dairy milk. For the PBDs examined, the greenhouse gas emissions were diminished by 59-71% per 250 mL, and the land use and eutrophication impact was markedly less than the levels displayed by dairy milk. The water usage for the oat and soya drinks, but not rice drinks, was substantially lower compared to dairy milk. When one substitutes the 250 mL serving of dairy milk allowed within the EAT Lancet Planetary Health Diet for a fortified plant-based drink, we found that the nutritional status is not compromised but the environmental footprint is reduced. Combining a nutrient density score with an environmental index can easily lead to a misclassification of food when the full nutrition profile is not utilized or only a selection of environmental factors is used. Many PBDAs have been categorized as ultra-processed foods (UPFs). Such a classification, with the implied adverse nutritional and health associations, is inconsistent with current findings regarding the nutritional quality of such products and may discourage people from transitioning to a plant-based diet with its health and environmental advantages.
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Affiliation(s)
- Winston J. Craig
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 93254, USA
| | - Virginia Messina
- Nutrition Consultant, Nutrition Matters, Inc., Pittsfield, MA 01201, USA;
| | - Ian Rowland
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DH, UK;
| | - Angelina Frankowska
- Independent Research Consultant, Environmental Sustainability Assessment, Bedford MK45 4BX, UK;
| | - Jane Bradbury
- School of Medicine, Edge Hill University, Ormskirk L39 4QP, UK;
| | - Sergiy Smetana
- German Institute of Food Technologies (DIL e.v.), 49610 Quakenbrueck, Germany;
| | - Elphee Medici
- Nutrition & Sustainable Diets Consultant, Nutrilicious Ltd., London N2 0EF, UK;
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Yamamoto A, Seki M, Koseki K, Yabuta Y, Shimizu K, Arima J, Watanabe F, Bito T. Production and characterization of cyanocobalamin-enriched tomato (Solanum lycopersicum) fruits grown using hydroponics. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:3685-3690. [PMID: 36321533 DOI: 10.1002/jsfa.12297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/03/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Vitamin B12 is an essential vitamin that is absent in plant-derived foods such as fruits and vegetables. This can result in an increased risk of developing vitamin B12 deficiency in strict vegetarians (vegans). There are several studies that have aimed to enhance nutrients in food crops. The purpose of the present study was to fortify tomato fruits with vitamin B12 (or cyanocobalamin). RESULTS Tomato plants were grown for 70 days in hydroponic culture pots and treated with 5 μm of cyanocobalamin on days 1-24 after the fruiting, and then harvested for tomato fruits. The ripened tomato fruits contained 4.0 × 10-7 g of cyanocobalamin per 100 g of dry weight and showed a significant increase in glucose and lycopene levels. CONCLUSION The present study highlights the use of a cyanocobalamin-supplementation system for the production of B12 fortified tomato fruits that can help prevent B12 deficiency in vegetarians. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Aoi Yamamoto
- Department of Agricultural Science, Graduate School of Sustainability Science, Tottori University, Tottori, Japan
| | - Mahiro Seki
- Department of Agricultural Science, Graduate School of Sustainability Science, Tottori University, Tottori, Japan
| | - Kyohei Koseki
- The United Graduate School of Agricultural Sciences and Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Yukinori Yabuta
- Department of Agricultural Science, Graduate School of Sustainability Science, Tottori University, Tottori, Japan
- The United Graduate School of Agricultural Sciences and Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Katsuhiko Shimizu
- Platform for Community-based Research and Education, Tottori University, Tottori, Japan
| | - Jiro Arima
- Department of Agricultural Science, Graduate School of Sustainability Science, Tottori University, Tottori, Japan
- The United Graduate School of Agricultural Sciences and Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Fumio Watanabe
- Department of Agricultural Science, Graduate School of Sustainability Science, Tottori University, Tottori, Japan
- The United Graduate School of Agricultural Sciences and Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Tomohiro Bito
- Department of Agricultural Science, Graduate School of Sustainability Science, Tottori University, Tottori, Japan
- The United Graduate School of Agricultural Sciences and Faculty of Agriculture, Tottori University, Tottori, Japan
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Gillies NA, Sharma P, Han SM, Teh R, Fraser K, Roy NC, Cameron-Smith D, Milan AM. The acute postprandial response of homocysteine to multivitamin and mineral supplementation with a standard meal is not impaired in older compared to younger adults. Eur J Nutr 2023; 62:1309-1322. [PMID: 36539620 DOI: 10.1007/s00394-022-03068-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE B vitamins are required for the complex regulation of homocysteine and one-carbon (1C) metabolism. Nutritional supplements are frequently used by older adults to counter nutritional inadequacies. However, the postprandial use of B vitamins from supplements in 1C metabolism may be altered with age owing to impaired nutrient absorption and metabolic regulation. Despite implications for health and nutritional status, postprandial 1C metabolite responses have not been characterised in older adults. METHODS Healthy older (n = 20, 65-76 years) and younger (n = 20, 19-30 years) participants were recruited through online and printed advertisements in Auckland, New Zealand. Participants consumed a multivitamin and mineral supplement with a standard breakfast meal. Blood samples were collected at baseline and hourly for 4 h following ingestion. Plasma 1C metabolites (betaine, choline, cysteine, dimethylglycine, glycine, methionine, serine) were quantified using liquid chromatography coupled with mass spectrometry. Serum homocysteine, folate and vitamin B12 were quantified on a Cobas e411 autoanalyzer. RESULTS Older adults had higher fasting homocysteine concentrations (older: 14.0 ± 2.9 µmol/L; younger: 12.2 ± 2.5 µmol/L; p = 0.036) despite higher folate (older: 36.7 ± 17.4 nmol/L; younger: 21.6 ± 7.6 nmol/L; p < 0.001) and similar vitamin B12 concentrations (p = 0.143) to younger adults. However, a similar postprandial decline in homocysteine was found in older and younger subjects in response to the combined meal and supplement. Except for a faster decline of cystathionine in older adults (p = 0.003), the postprandial response of other 1C metabolites was similar between young and older adults. CONCLUSION Healthy older adults appear to maintain postprandial responsiveness of 1C metabolism to younger adults, supported by a similar postprandial decline in homocysteine concentrations.
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Affiliation(s)
- Nicola A Gillies
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1142, New Zealand
- The Riddet Institute, Palmerston North, New Zealand
| | - Pankaja Sharma
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1142, New Zealand
- The Riddet Institute, Palmerston North, New Zealand
| | - Soo Min Han
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1142, New Zealand
| | - Ruth Teh
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karl Fraser
- The Riddet Institute, Palmerston North, New Zealand
- The High-Value Nutrition National Science Challenge, Auckland, New Zealand
- Grasslands Research Centre, AgResearch Ltd, Palmerston North, New Zealand
| | - Nicole C Roy
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1142, New Zealand
- The Riddet Institute, Palmerston North, New Zealand
- The High-Value Nutrition National Science Challenge, Auckland, New Zealand
- Department of Human Nutrition, The University of Otago, Dunedin, New Zealand
| | - David Cameron-Smith
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1142, New Zealand
- The Riddet Institute, Palmerston North, New Zealand
- College of Engineering, Science and Environment, The University of Newcastle, Callaghan, Australia
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Amber M Milan
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1142, New Zealand.
- The High-Value Nutrition National Science Challenge, Auckland, New Zealand.
- Grasslands Research Centre, AgResearch Ltd, Palmerston North, New Zealand.
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15
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Nutritional Care for the Older Adult. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Bell DSH. Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes. Diabetes Obes Metab 2022; 24:1423-1428. [PMID: 35491956 DOI: 10.1111/dom.14734] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/15/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022]
Abstract
Metformin blocks the absorption of vitamin B12 through a mechanism that has not been established but could be because of interference with the calcium-dependent binding of the intrinsic factor vitamin B12 complex to the cubam receptor in the terminal ileum. The subsequent deficiency of vitamin B12 may cause or accelerate distal symmetrical and autonomic neuropathy in the patient with diabetes. Several observational studies and meta-analyses have reported a significant association between metformin utilization and vitamin B12 deficiency. Prospective studies have shown that not only do metformin utilizers have lower vitamin B12 levels but they also have higher frequencies of distal symmetrical polyneuropathy and autonomic neuropathy (including cardiac denervation, which is associated with increased incidences of cardiac arrhythmias, cardiac events and mortality). Therefore, periodic monitoring of vitamin B12 is recommended in all patients who utilize metformin, particularly if metformin has been used for over 5 years at which stage hepatic stores of vitamin B12 would probably be depleted. Factors that accelerate the loss of hepatic vitamin B12 stores are proton pump inhibitors, bariatric surgery, being elderly and having an increased turnover of red blood cells. If serum vitamin B12 levels are borderline, measurement of methylmalonic acid and homocysteine levels can detect vitamin B12 deficiency at its earliest stage. Therapies include prophylactic calcium and vitamin B12 supplements, metformin withdrawal, replenishing vitamin B12 stores with intramuscular or oral vitamin B12 therapy and regular monitoring of vitamin B12 levels and vitamin B12 supplements if metformin continues to be utilized. With adequate vitamin B12 replacement, while symptoms of neuropathy may or may not improve, objective findings of neuropathy stabilize but do not improve.
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Vitamin B12 Deficiency in Patients with Diabetes on Metformin: Arab Countries. Nutrients 2022; 14:nu14102046. [PMID: 35631186 PMCID: PMC9144422 DOI: 10.3390/nu14102046] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Diabetes is a global pandemic, especially in Arab countries. Aim: The goal of this study was to review the published studies that were conducted to determine the relationship between metformin treatment for type 2 diabetes mellitus (T2DM) and vitamin B12 deficiency and to identify possible complications in this relationship. Methods: I searched for all relevant studies published in English before 2020 on the PubMed and Web of Knowledge databases using the following terms: “metformin”, “vitamin B12”, “neuropathy”, “diabetes mellitus”, and Middle Eastern countries. Results: Eleven studies were included in this review which indicated an association between taking metformin and B12 deficiency in patients with T2DM in Arab countries. This B12 deficiency was found to be negatively associated with the dose and duration of metformin therapy. The physician’s knowledge of current ADA recommendations regarding supplementation with and screening of the B12 level for T2DM patients on metformin was also found to have an effect. Conclusion: Metformin therapy is associated with B12 deficiency among people with T2DM in Arabic countries. Thus, diabetes must be managed in compliance with current guidelines and recommendations, and B12 levels must be routinely monitored, particularly in those who have been long-term takers of metformin, to ensure the suitable management of diabetes and its complications.
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Madebo T, Bemanian M, Vold JH, Chowdhury R, Aas CF, Druckrey-Fiskaaen KT, Johansson KA, Fadnes LT. Vitamin B12 Levels, Substance Use Patterns and Clinical Characteristics among People with Severe Substance Use Disorders: A Cohort Study from Western Norway. Nutrients 2022; 14:1941. [PMID: 35565908 PMCID: PMC9105230 DOI: 10.3390/nu14091941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
People with severe substance use disorder (SUD) have a higher burden of micronutrient deficiency compared with the general population. The aim of this study was to investigate vitamin B12 status and risk factors of deficiency related to substance use, opioid agonist therapy (OAT), as well as hepatitis C infection and liver fibrosis. In this prospective cohort study, participants were recruited from outpatient OAT and SUD clinics in western Norway, and assessed annually with a clinical interview and exam, including venous blood sampling. Data were collected between March 2016 and June 2020, and a total of 2451 serum vitamin B12 measurements from 672 participants were included. The median serum vitamin B12 concentration was 396 (standard deviation 198) pmol/L at baseline, 22% of the population had suboptimal levels (<300 pmol/L) and 1.2% were deficient at baseline (<175 pmol/L). No clear associations were seen with substance use patterns, but liver disease and younger age were associated with higher vitamin B12 levels. Although the majority of participants had satisfactory vitamin B12 levels, about a fifth had suboptimal levels that might or might not be adequate for metabolic needs. Future studies could investigate potential gains in interventions among patients with suboptimal but non-deficient levels.
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Affiliation(s)
- Tesfaye Madebo
- Department of Pulmonary Medicine, Stavanger University Hospital, P.O. Box 8100, 4068 Stavanger, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
| | - Mitra Bemanian
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box, 7804 Bergen, Norway
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box, 7804 Bergen, Norway
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, 45, Vijay Mandal Enclave, Kalu Sarai New Delhi, Delhi 110016, India;
| | - Christer Frode Aas
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box, 7804 Bergen, Norway
| | - Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box, 7804 Bergen, Norway
| | - Kjell Arne Johansson
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box, 7804 Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; (M.B.); (J.H.V.); (C.F.A.); (K.T.D.-F.); (K.A.J.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box, 7804 Bergen, Norway
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Vinueza Veloz AF, Carpio Arias TV, Vargas Mejía JS, Tapia Veloz EC, Piedra Andrade JS, Nicolalde Cifuentes TM, Heredia Aguirre SI, Vinueza Veloz MF. Cognitive function and vitamin B12 and D among elders: A cross-sectional study. Clin Nutr ESPEN 2022; 50:270-276. [DOI: 10.1016/j.clnesp.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
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20
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Maurya S, Tripathi AK, Verma SP, Ali W, Shukla S. Assessment of Baseline Nutritional Status, Vitamin B12, and Folate Levels in Patients with Acute Leukemia and Their Effect on Initial Treatment Outcome: A Prospective Observational Study. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1742665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Introduction Poor nutrition is a common finding in patients with acute leukemia, affecting disease progression, treatment outcome, and survival. Overall nutritional status and micronutrients status evaluation may be an important step in management of acute leukemia.
Objective The objective of this study was to investigate baseline nutritional status, vitamin B12, and folate levels in patients with acute leukemia at the time of admission before starting chemotherapy and their initial treatment outcome.
Materials and Methods This was a prospective observational study. We assessed the pretreatment nutritional status of 73 patients by body mass index (BMI), serum vitamin B12 using a two-step chemiluminescent microparticle immunoassay, and serum folate using electrochemiluminescence by Cobas e411 analyzer before initiation of induction chemotherapy and evaluated for treatment response at the end of induction chemotherapy.
Results Out of a total of 73 patients, 51 (69.8%) completed induction chemotherapy, 36 (49.3%) showed complete remission, and 15 (20.5%) were in incomplete remission. Of the remaining 22 (30.1%) patients, 11 (15.1%) died due to toxicity during therapy. The mean values of baseline BMI, serum vitamin B12, and folate was 20.46 kg/m2, 956.04, and 13.52 ng/mL, respectively. There was no significant association between vitamin B12 (p-value = 0.609) and folate (p-value = 0.404) deficiency and the response to treatment.
Conclusion Baseline nutritional status, serum vitamin B12, and folate levels have no significant role in induction outcome in response to treatment, including mortality in patients with acute leukemia.
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Affiliation(s)
- Shweta Maurya
- Department of Clinical Hematology, King George's Medical University, Chowk, Lucknow, India
| | - Anil Kumar Tripathi
- Department of Clinical Hematology, King George's Medical University, Chowk, Lucknow, India
| | | | - Wahid Ali
- Department of Pathology, King George's Medical University, Chowk, Lucknow, India
| | - Saurabh Shukla
- Department of Clinical Hematology, King George's Medical University, Chowk, Lucknow, India
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21
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Pangilinan F, Watkins D, Bernard D, Chen Y, Dong N, Wu Q, Ozel-Abaan H, Kaur M, Caggana M, Morrissey M, Browne ML, Mills JL, Van Ryzin C, Shchelochkov O, Sloan J, Venditti CP, Sarafoglou K, Rosenblatt DS, Kay DM, Brody LC. Probing the functional consequence and clinical relevance of CD320 p.E88del, a variant in the transcobalamin receptor gene. Am J Med Genet A 2022; 188:1124-1141. [PMID: 35107211 DOI: 10.1002/ajmg.a.62627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/12/2021] [Accepted: 11/20/2021] [Indexed: 11/06/2022]
Abstract
The biological and clinical significance of the p.E88del variant in the transcobalamin receptor, CD320, is unknown. This allele is annotated in ClinVar as likely benign, pathogenic, and of uncertain significance. To determine functional consequence and clinical relevance of this allele, we employed cell culture and genetic association studies. Fibroblasts from 16 CD320 p.E88del homozygotes exhibited reduced binding and uptake of cobalamin. Complete ascertainment of newborns with transiently elevated C3 (propionylcarnitine) in New York State demonstrated that homozygosity for CD320 p.E88del was over-represented (7/348, p < 6 × 10-5 ). Using population data, we estimate that ~85% of the p.E88del homozygotes born in the same period did not have elevated C3, suggesting that cobalamin metabolism in the majority of these infants with this genotype is unaffected. Clinical follow-up of 4/9 homozygous individuals uncovered neuropsychological findings, mostly in speech and language development. None of these nine individuals exhibited perturbation of cobalamin metabolism beyond the newborn stage even during periods of acute illness. Newborns homozygous for this allele in the absence of other factors are at low risk of requiring clinical intervention, although more studies are required to clarify the natural history of various CD320 variants across patient populations.
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Affiliation(s)
- Faith Pangilinan
- Genetics and Environment Interaction Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - David Watkins
- Department of Human Genetics, McGill University and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - David Bernard
- Genetics and Environment Interaction Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Yue Chen
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Soochow University, Suzhou, China
| | - Ningzheng Dong
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Soochow University, Suzhou, China.,MOH Key Laboratory of Thrombosis and Hemostasis, Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qingyu Wu
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Soochow University, Suzhou, China
| | - Hatice Ozel-Abaan
- Genetics and Environment Interaction Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Manjit Kaur
- Genetics and Environment Interaction Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Michele Caggana
- Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Mark Morrissey
- Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Marilyn L Browne
- Birth Defects Registry, New York State Department of Health, Albany, New York and University at Albany School of Public Health, Rensselaer, New York, USA
| | - James L Mills
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Carol Van Ryzin
- Organic Acid Research Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Oleg Shchelochkov
- Organic Acid Research Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Jennifer Sloan
- Organic Acid Research Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Charles P Venditti
- Organic Acid Research Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
| | - Kyriakie Sarafoglou
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - David S Rosenblatt
- Department of Human Genetics, McGill University and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Division of Medical Biochemistry, Department of Specialized Medicine, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Denise M Kay
- Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Lawrence C Brody
- Genetics and Environment Interaction Section, National Human Genome Research Institute, National Institutes of Health, Maryland, USA
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Uche IE, Akinbami AA, Bamiro AR, Suleiman MA, Benjamin A, Kareem OA, Odebiyi AH, Oduniyi AO. Assessment of megaloblastic anemia in geriatrics in Lagos State, Nigeria. THE EGYPTIAN JOURNAL OF HAEMATOLOGY 2022. [DOI: 10.4103/ejh.ejh_64_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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23
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Dhiman P, Bharadwaj B, Veena P, Rajendiran S. Polymorphisms in vitamin B12 and folate metabolising genes and their association with adverse pregnancy outcome: secondary analysis of a population based case control study. J OBSTET GYNAECOL 2021; 42:962-967. [PMID: 34907829 DOI: 10.1080/01443615.2021.1979948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Vitamin B12 and folate deficiency leads to accumulation of homocysteine that increases the risk of adverse pregnancy outcomes like preterm birth and low birth weight (LBW) of the neonate. We explored the association of genetic variants of key vitamin B12 and folate metabolising enzymes (MTHFR C677T and A1298C, MTR A2756G, TCN-2 C776G) with preterm birth and LBW in South Indian women. MTHFR A1298C heterozygotes (AC) were at higher risk for preterm delivery, whereas TCN-2 C776G heterozygotes (CG) were at higher risk for both preterm delivery and LBW. MTHFR C677T, A1298C and MTR A2756G haplotype CAG was protective for preterm delivery (p=.036, OR = 0.475; 95% CI: 0.233-0.97), whereas, haplotype CCG increasing the risk of preterm birth by 1.8 folds (p=.018, OR = 1.81; 95% CI: 1.09-2.98). These results underscore the significance of vitamin B12 and folate in the pathophysiology of preterm birth and LBW.Impact StatementWhat is already known on this subject? Polymorphisms of vitamin B12 and folate metabolising genes have been reported to influence preterm birth and LBW, but the reports are not consistent.What do the results of this study add? We observed a relationship of MTHFR A1298C and TCN-2 C776G with preterm birth, and significant association of TCN-2 C776G with LBW in infants.What are the implications of these findings for clinical practice and/or further research? Identification of women carrying these polymorphic risk alleles may benefit from early nutritional modifications.
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Affiliation(s)
- Pooja Dhiman
- Department of Biochemistry, JIPMER, Puducherry, India
| | | | - P Veena
- Department of Obstetrics & Gynecology, JIPMER, Puducherry, India
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Coelho SC, Laget S, Benaut P, Rocha F, Estevinho BN. A new approach to the production of zein microstructures with vitamin B12, by electrospinning and spray drying techniques. POWDER TECHNOL 2021. [DOI: 10.1016/j.powtec.2021.06.056] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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25
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Kesserwani GW, de Oliveira NC, de Oliveira TC, Batista TBD, Chaiben CL, Machado MÂN, de Lima AAS. The potential impact of vegetarian diet on the oral mucosa: A preliminary cytopathological study. J Formos Med Assoc 2021; 121:824-831. [PMID: 34690029 DOI: 10.1016/j.jfma.2021.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/29/2020] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/PURPOSE Actually, many individuals have opted for the vegetarian diet. The objective of this study was to evaluate the impact of the vegetarian diet on the oral epithelium through cytopathology. METHODS Oral smears of the tongue and buccal mucosa of 60 adult subjects (30 vegetarians and 30 controls) were collected. Smears were analyzed morphologically and for three morphometric variables: nucleus area (NA), cytoplasm area (CA) and nucleus/cytoplasm ratio. RESULTS Vegetarians were classified as ovolactovegetarian (53.3%), vegans (30%) and strict vegetarians (16.7%). The NA and CA of the epithelial cells of vegetarian individuals were smaller when compared to controls both in the region of the buccal mucosa and tongue. However, there was no statistically significant difference according to the Student's t-test. For the NA/CA ratio, cells in the oral mucosa region were larger for vegetarians compared to controls. For the tongue, both groups had the same value and the Mann-Whitney U test confirmed that there is no difference between the groups for this cytomorphometric variable. RESULTS Vegan individuals had a smaller (but not larger) area of CA when compared to controls for the tongue (vegan = 2604.2 ± 179.2 versus control = 3256.7 ± 463.8 p = 0.013). Most smears showed normal epithelial cells and some individuals had changes of an inflammatory nature, mainly in the tongue. CONCLUSION Despite the small sample size, the results of this study raise the hypothesis that the vegetarian diet (especially the vegan diet) can compromise the thickness of the oral epithelium of the tongue.
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Affiliation(s)
| | | | | | | | - Cassiano Lima Chaiben
- School of Life's Sciences, Pontifícia Universidade Católica Do Paraná, Curitiba, Brazil
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Infante M, Leoni M, Caprio M, Fabbri A. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. World J Diabetes 2021; 12:916-931. [PMID: 34326945 PMCID: PMC8311483 DOI: 10.4239/wjd.v12.i7.916] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/21/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023] Open
Abstract
To date, metformin remains the first-line oral glucose-lowering drug used for the treatment of type 2 diabetes thanks to its well-established long-term safety and efficacy profile. Indeed, metformin is the most widely used oral insulin-sensitizing agent, being prescribed to more than 100 million people worldwide, including patients with prediabetes, insulin resistance, and polycystic ovary syndrome. However, over the last decades several observational studies and meta-analyses have reported a significant association between long-term metformin therapy and an increased prevalence of vitamin B12 deficiency. Of note, evidence suggests that long-term and high-dose metformin therapy impairs vitamin B12 status. Vitamin B12 (also referred to as cobalamin) is a water-soluble vitamin that is mainly obtained from animal-sourced foods. At the cellular level, vitamin B12 acts as a cofactor for enzymes that play a critical role in DNA synthesis and neuroprotection. Thus, vitamin B12 deficiency can lead to a number of clinical consequences that include hematologic abnormalities (e.g., megaloblastic anemia and formation of hypersegmented neutrophils), progressive axonal demyelination and peripheral neuropathy. Nevertheless, no definite guidelines are currently available for vitamin B12 deficiency screening in patients on metformin therapy, and vitamin B12 deficiency remains frequently unrecognized in such individuals. Therefore, in this "field of vision" article we propose a list of criteria for a cost-effective vitamin B12 deficiency screening in metformin-treated patients, which could serve as a practical guide for identifying individuals at high risk for this condition. Moreover, we discuss additional relevant topics related to this field, including: (1) The lack of consensus about the exact definition of vitamin B12 deficiency; (2) The definition of reliable biomarkers of vitamin B12 status; (3) Causes of vitamin B12 deficiency other than metformin therapy that should be identified promptly in metformin-treated patients for a proper differential diagnosis; and (4) Potential pathophysiological mechanisms underlying metformin-induced vitamin B12 deficiency. Finally, we briefly review basic concepts related to vitamin B12 supplementation for the treatment of vitamin B12 deficiency, particularly when this condition is induced by metformin.
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Affiliation(s)
- Marco Infante
- UniCamillus, Saint Camillus International University of Health Sciences, Rome 00131, Italy
- Diabetes Research Institute Federation (DRIF), Division of Endocrinology and Diabetes, CTO Alesini Hospital, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00145, Italy
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome 00145, Italy
| | - Martina Leoni
- Diabetes Research Institute Federation (DRIF), Division of Endocrinology and Diabetes, CTO Alesini Hospital, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00145, Italy
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome 00166, Italy
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, Rome 00166, Italy
| | - Andrea Fabbri
- Diabetes Research Institute Federation (DRIF), Division of Endocrinology and Diabetes, CTO Alesini Hospital, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00145, Italy
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Obesity and aging: Molecular mechanisms and therapeutic approaches. Ageing Res Rev 2021; 67:101268. [PMID: 33556548 DOI: 10.1016/j.arr.2021.101268] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/19/2021] [Accepted: 02/02/2021] [Indexed: 02/08/2023]
Abstract
The epidemic of obesity is a major challenge for health policymakers due to its far-reaching effects on population health and potentially overwhelming financial burden on healthcare systems. Obesity is associated with an increased risk of developing acute and chronic diseases, including hypertension, stroke, myocardial infarction, cardiovascular disease, diabetes, and cancer. Interestingly, the metabolic dysregulation associated with obesity is similar to that observed in normal aging, and substantial evidence suggests the potential of obesity to accelerate aging. Therefore, understanding the mechanism of fat tissue dysfunction in obesity could provide insights into the processes that contribute to the metabolic dysfunction associated with the aging process. Here, we review the molecular and cellular mechanisms underlying both obesity and aging, and how obesity and aging can predispose individuals to chronic health complications. The potential of lifestyle and pharmacological interventions to counter obesity and obesity-related pathologies, as well as aging, is also addressed.
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Sleep Quality Is Associated with Vitamin B12 Status in Female Arab Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094548. [PMID: 33922970 PMCID: PMC8123316 DOI: 10.3390/ijerph18094548] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/16/2021] [Accepted: 04/23/2021] [Indexed: 12/04/2022]
Abstract
Studies have explored how vitamin B12 status affects sleep among elders and children, but this remains to be investigated among young adults. We used the Pittsburgh Sleep Quality Index (PSQI) to assess the association between serum vitamin B12 and sleep among female college students in Saudi Arabia. In this cross-sectional study, we enrolled 355 participants (age (years), 20.7 ± 1.5; body mass index, 23.6 kg/m2 ± 5.2) at King Saud University, Riyadh, Saudi Arabia. Fasting blood samples were analyzed regarding the serum vitamin B12 and blood lipids. Anthropometric, socio-demographic, clinical history, stress, physical activity, and dietary data were collected. We assessed the sleep statuses of the participants using the PSQI. Around 72% of the participants were “poor” sleepers (PSQI > 5). Subgroup analysis within the tertiles showed that participants with higher vitamin B12 in the second and third tertiles reported better scores for sleep quality (B ± SE = −12.7 ± 5.6, p = 0.03; B ± SE = −32.7 ± 16.4, p = 0.05, respectively) and also reported a lower use of sleep medication (B ± SE = −21.2 ± 9.9, p = 0.03, in the second tertile only), after adjusting for the waist–hip ratio and stress. However, sleep was not found to be directly associated with either serum vitamin B12 or dietary vitamin B12. In conclusion, the serum vitamin B12 results show that the participants with higher vitamin B12 in the second and third tertiles reported better scores on the sleep quality scale and a lower use of sleep medication. However, no such associations were observed with the overall PSQI. More studies with larger sample sizes are needed to establish a direct relationship between sleep and vitamin B12.
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Abstract
BACKGROUND Rwanda's commitment to reducing malnutrition is evident in their multisectoral nutrition policy and wide array of nutrition partners. However, the prevalence of micronutrient deficiencies and the suitability of current strategies to address existing deficiencies is unclear. OBJECTIVE To review the available evidence related to the prevalence of micronutrient deficiencies across the life cycle and strategies in place to address them. METHODS We reviewed scientific and grey literature on nutritional problems in Rwanda, emphasizing micronutrient deficiencies and anemia, and current strategies to address micronutrient malnutrition. RESULTS Overall, there is scant evidence related to the types and prevalence of micronutrient deficiencies among populations across the life cycle in Rwanda. Existing evidence is primarily limited to outdated or small regional surveys focusing on iron or vitamin A among women and young children. Surveys have assessed the prevalence of anemia and indicate that anemia is very high among young children and moderately high among other age-groups. However, there are limited data on the context-specific causes of anemia in Rwanda across population groups. Current nutrition strategies mainly target women and young children and are primarily designed to reduce vitamin A deficiency and/or anemia caused by micronutrient deficiencies. CONCLUSIONS Rwanda has many nutrition programs in place that address micronutrient deficiencies in young children and a few for women of reproductive age. However, gaps exist in knowledge of the extent of different types of micronutrient deficiencies among all populations across the life cycle and whether the delivery of nutrients through current programs is meeting actual needs.
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Affiliation(s)
| | - Deanna K Olney
- 8357International Food Policy Research Institute, Washington, DC, USA
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Maternal vitamin B12 deficiency and perinatal outcomes in southern India. PLoS One 2021; 16:e0248145. [PMID: 33822790 PMCID: PMC8023483 DOI: 10.1371/journal.pone.0248145] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background Vitamin B12 deficiency during pregnancy has been associated with adverse maternal and infant health outcomes. Few prospective studies have investigated vitamin B12 status early in pregnancy, and its links to infant vitamin B12 status, particularly in India where the burden of vitamin B12 deficiency is estimated to be the highest globally. The objective of this study was to examine the associations of maternal vitamin B12 biomarkers with neonatal vitamin B12 status. Methods Pregnant women (~12 weeks’ gestation) were enrolled in a perinatal cohort study in Bangalore, India. Total vitamin B12, methylmalonic acid (MMA), and homocysteine concentrations were evaluated in maternal samples at enrollment and in neonates at birth using cord blood. Linear and binomial regression models were used to evaluate the associations of maternal vitamin B12 biomarkers with neonatal vitamin B12 status and perinatal outcomes. Results A total of 63.2% of women had vitamin B12 deficiency (<148 pmol/L), 87.2% had vitamin B12 insufficiency (<221 pmol/L), and 47.3% had impaired vitamin B12 status (vitamin B12<148 pmol/L and MMA>0.26μmol/L) at enrollment; 40.8% of neonates had vitamin B12 deficiency, 65.6% were insufficiency, and 38.1% had impaired vitamin B12 status at birth. Higher maternal vitamin B12 concentrations at enrollment were associated with increased neonatal vitamin B12 concentrations (β(SE): 0.40 (0.05); p<0.0001) and lower risk of neonatal vitamin B12 deficiency (Risk Ratio [RR]: 0.53; 95% CI: [0.43, 0.65]; p<0.0001). Maternal vitamin B12 deficiency (RR: 1.97 [1.43, 2.71]; p<0.001), insufficiency (RR: 2.18 [1.23, 3.85]; p = 0.007), and impaired vitamin B12 status (RR: 1.49 [1.13, 1.97]; p = 0.005) predicted a two-fold increase in the risk of neonatal vitamin B12 deficiency at birth. Conclusions The prevalence of vitamin B12 deficiency was high early in pregnancy and predicted neonatal vitamin B12 status. Future research is needed to determine the role of vitamin B12 in the development of pregnancy and infant outcomes, and to inform screening and interventions to improve maternal and child health.
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Boachie J, Adaikalakoteswari A, Goljan I, Samavat J, Cagampang FR, Saravanan P. Intracellular and Tissue Levels of Vitamin B12 in Hepatocytes Are Modulated by CD320 Receptor and TCN2 Transporter. Int J Mol Sci 2021; 22:3089. [PMID: 33803025 PMCID: PMC8002616 DOI: 10.3390/ijms22063089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 11/17/2022] Open
Abstract
The liver mass constitutes hepatocytes expressing receptors for vitamin B12 (B12)-bound transporters in circulation. However, intrahepatic and circulating B12 interrelationship levels remain unclear. We assessed the intracellular B12 levels at various circulating B12 concentrations in human HepG2 cell-line and liver tissue levels of B12 in the C57BL/6 mouse model. In HepG2 cells treated with a range of B12 concentrations, the intracellular and circulatory B12 levels, transcript and protein levels of B12 receptor (CD320) and transporter (TCN2) were determined using immunoassays, qRT-PCR and Western blot, respectively. Similar assessments were done in plasma and liver tissue of C57BL/6 mice, previously fed a diet of either a high or low B12 (30.82 µg B12/kg and 7.49 µg B12/kg, respectively) for 8-10 weeks. The physiological B12 status (0.15-1 nM) resulted in increased levels of intracellular B12 in HepG2 cells compared to supraphysiological levels of B12 (>1 nM). Gene and protein expression of CD320 and TCN2 were also higher at physiological levels of B12. Progressively increasing extracellular B12 to supraphysiological levels led to relative decreased levels of intracellular B12, lower expression of gene and protein levels of CD320 and TCN2. Similar results were observed in liver tissue from mice fed on a low B12 diet verses high B12 diet. These findings suggest that unlike supraphysiological B12, physiological levels of B12 in the extracellular media or circulation accelerates active transport of B12, and expression of CD320 and TCN2, resulting in higher relative uptake of B12 in hepatocytes.
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Affiliation(s)
- Joseph Boachie
- Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK; (J.B.); (J.S.)
| | - Antonysunil Adaikalakoteswari
- Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK; (J.B.); (J.S.)
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Ilona Goljan
- Diabetes Centre, George Eliot Hospital NHS Trust College Street, Nuneaton CV10 7DJ, UK;
| | - Jinous Samavat
- Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK; (J.B.); (J.S.)
| | - Felino R. Cagampang
- Institute of Developmental Sciences, University of Southampton, Faculty of Medicine, Southampton General Hospital, Southampton SO16 6YD, UK;
| | - Ponnusamy Saravanan
- Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK; (J.B.); (J.S.)
- Diabetes Centre, George Eliot Hospital NHS Trust College Street, Nuneaton CV10 7DJ, UK;
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
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Vegan Diet Health Benefits in Metabolic Syndrome. Nutrients 2021; 13:nu13030817. [PMID: 33801269 PMCID: PMC7999488 DOI: 10.3390/nu13030817] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/09/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022] Open
Abstract
Plant-based diets (PBDs) are increasingly consumed by the Italian population and around the world. In particular, among PBDs, the vegan diet is a food pattern characterized by the exclusion of all animal-origin foods. What drives people to adopt this model are mainly ethical, health and environmental reasons. A vegan diet, if well-balanced and varied, can help in achieving and maintaining an optimal state of health. However, this nutritional approach, if not well-balanced, can cause deficiencies in proteins, ω-3 fatty acids, iron, vitamin D and calcium, zinc, iodine and, above all, vitamin B12. Oral food supplements especially fortified foods are recommended in these cases to restore the nutritional deficiencies. A vegan diet generally reduces the risk of developing chronic non-communicable degenerative diseases, such as metabolic syndrome (MetS) and, in addition, requires fewer natural resources for food production than an omnivorous diet. The aim of this review is to analyze the possible impact of the vegan diet on MetS onset and its treatment.
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Tribble JR, Hui F, Jöe M, Bell K, Chrysostomou V, Crowston JG, Williams PA. Targeting Diet and Exercise for Neuroprotection and Neurorecovery in Glaucoma. Cells 2021; 10:295. [PMID: 33535578 PMCID: PMC7912764 DOI: 10.3390/cells10020295] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 12/11/2022] Open
Abstract
Glaucoma is a leading cause of blindness worldwide. In glaucoma, a progressive dysfunction and death of retinal ganglion cells occurs, eliminating transfer of visual information to the brain. Currently, the only available therapies target the lowering of intraocular pressure, but many patients continue to lose vision. Emerging pre-clinical and clinical evidence suggests that metabolic deficiencies and defects may play an important role in glaucoma pathophysiology. While pre-clinical studies in animal models have begun to mechanistically uncover these metabolic changes, some existing clinical evidence already points to potential benefits in maintaining metabolic fitness. Modifying diet and exercise can be implemented by patients as an adjunct to intraocular pressure lowering, which may be of therapeutic benefit to retinal ganglion cells in glaucoma.
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Affiliation(s)
- James R. Tribble
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, 171 64 Stockholm, Sweden; (J.R.T.); (M.J.)
| | - Flora Hui
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia; (F.H.); (J.G.C.)
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, VIC 3053, Australia
| | - Melissa Jöe
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, 171 64 Stockholm, Sweden; (J.R.T.); (M.J.)
| | - Katharina Bell
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 168751, Singapore; (K.B.); (V.C.)
| | - Vicki Chrysostomou
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 168751, Singapore; (K.B.); (V.C.)
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Jonathan G. Crowston
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia; (F.H.); (J.G.C.)
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 168751, Singapore; (K.B.); (V.C.)
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Pete A. Williams
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, 171 64 Stockholm, Sweden; (J.R.T.); (M.J.)
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Nalder L, Zheng B, Chiandet G, Middleton LT, de Jager CA. Vitamin B12 and Folate Status in Cognitively Healthy Older Adults and Associations with Cognitive Performance. J Nutr Health Aging 2021; 25:287-294. [PMID: 33575718 DOI: 10.1007/s12603-020-1489-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To determine prevalence of vitamin B12 and folate deficiency and associations with cognitive performance in participants recruited for the Cognitive Health in Ageing Register: Investigational, Observational, and Trial Studies in Dementia Research: Prospective Readiness cOhort Study (CHARIOTPRO) SubStudy (CPRO-SS). DESIGN Cross-sectional analysis of data collected in the screening phase for the CPRO-SS. SETTING Participants were recruited from the Chariot Register at Imperial College London comprising approximately 39,000 community dwelling volunteers. PARTICIPANTS Community dwelling individuals aged 60-85 years with B vitamin biomarker measures available were included (n=1946). After medical history and other exclusions, 1347 cognitively healthy participants were included for analysis of cognitive data. MEASUREMENTS Cognitive status was assessed with the Repeatable Battery for Neuropsychological Status (RBANS). Assays included vitamin B12 and folate, followed by serum methylmalonic acid and homocysteine levels for those with low vitamin B12. Gender-specific linear regression analysis was performed for associations between cognition and biomarkers. Non-gender specific regression for groups graded by B vitamin deficiency severity were also performed. RESULTS Vitamin B12 deficiency (<148pmol/L) was found in 17.2% of individuals and folate deficiency (<10nmol/L) in 1% of our participants. Low vitamin B12 was associated with poorer memory (p<0.03) in men. A high BMI predicted poorer attention and visuospatial indices (p<0.05). A regression analysis by B12 level revealed associations with poorer attention (β -6.46; p=0.004) for the deficient group and with immediate memory (β -2.99; p=0.019) for those categorised as severely deficient. CONCLUSION Older men and women are prone to vitamin B12 deficiency with associated subtle and different domain-specific disruptive effects in measures of memory and attention. Elevated homocysteine and methylmalonic acid contributed to poorer cognitive performance. Novel groups at particular risk of cognitive deficit were identified for future interventional studies in this field.
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Affiliation(s)
- L Nalder
- Celeste A. de Jager, Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, United Kingdom, , Tel: +44 020 33110323
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Devi S, Pasanna RM, Shamshuddin Z, Bhat K, Sivadas A, Mandal AK, Kurpad AV. Measuring vitamin B-12 bioavailability with [13C]-cyanocobalamin in humans. Am J Clin Nutr 2020; 112:1504-1515. [PMID: 32844171 DOI: 10.1093/ajcn/nqaa221] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/10/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Vitamin B-12 deficiency is widespread in many parts of the world, affecting all age groups and increasing with age. It is primarily due to a low intake of animal source foods or malabsorption. The measurement of bioavailability of vitamin B-12 is etiologically important in deficiency but is limited due to the use of radioactive isotopes like [57Co]- or [14C]-cyanocobalamin. OBJECTIVES The aim of this study was to measure the bioavailability of [13C]-cyanocobalamin in humans and to assess the effect of parenteral replenishment of vitamin B-12 on the bioavailability. METHODS We synthesized a stable isotope-labeled vitamin B-12, [13C]-cyanocobalamin, using Salmonella enterica by providing [13C2]-ethanolamine as a sole carbon source. After purification and mass spectrometry-based characterization, its oral bioavailability was measured in the fasted state with high and low oral doses, before and after parenteral replenishment of vitamin B-12 stores, from the kinetics of its plasma appearance in a 2-compartment model. RESULTS [13C]-cyanocobalamin was completely decyanated to [13C]-methylcobalamin describing metabolic utilization, and its plasma appearance showed early and late absorption phases. At a low dose of 2.3 µg, the mean bioavailability was 46.2 ± 12.8 (%, mean ± SD, n = 11). At a higher dose of 18.3 µg, the mean bioavailability was 7.6 ± 1.7 (%, mean ± SD, n = 4). Parenteral replenishment of the vitamin B-12 store in deficient individuals prior to the measurement resulted in a 1.9-fold increase in bioavailability. CONCLUSIONS Vitamin B-12 bioavailability is dose dependent and at a low dose that approximates the normal daily requirement (46%). The stable isotope method described here could be used to define the etiology of deficiency and to inform the dietary requirement in different physiologic states as well as the dose required for supplementation and food fortification. This trial was registered at the Clinical Trials Registry of India as CTRI/2018/04/012957.
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Affiliation(s)
- Sarita Devi
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Roshni M Pasanna
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Zeeshan Shamshuddin
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Kishor Bhat
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Ambily Sivadas
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Amit K Mandal
- Division of Clinical Proteomics, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Anura V Kurpad
- Department of Physiology, St. John's Medical College, St. John's National Academy of Health Sciences, Bangalore, India
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Pramanik S, Roy S, Bhandari S. The quantum dot-FRET-based detection of vitamin B12 at a picomolar level. NANOSCALE ADVANCES 2020; 2:3809-3814. [PMID: 36132751 PMCID: PMC9417707 DOI: 10.1039/d0na00540a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/10/2020] [Indexed: 06/16/2023]
Abstract
Herein we report the picomolar level detection of vitamin B12 (VB12) using orange-red emitting ligand-free Mn2+-doped ZnS quantum dots (QDs; λ em = 587 nm) in an aqueous dispersion. Sensing was achieved following the quenching of the luminescence of the Mn2+-doped ZnS QDs with an increasing concentration of VB12. The Stern-Volmer constant was determined to be 5.2 × 1010 M-1. Importantly, the Mn2+-doped ZnS QDs exhibited high sensitivity towards VB12, with a limit of detection as low as 1.15 ± 0.06 pM (in the linear range of 4.9-29.4 pM) and high selectivity in the presence of interfering amino acids, metal ions, and proteins. Notably, a Förster resonance energy transfer (FRET) mechanism was primarily proposed for the observed quenching of luminescence of Mn2+-doped ZnS QDs upon the addition of VB12. The Förster distance (R o) and energy transfer efficiency (E) were calculated to be 2.33 nm and 79.3%, respectively. Moreover, the presented QD-FRET-based detection may bring about new avenues for future biosensing applications.
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Affiliation(s)
- Sabyasachi Pramanik
- Department of Chemistry, National Institute of Technology Sikkim Sikkim-737139 India
| | - Shilaj Roy
- Centre for Nanotechnology, Indian Institute of Technology Guwahati Assam-781039 India
| | - Satyapriya Bhandari
- Physics Discipline, Indian Institute of Technology Gandhinagar Gujrat-382355 India
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Gomes AP, Ilter D, Low V, Endress JE, Fernández-García J, Rosenzweig A, Schild T, Broekaert D, Ahmed A, Planque M, Elia I, Han J, Kinzig C, Mullarky E, Mutvei AP, Asara J, de Cabo R, Cantley LC, Dephoure N, Fendt SM, Blenis J. Age-induced accumulation of methylmalonic acid promotes tumour progression. Nature 2020; 585:283-287. [PMID: 32814897 PMCID: PMC7785256 DOI: 10.1038/s41586-020-2630-0] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/10/2020] [Indexed: 12/21/2022]
Abstract
From age 65 onwards, the risk of cancer incidence and associated mortality is substantially higher1–6. Nonetheless, our understanding of the complex relationship between age and cancer is still in its infancy2,3,7,8. For decades, this link has largely been attributed to increased exposure time to mutagens in older individuals. However, this view does not account for the well-established role of diet, exercise and small molecules that target the pace of metabolic aging9–12. Here, we show that metabolic alterations that occur with age can render a systemic environment favorable to progression and aggressiveness of tumors. Specifically, we show that methylmalonic acid (MMA), a by-product of propionate metabolism, is significantly up-regulated in the serum of older people, and functions as a mediator of tumor progression. We traced this to MMA’s ability to induce SOX4 and consequently eliciting a transcriptional reprogramming that can endow cancer cells with aggressive properties. Thus, accumulation of MMA represents a novel link between aging and cancer progression, implicating MMA as a novel therapeutic target for advanced carcinomas.
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Affiliation(s)
- Ana P Gomes
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA. .,Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA. .,Department of Molecular Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA.
| | - Didem Ilter
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA.,Department of Molecular Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Vivien Low
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,The Biochemistry, Structural, Developmental, Cell and Molecular Biology Allied PhD Program, Weill Cornell Medicine, New York, NY, USA
| | - Jennifer E Endress
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,The Biochemistry, Structural, Developmental, Cell and Molecular Biology Allied PhD Program, Weill Cornell Medicine, New York, NY, USA
| | - Juan Fernández-García
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium.,Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Adam Rosenzweig
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA
| | - Tanya Schild
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,The Biochemistry, Structural, Developmental, Cell and Molecular Biology Allied PhD Program, Weill Cornell Medicine, New York, NY, USA
| | - Dorien Broekaert
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium.,Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Adnan Ahmed
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Biochemistry, Weill Cornell Medicine, New York, NY, USA
| | - Melanie Planque
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium.,Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Ilaria Elia
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium.,Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Julie Han
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA
| | - Charles Kinzig
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Weill Cornell Medicine/Rockefeller University/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Edouard Mullarky
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Anders P Mutvei
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA
| | - John Asara
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Rafael de Cabo
- Laboratory of Experimental Gerontology, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Lewis C Cantley
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Noah Dephoure
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.,Department of Biochemistry, Weill Cornell Medicine, New York, NY, USA
| | - Sarah-Maria Fendt
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium.,Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - John Blenis
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA. .,Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA. .,Department of Biochemistry, Weill Cornell Medicine, New York, NY, USA.
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38
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Groenendijk I, Chan R, Woo J, Ong S, Parikh P, Bragt MCE, de Groot LCPGM. A Combined Nutrition and Exercise Intervention Influences Serum Vitamin B-12 and 25-Hydroxyvitamin D and Bone Turnover of Healthy Chinese Middle-Aged and Older Adults. J Nutr 2020; 150:2112-2119. [PMID: 32588047 PMCID: PMC7398768 DOI: 10.1093/jn/nxaa149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/09/2020] [Accepted: 05/04/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hong Kong faces several public health problems including malnutrition and osteoporosis. Considering the typical Chinese diet and overall low physical activity levels of Chinese adults, timely interventions to improve nutritional status and bone health are needed. OBJECTIVES We examined the effects of a nutrition plus exercise intervention on serum vitamin B-12 and 25-hydroxyvitamin D [25(OH)D], bone turnover markers, and parathyroid hormone (PTH) concentrations in apparently healthy Chinese middle-aged and older adults. METHODS In this 24-wk randomized controlled trial, 180 Chinese adults (85 women, mean ± SD age: 61 ± 6 y) were randomly assigned to receive a fortified milk supplement (2 × 30 g/d) and an exercise program (2 × 1 h/wk including resistance, balance, and aerobic training) or no intervention. The primary outcome was physical performance. In this article we analyzed the secondary outcomes serum vitamin B-12 and 25(OH)D concentrations, assessed at baseline, 12 wk, and 24 wk. Also, bone turnover markers and PTH concentrations were studied. Linear mixed models evaluated group differences over time. RESULTS A significant time × group interaction (P < 0.001) was found for serum vitamin B-12 and 25(OH)D concentrations and the bone turnover markers, but not for serum PTH concentrations (P = 0.09). The intervention increased mean ± SD vitamin B-12 concentrations from baseline (345 ± 119 pmol/L) to 24 wk (484 ± 136 pmol/L), whereas concentrations remained stable within the control. For 25(OH)D concentrations, the intervention group had a greater increase from baseline (54.7 ± 14.2 nmol/L) to 24 wk (80.1 ± 19.2 nmol/L) than the control (60.6 ± 15.2 compared with 65.6 ± 14.6 nmol/L). The ratio of the net effect of bone formation and resorption was greater in the intervention group, suggesting less bone remodeling, irrespective of sex. CONCLUSIONS A fortified milk supplement and exercise intervention successfully improved vitamin B-12 and 25(OH)D concentrations as well as the balance of bone turnover markers of Chinese middle-aged and older adults.This trial was registered at trialregister.nl as NTR6214.
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Affiliation(s)
| | - Ruth Chan
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jean Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | | | | | - Lisette C P G M de Groot
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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Sugawara K, Okada Y, Hirota Y, Sakaguchi K, Ogawa W. Relationship between metformin use and vitamin B 12 status in patients with type 2 diabetes in Japan. J Diabetes Investig 2020; 11:917-922. [PMID: 31868971 PMCID: PMC7378433 DOI: 10.1111/jdi.13200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/09/2019] [Accepted: 12/15/2019] [Indexed: 12/18/2022] Open
Abstract
AIMS/INTRODUCTION Metformin therapy has been associated with vitamin B12 (VB12) deficiency, but information regarding this adverse effect in Asian populations is limited. We have now examined the relationship between metformin use and VB12 status in individuals with type 2 diabetes mellitus in Japan. MATERIALS AND METHODS This cross-sectional study was carried out with type 2 diabetes mellitus patients treated (Met group, n = 122) or not treated (control group, n = 63) with metformin. The primary end-point was the difference in the serum concentration of homocysteine, a marker of VB12 activity, between the two groups. The serum concentrations of VB12, blood hemoglobin level and mean corpuscular volume were also compared between the groups. Subset analysis was carried out with individuals aged ≥70 years. The potential correlation between the daily dose or duration of metformin treatment and the other measured parameters was also examined. RESULTS The level of homocysteine, as well as the VB12 level, hemoglobin concentration and mean corpuscular volume, did not differ significantly between the control and treated with metformin groups. The level of homocysteine was positively and that of VB12 negatively correlated with the daily dose of metformin. Among elderly individuals, the hemoglobin level was significantly lower in the treated with metformin group than in the control group, although the mean corpuscular volume was similar in the two groups. CONCLUSIONS The risk of VB12 deficiency during metformin treatment appears to be low in Japanese type 2 diabetes mellitus patients. However, high doses of metformin might result in a moderate decrease in the circulating VB12 level, as well as in anemia in elderly individuals.
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Affiliation(s)
- Kenji Sugawara
- Division of Diabetes and EndocrinologyKobe University Graduate School of MedicineKobeJapan
| | - Yuko Okada
- Division of Diabetes and EndocrinologyKobe University Graduate School of MedicineKobeJapan
| | - Yushi Hirota
- Division of Diabetes and EndocrinologyKobe University Graduate School of MedicineKobeJapan
| | - Kazuhiko Sakaguchi
- Division of General Internal MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Wataru Ogawa
- Division of Diabetes and EndocrinologyKobe University Graduate School of MedicineKobeJapan
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Duplessis M, Pellerin D, Girard CL, Santschi DE, Soyeurt H. Short communication: Potential prediction of vitamin B 12 concentration based on mid-infrared spectral data using Holstein Dairy Herd Improvement milk samples. J Dairy Sci 2020; 103:7540-7546. [PMID: 32505395 DOI: 10.3168/jds.2019-17758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/04/2020] [Indexed: 11/19/2022]
Abstract
The purpose of this study was (1) to predict the quantitative concentration of vitamin B12 in milk using mid-infrared (MIR) spectrometry, and (2) to evaluate the potential of MIR spectra to discriminate different clusters of records based on their B12 concentration. Milk samples were collected from 4,340 Holstein cows between 3 and 592 d in milk and located in 100 herds. Samples were taken using in-line milk meters and divided into 2 aliquots: one for MIR spectrometry and the other for B12 concentration reference analyses by radioassay. Analyses were performed on 311 selected spectral wavelengths. A partial least squares regression model was built to quantify B12 concentration. Discriminant analysis was used to isolate B12 concentration clusters. A B12 concentration threshold was set at 442 ng/dL, because this represents the cutoff value for a 250-mL glass of milk to fulfill 46% of the daily vitamin B12 recommended dietary allowance for individuals 14 yr or older. For each analysis, records coming from two-thirds of herds were used to calibrate prediction equations, and the remaining records (one-third of herds for validation) were used to assess the prediction performance. In the case of discriminant analysis, validation sets were divided into evaluation sets (one-third of herds) to obtain alternate probability cutoffs and in test sets (two-thirds of herds) to validate equations. Spectral and B12 concentration outliers were identified by calculating standardized Mahalanobis distance and with a residual analysis, respectively (n = 3,154). Regarding quantitative B12 concentration, cross-validation and validation coefficients of determination averaged 0.51 and 0.46, respectively, which are relatively low, which would limit the potential use of the developed quantitative equations. In addition, root mean square errors of prediction of cross validation and validation sets averaged 88.9 and 94.7 ng/dL, respectively. Area under the receiver operating characteristic curve of test sets averaged 0.81 based on the 442 ng/dL threshold, which could be considered to represent good accuracy of classification. However, the false discovery rate averaged 36%. In summary, models predicting quantitative B12 concentration had low cross-validation and validation coefficients of determination, limiting their use, but the proposed discriminant models could be used to identify milk samples with naturally high B12.
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Affiliation(s)
- M Duplessis
- Centre de Recherche et Développement de Sherbrooke, Sherbrooke, QC, J1M 0C8, Canada.
| | - D Pellerin
- Département des Sciences Animales, Université Laval, Québec, G1V 0A6, Canada
| | - C L Girard
- Centre de Recherche et Développement de Sherbrooke, Sherbrooke, QC, J1M 0C8, Canada
| | - D E Santschi
- Lactanet, Sainte-Anne-de-Bellevue, QC, H9X 3R4, Canada
| | - H Soyeurt
- Agriculture, Bio-Engineering, and Chemistry Department, Gembloux Agro-Bio Tech, University of Liège, 5030 Gembloux, Belgium
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41
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Jiang W, Men S, Wen X, Yuan X, Pu D, Liu X, Jia X, Wang C. A preliminary study for the establishment of a reference interval for vitamin B12 in China after performance verification of a second-generation ECLIA kit. J Clin Lab Anal 2020; 34:e23165. [PMID: 31907976 PMCID: PMC7246358 DOI: 10.1002/jcla.23165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/16/2019] [Accepted: 11/26/2019] [Indexed: 11/18/2022] Open
Abstract
Background The second‐generation electrochemiluminescence immunoassay (ECLIA) kit of vitamin B12 is widely used in clinical laboratories, and the establishment of a reference interval (RI) is essential to provide the basis for clinical monitoring. The purpose of this study was to establish a laboratory RI for vitamin B12 in China and at the same time verify the method performance of the second‐generation kit. Methods The verification of the method performance was conducted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Based on these guidelines, a total of 580 serum samples were collected, and 391 serum samples were used for the establishment of the RI according to CLSI guidelines. The subjects were grouped by sex and age. The age groups were as follows: 21‐40, 41‐60, and 61‐80 years. The RI was defined by nonparametric 2.5th and 97.5th percentile intervals. Results The performance of the second‐generation kit of vitamin B12 from the Roche Cobas E602 system was in compliance with laboratory requirements. Serum vitamin B12 levels conformed to a non‐Gaussian distribution. Harris‐Boyd's test did not indicate partitioning for different age and gender group. Besides, there was no significant difference between different age groups (P = .07) and gender groups (P = .2002). The RI for healthy Chinese adults (aged 21‐80 years) calculated by the nonparametric method was 250.8‐957.1 pg/mL. Conclusions The reference range of vitamin B12 was established, which provided a theoretical basis for the clinical application and monitoring of vitamin B12 detection.
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Affiliation(s)
- Wencan Jiang
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Shasha Men
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Xinyu Wen
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Xiaozhou Yuan
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Danna Pu
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Xiaoting Liu
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Xingwang Jia
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
| | - Chengbin Wang
- Department of Clinical Laboratory Medicine, Chinese People's Liberation Army General Hospital & Postgraduate Medical School, Beijing, China
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42
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van Gool JD, Hirche H, Lax H, Schaepdrijver LD. Fallacies of clinical studies on folic acid hazards in subjects with a low vitamin B 12 status. Crit Rev Toxicol 2020; 50:177-187. [PMID: 32228273 DOI: 10.1080/10408444.2020.1727842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A 2016 plea for revision of the 1 mg/day upper level of folic acid intake prompted us to comprehensively review the 1945-2017 literature on folic acid hazards in subjects with low cyanocobalamin. The concept of folic acid treatment 'masking' the anemia in undiagnosed cyanocobalamin deficiency, thereby delaying the diagnosis of neuropathy, does not account for the dissociation between the deficiency's hematologic and neurologic manifestations. Possible risks of this concept were addressed by 1963-1971 FDA rulings, classifying all folic acid preparations as prescription-only drugs, delivering ≤1 mg daily. The neuropathy in folic acid trials for 'pernicious anemia' is due to the singular use of folic acid-neuropathy improved or disappeared with replacement of folic acid by liver extract or cyanocobalamin. The hypothesis that cognitive impairment in 'subclinical' cyanocobalamin deficiency is folate-mediated is untenable. Of 6 papers specifically investigating this, none could prove that increased cognitive impairment was related to high folate intake. This review fully supports the safety of the 1 mg/day upper level for folic acid intake.
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Affiliation(s)
- Jan D van Gool
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen-Duisburg University, Essen, Germany
| | - Herbert Hirche
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen-Duisburg University, Essen, Germany
| | - Hildegard Lax
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen-Duisburg University, Essen, Germany
| | - Luc De Schaepdrijver
- Department of Nonclinical Safety, Janssen Research and Development, Beerse, Belgium
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43
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Salinas M, López-Garrigós M, Flores E, Blasco A, Leiva-Salinas C. Less is more: Two automated interventions to increase vitamin B 12 measurement when long-term proton pump inhibitor and decrease redundant testing. Clin Chim Acta 2020; 506:176-179. [PMID: 32234494 DOI: 10.1016/j.cca.2020.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION To test the efficacy of two interventions to promote the measurement of serum vitamin B12 (s- vitamin B12) in patients with long-term proton pump inhibitor (PPI) use and to decrease inadequate s-vitamin B12 measurement by implementing a minimum retest interval. MATERIAL AND METHODS The Laboratory Information System (LIS) automatically registered s-vitamin B12 when not ordered by General Practitioners to all requests patients with long term (>3years) PPI treatment, and with no s-vitamin B12 testing in the previous year. Through the second intervention, the LIS reported the previous s-vitamin B12 result through an explanatory comment in the report, when the test had been requested in the previous three months. We calculated the new diagnoses of vitamin deficiency (s-vitamin B12 < 200 pg/mL), examined the number of tests needed to detect a new case and investigated the economic cost of each one identified by the intervention. Additionally, we counted the s-vitamin B12 that were requested but not measured, and calculated the savings in reagent. RESULTS The strategy added 548 s-vitamin B12 and identified 47 new cases of vitamin B12 deficit. The number of added s-vitamin B12 needed to identify a new case by means of the intervention was 12. The total intervention reagent cost was 1446€, with a cost of 30.7€ per new case. The second intervention avoided unnecessary measurement of 611 tests, with 1613€ savings. CONCLUSIONS Through the two automated interventions we improved the diagnosis of vitamin B12 deficiency, and decreased inadequate redundant s-vitamin B12 measurement, cutting unnecessary laboratory costs.
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Affiliation(s)
- Maria Salinas
- Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain; Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
| | - Maite López-Garrigós
- Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Emilio Flores
- Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain; Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain.
| | - Alvaro Blasco
- Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
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Ng TKS, Matchar DB, Sultana R, Chan A. Effects of Self-Care for Older PErsons (SCOPE) on Functional and Physiological Measures: A Cluster Randomized Controlled Trial. J Clin Med 2020; 9:jcm9030885. [PMID: 32213860 PMCID: PMC7141527 DOI: 10.3390/jcm9030885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Population aging poses unprecedented demands on the healthcare system. There is also a scarcity of evidence on self-care intervention to improve objective measures of morbidity and aging-associated functional and physiological measures in a low-income multi-ethnic population setting. Methods: We conducted a cluster randomized controlled trial (ClinicalTrials.gov Identifier: NCT01672177) to examine the effects of the Self-Care for Older PErsons (SCOPE) program. We randomized 14 Senior Activity Centers and randomly selected older adults within these centers. Functional and physiological measurements were performed at baseline, 10-month, and 18-month periods. The primary outcome was a composite of three morbidity-specific measures, which include hemoglobin A1c (HbA1C), peak expiratory flow, and systolic blood pressure. Aging-associated functional and physiological measures were examined as secondary outcomes. Repeated-measure mixed models were employed to examine the effects of SCOPE on these measures. Results: 378 community-dwelling older adults participated in either the treatment (n= 164) or the control arm (n = 214). The primary outcome was not significantly improved. For the secondary outcomes, SCOPE participants demonstrated slower oxygen desaturation at an 18-month period (p = 0.001), improved time to complete the chair-stand test (p < 0.001) at a 10-month period with the effect persisting at the 18-month period (p < 0.001). SCOPE participants also had significantly improved vitamin B12 levels at the 18-month period (p < 0.001), increased hemoglobin concentration (p < 0.001), decreased mean corpuscular volume (p = 0.001), and decreased creatinine (p = 0.002) at the 10-month period. Conclusions: SCOPE did not improve morbidity-specific measures. However, it improved several aging-associated measures implicated in geriatric syndromes. This study highlights the potential of a self-care program in the prevention of geriatric syndromes in community-dwelling older adults, while emphasizing self-management to manage existing morbidities.
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Affiliation(s)
- Ted Kheng Siang Ng
- Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
| | - David Bruce Matchar
- Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
- Department of Medicine (General Internal Medicine), Duke University School of Medicine, Durham, NC 27710, USA
| | - Rehena Sultana
- Center for Quantitative Medicine, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
| | - Angelique Chan
- Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
- Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
- Department of Sociology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore 117570, Singapore
- Correspondence:
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Okamoto N, Bito T, Hiura N, Yamamoto A, Iida M, Baba Y, Fujita T, Ishihara A, Yabuta Y, Watanabe F. Food Additives (Hypochlorous Acid Water, Sodium Metabisulfite, and Sodium Sulfite) Strongly Affect the Chemical and Biological Properties of Vitamin B 12 in Aqueous Solution. ACS OMEGA 2020; 5:6207-6214. [PMID: 32226906 PMCID: PMC7097994 DOI: 10.1021/acsomega.0c00425] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
Food additives, such as hypochlorous acid water, sodium metabisulfite, and sodium sulfite, strongly affect the chemical and biological properties of vitamin B12 (cyanocobalamin) in aqueous solution. When cyanocobalamin (10 μmol/L) was treated with these compounds, hypochlorous acid water (an effective chlorine concentration of 30 ppm) rapidly reacted with cyanocobalamin. The maximum absorptions at 361 and 550 nm completely disappeared by 1 h, and vitamin B12 activity was lost. There were no significant changes observed in the absorption spectra of cyanocobalamin for 0.01% (w/v) sodium metabisulfite; however, a small amount of the reaction product was formed within 48 h, which was subsequently identified as sulfitocobalamin through high-performance liquid chromatography. Similar results were shown for sodium sulfite. The effects of these food additives on the vitamin B12 content of red shrimp and beef meats were determined, revealing no significant difference in vitamin B12 content of shrimp and beef meats with or without the treatment even in hypochlorous acid water. The results suggest that these food additives could not react with food vitamin B12 in food, as most of this vitamin present in food is its protein-bound form rather than the free form.
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Affiliation(s)
- Naho Okamoto
- The
United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori City, Tottori 680-8553, Japan
| | - Tomohiro Bito
- The
United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori City, Tottori 680-8553, Japan
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Nanami Hiura
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Ayaka Yamamoto
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Mayu Iida
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Yasuhiro Baba
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Tomoyuki Fujita
- Faculty
of Agriculture, Department of Agricultural and Life Sciences, Shinshu University, Nagano 399-4598, Japan
| | - Atsushi Ishihara
- The
United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori City, Tottori 680-8553, Japan
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Yukinori Yabuta
- The
United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori City, Tottori 680-8553, Japan
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
| | - Fumio Watanabe
- The
United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori City, Tottori 680-8553, Japan
- Faculty
of Agriculture, School of Agricultural, Biological, and Environmental
Sciences, Tottori University, Tottori 680-8553, Japan
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Soleja N, Agrawal N, Nazir R, Ahmad M, Mohsin M. Enhanced sensitivity and detection range of FRET-based vitamin B 12 nanosensor. 3 Biotech 2020; 10:87. [PMID: 32089982 DOI: 10.1007/s13205-020-2073-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 01/18/2020] [Indexed: 11/29/2022] Open
Abstract
Vitamin B12 (cobalamin) is a cobalt-containing compound that acts as an essential co-factor for various enzymes involved in the metabolic processes of the living cells. The constructed FRET Sensor for Vitamin Anemia Linked (SenVitAL) displayed marginal FRET efficiency. Here, we report the development of a molecular SenVitAL containing enhanced cyan fluorescent protein (ECFP) and venus as FRET pair to improve the FRET efficiency for optical imaging and screening of already developed sensor by our group. The sensor is the improved version of previously reported SenVitAL and consists of ECFP/venus as FRET pair instead of the originally used pair CFP/YFP. To increase the physiological range of vitamin B12 measurement, affinity mutants were created. Compared to the wild type, SenVitAL-5 with W44Q mutation has higher affinity and displayed large dynamic detection range (0.10-480 µM) in response to vitamin B12 binding. For cell-based monitoring and dynamic measurement of vitamin B12 flux rates, SenVitAL-5 was successfully expressed in cytosol of yeast and mammalian cells. Changes in the emission intensities of the two fluorophores were detected using confocal microscopy in both cell types in response to vitamin B12. With the addition of 50 µM extracellular vitamin B12 to the cells, the emission intensity of venus increased and that of ECFP decreased over the time. Furthermore, the results show that the variant SenVitAL-5 measures the vitamin B12 in a concentration-dependent manner, showing the resulting increase in the FRET ratio and thus confirming its utility as an ideal fluorescent indicator for the detection of vitamin B12 in eukaryotic systems in real time.
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Affiliation(s)
- Neha Soleja
- 1Department of Biosciences, Metabolic Engineering Laboratory, Jamia Millia Islamia, New Delhi, 110025 India
| | - Neha Agrawal
- 1Department of Biosciences, Metabolic Engineering Laboratory, Jamia Millia Islamia, New Delhi, 110025 India
| | - Rahila Nazir
- 1Department of Biosciences, Metabolic Engineering Laboratory, Jamia Millia Islamia, New Delhi, 110025 India
| | - Mohd Ahmad
- 2Department of Physics, Syracuse University, New York, NY USA
| | - Mohd Mohsin
- 1Department of Biosciences, Metabolic Engineering Laboratory, Jamia Millia Islamia, New Delhi, 110025 India
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Jatoi S, Hafeez A, Riaz SU, Ali A, Ghauri MI, Zehra M. Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia. Cureus 2020; 12:e6976. [PMID: 32206454 PMCID: PMC7077099 DOI: 10.7759/cureus.6976] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Vitamin B12 deficiency is linked to impaired cognition and memory along with a sensation of tingling and numbness, an outcome of poor myelination. Elevated methylmalonic acid and serum homocysteine levels are markers of Vitamin B12 deficiency. Elevated homocysteine levels are also often associated with Alzheimer’s disease and stroke. We conducted this study to determine the effect of vitamin B12 replacement therapy on vitamin B12-deficient patients with noted cognitive impairment. Methods We conducted a cross-sectional, multicenter study of patients with minimal cognitive impairment (MCI) to assess for Vitamin B12 and homocysteine levels. All patients found to be deficient in vitamin B12 underwent replacement therapy and were assessed again after three months via the Mini-Mental State Examination (MMSE) and a review of symptoms. Results A total of 202 patients were included in the study. Of those, 171 (84%) patients reported marked symptomatic improvement after vitamin B12 replacement while MMSE scores improved in 158 (78%) patients. Of the remaining 44 patients who reported no symptomatic improvement, MMSE scores improved in 26 while 18 patients showed no MMSE score improvements. Conclusions Vitamin B12 deficiency is linked to cognition, and replacement therapy may be an option to improve patient cognition outcomes. Further studies are needed to confirm and refine the observed associations over a larger scale and to determine whether these findings will translate to a reduction in cognitive decline.
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Affiliation(s)
- Shazia Jatoi
- Medicine, Jinnah Medical and Dental College, Karachi, PAK
| | - Abdul Hafeez
- Neurology, Liaquat University of Medical and Health Sciences, Liaquat University Hospital Jamshoro, Hyderabad, PAK
| | - Syeda Urooj Riaz
- Internal Medicine, Jinnah Medical College Hospital, Karachi, PAK
| | - Aijaz Ali
- Medicine, Jinnah Medical and Dental College, Karachi, PAK
| | | | - Maham Zehra
- Medicine, Jinnah Medical and Dental College, Karachi, PAK
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Wang B, Sahyoun NR, Shao K, Dutta E, Clarke J. Assessment of the Dose-Response Relationship Between Folate Exposure and Cognitive Impairment: Synthesizing Data from Documented Studies. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:276-293. [PMID: 31536147 DOI: 10.1111/risa.13404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/09/2019] [Accepted: 08/26/2019] [Indexed: 06/10/2023]
Abstract
The dose-response relationship between folate levels and cognitive impairment among individuals with vitamin B12 deficiency is an essential component of a risk-benefit analysis approach to regulatory and policy recommendations regarding folic acid fortification. Epidemiological studies provide data that are potentially useful for addressing this research question, but the lack of analysis and reporting of data in a manner suitable for dose-response purposes hinders the application of the traditional evidence synthesis process. This study aimed to estimate a quantitative dose-response relationship between folate exposure and the risk of cognitive impairment among older adults with vitamin B12 deficiency using "probabilistic meta-analysis," a novel approach for synthesizing data from observational studies. Second-order multistage regression was identified as the best-fit model for the association between the probability of cognitive impairment and serum folate levels based on data generated by randomly sampling probabilistic distributions with parameters estimated based on summarized information reported in relevant publications. The findings indicate a "J-shape" effect of serum folate levels on the occurrence of cognitive impairment. In particular, an excessive level of folate exposure is predicted to be associated with a higher risk of cognitive impairment, albeit with greater uncertainty than the association between low folate exposure and cognitive impairment. This study directly contributes to the development of a practical solution to synthesize observational evidence for dose-response assessment purposes, which will help strengthen future nutritional risk assessments for the purpose of informing decisions on nutrient fortification in food.
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Affiliation(s)
- Bing Wang
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
| | - Kan Shao
- Department of Environmental and Occupational Health, Indiana University, Bloomington, IN, USA
| | - Enakshy Dutta
- Department of Statistics, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jennifer Clarke
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, USA
- Department of Statistics, University of Nebraska-Lincoln, Lincoln, NE, USA
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Menegardo CS, Friggi FA, Santos AD, Devens LT, Tieppo A, Morelato RL. Deficiência de vitamina B12 e fatores associados em idosos institucionalizados. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.200022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Avaliar a frequência de deficiência de vitamina B12 e fatores associados em idosos institucionalizados. Método Analisamos 65 idosos, com idade média de 80±9 anos (61-113), de uma instituição geriátrica filantrópica de longa permanência. A dosagem sérica de vitamina B12 foi analisada e classificada em: normal (≥299 pg/mL), limítrofe (200-298 pg/mL) e deficiência (<200 pg/mL). Foi analisada a associação com tempo de permanência na instituição, declínio cognitivo e funcional, uso regular de biguanidas e inibidores de bomba de prótons, considerados fatores de risco para hipovitaminose B12, utilizando os testes de análise bivariada (paramétrica e não paramétrica) e regressão de Poisson. Resultados A deficiência de vitamina B12 estava presente em 21,5% e valores limítrofes em 32,3% da amostra. Dentre os idosos, 52,9% apresentavam demência de causas diversas, 49,2% hipertensão arterial, 29,2% com anemia (21,5% normocítica, 4,6% microcítica e 3,1% macrocítica), 18,5% diabéticos; 27,7% faziam uso de polifarmácia, com 12,3% em uso de metformina e 16,9% com inibidores de bomba de prótons. No modelo multivariado não houve associação entre a deficiência de vitamina B12 com as variáveis estudadas. Conclusão Observamos uma frequência importante de valores limítrofes e baixos de vitamina B12 nos pacientes dessa instuição geriátrica de cuidados permanentes, porém sem associação com os fatores de risco para sua deficiência estudado, o que torna importante a inclusão da dosagem sérica dessa vitamina na rotina de exames laboratoriais desse grupo.
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Affiliation(s)
| | | | | | | | - Alessandra Tieppo
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Brasil
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O'Connell ML, Coppinger T, McCarthy AL. The role of nutrition and physical activity in frailty: A review. Clin Nutr ESPEN 2019; 35:1-11. [PMID: 31987100 DOI: 10.1016/j.clnesp.2019.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/14/2019] [Indexed: 12/12/2022]
Abstract
Frailty is a clinical syndrome with a worldwide prevalence of 5-27% among those aged over 65 years. Frailty is characterised by loss of muscle strength and impaired physical function, and is associated with increased falls, hospitalisation and death. Nutritional deficiencies and low physical activity are common in this age group due to ill health, disability and reductions in enthusiasm, food intake and therefore, energy availability. Both low physical activity and inadequate dietary intake have a significant role to play in the onset and progression of frailty, primarily through bone and muscle health implications. Frailty is, however, preventable and reversible, and several interventions have been carried out to offset and reverse the condition. This article reports the recent evidence on the role of nutrition and physical activity in the pathogenesis of frailty and provides a critical review of previously implemented interventions focussed on physical activity and nutrition to prevent and reduce frailty among older adults.
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Affiliation(s)
- Maeve Lorraine O'Connell
- Department of Biological Sciences, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland.
| | - Tara Coppinger
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland
| | - Aoife Louise McCarthy
- Department of Biological Sciences, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland
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