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Amado-Garzon SB, Molina-Pimienta L, Vejarano-Pombo A, Vélez-Bonilla M, Moreno-Chaparro J, Buitrago-Lopez A. Elevated Vitamin B12, Risk of Cancer, and Mortality: A Systematic Review. Cancer Invest 2024; 42:515-526. [PMID: 38953509 DOI: 10.1080/07357907.2024.2366907] [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: 01/10/2023] [Accepted: 06/08/2024] [Indexed: 07/04/2024]
Abstract
Vitamin B12 (B12) is a molecule involved in several biological. Abnormally high levels are frequently found, but their causes can be multiple, and consequences have not been clearly elucidated. The objective of this review was to summarize the current evidence on the associations of elevated B12 and the development of cancer, and all-cause mortality in adults. Six references looking at mortality and seven looking at cancer risk were included. The evidence suggests an association between elevated B12 with a higher risk of cancer, with risk ratios ranging 1,88 to 5,9. There was less consistent evidence linking vitamin B12 and mortality.
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Affiliation(s)
- Sandra B Amado-Garzon
- Department of Internal Medicine at Hospital Universitario San Ignacio. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, D.C. Colombia
| | - Luisana Molina-Pimienta
- Department of Internal Medicine at Hospital Universitario San Ignacio. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, D.C. Colombia
| | - Andrea Vejarano-Pombo
- Department of Internal Medicine at Hospital Universitario San Ignacio. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, D.C. Colombia
| | - Mariana Vélez-Bonilla
- Department of Internal Medicine at Hospital Universitario San Ignacio. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, D.C. Colombia
| | - Jaime Moreno-Chaparro
- Department of Clinical Epidemiology and Biostatistics. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, D.C. Colombia
| | - Adriana Buitrago-Lopez
- Department of Clinical Epidemiology and Biostatistics. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, D.C. Colombia
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Liu K, Yang Z, Lu X, Zheng B, Wu S, Kang J, Sun S, Zhao J. The origin of vitamin B12 levels and risk of all-cause, cardiovascular and cancer specific mortality: A systematic review and dose-response meta-analysis. Arch Gerontol Geriatr 2024; 117:105230. [PMID: 38252787 DOI: 10.1016/j.archger.2023.105230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Vitamin B12 is essential to human but the implications of serum vitamin B12 level for mortality in clinical practice remain unclear. We conducted a systematic review and dose-response meta-analysis to quantify the relationship between vitamin B12 levels and the risk of all-cause, cardiovascular, and cancer mortality. METHODS Electronic databases of PubMed, Embase, and the Cochrane Library Central Register of Controlled Trials were searched from inception through May 2023. Two reviewers independently extracted individual study data and evaluated the risk of bias among the studies using the Newcastle‒Ottawa Scale. To examine a potential nonlinear relationship between the vitamin B12 levels and all-cause mortality, we performed a two-stage random effects dose‒response meta-analysis. RESULTS Twenty-two cohort studies (92,346 individuals with 10,704 all-cause deaths) were included. A linear trend dose-response analysis showed that each 100 pmol/L increase in serum vitamin B12 concentration was associated with a 4 % higher risk of all-cause mortality in the general population (adjusted HR 1.04, 95 % confidence interval CI 1.01 to 1.08; n = 8; P non-linearity = 0.11) and a 6 % higher risk for all-cause mortality in older adults (adjusted HR 1.06, 95 % CI 1.01 to 1.13; n = 4; P non-linearity = 0.78). Current evidence was mixed for the association between serum vitamin B12 concentration and cardiovascular mortality and was limited for cancer mortality. The meta-analysis of cohort studies showed a positive association between a high serum vitamin B12 concentration (>600 pmol/L) and all-cause mortality (adjusted HR 1.50, 95 % CI 1.29 to 1.74; n = 10; p < 0.01), CVD mortality (adjusted HR 2.04, 95 % CI 0.99 to 4.19; n = 2; p = 0.02), except cancer mortality (adjusted HR 1.56, 95 % CI 0.82 to 2.95; n = 3). Similarly, serum vitamin B12 concentrations (400-600 pmol/L) were associated with increased all-cause mortality (adjusted HR 1.34, 95 % CI 1.10 to 1.64; n = 9; p < 0.01). CONCLUSIONS Serum vitamin B12 concentration was positively associated with the risk of all-cause mortality, especially among older adults, with a linear increasing trend. These findings suggested the primary cause of elevated level of serum vitamin B12 concentration should be timely identified and effectively managed in clinical practice.
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Affiliation(s)
- Kefeng Liu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou 450052, China
| | - Zhirong Yang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Xiaojing Lu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou 450052, China
| | - Bang Zheng
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Shanshan Wu
- Department of Clinical Epidemiology and Evidence-based Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jian Kang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou 450052, China
| | - Shusen Sun
- College of Pharmacy and Health Sciences, Western New England University, MA, United States of America.
| | - Jie Zhao
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; National Engineering Laboratory of Internet Medical System and Application, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Eduin B, Roubille C, Badiou S, Cristol JP, Fesler P. Association between Elevated Plasma Vitamin B12 and Short-Term Mortality in Elderly Patients Hospitalized in an Internal Medicine Unit. Int J Clin Pract 2023; 2023:6652671. [PMID: 38146346 PMCID: PMC10749720 DOI: 10.1155/2023/6652671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/14/2023] [Accepted: 11/25/2023] [Indexed: 12/27/2023] Open
Abstract
Background The prognostic value of vitamin B12 blood levels remains controversial. An association between elevated vitamin B12 and mortality has been reported, particularly among elderly patients with cancers and liver or blood diseases. The present study explored the relationship between mortality and elevated vitamin B12 levels in a population of unscheduled inpatients in an internal medicine unit. Methods This retrospective observational analysis was conducted between August 2014 and December 2018. We compared 165 patients with elevated plasma vitamin B12 levels (>600 pmol/l) with a random sample of 165 patients with normal B12 levels who were hospitalized during the same period. Demographic, clinical, and biological characteristics were assessed during hospitalization. The primary endpoint was all-cause death at 1 year. Results Patients with elevated B12 were younger, with a lower body mass index and lower plasma albumin than those with normal B12 (75 ± 16 years vs 79 ± 13 years, p = 0.047; 23 ± 5 vs 26 ± 7 kg/m2, p < 0.001; and 33 ± 5 vs 35 ± 5 g/l, p < 0.001, respectively). The prevalence of auto-immune disease and referral from an intensive care unit was higher among patients with elevated B12 (11% vs 5%, p = 0.043 and 36% vs 10%, p < 0.001, respectively). After 1 year of follow-up, 64 (39%) patients with elevated B12 had died compared to 43 (26%) patients with normal B12 (p = 0.018). Multivariate analysis using the Cox proportional hazards regression model adjusted for age, gender, body mass index, intensive care unit hospitalization, albumin level, and the presence of solid cancer or autoimmune disease revealed elevated B12 to be associated with a significant risk of death in the first year of follow-up (hazard ratio: 1.71 [1.08-2.7], p = 0.022). Conclusion Elevated B12 is an early warning indicator of increased short-term mortality, such as independently of age, cancer, or comorbidities, in patients hospitalized in an internal medicine department.
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Affiliation(s)
- Benjamin Eduin
- Department of Internal Medicine, University Hospital of Montpellier, Montpellier, France
| | - Camille Roubille
- Department of Internal Medicine, University Hospital of Montpellier, Montpellier, France
- PhyMedExp, University of Montpellier, INSERM, CNRS, University Hospital of Montpellier, Montpellier, France
| | - Stéphanie Badiou
- PhyMedExp, University of Montpellier, INSERM, CNRS, University Hospital of Montpellier, Montpellier, France
- Department of Biochemistry and Hormonology, University Hospital of Montpellier, Montpellier, France
| | - Jean Paul Cristol
- PhyMedExp, University of Montpellier, INSERM, CNRS, University Hospital of Montpellier, Montpellier, France
- Department of Biochemistry and Hormonology, University Hospital of Montpellier, Montpellier, France
| | - Pierre Fesler
- Department of Internal Medicine, University Hospital of Montpellier, Montpellier, France
- PhyMedExp, University of Montpellier, INSERM, CNRS, University Hospital of Montpellier, Montpellier, France
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Guo J, Liu X, Wang Z, Lu R, Liu Y, Zhang Y, Tian W, Fang S, Wang S, Yu B. Methylmalonic acid, vitamin B12, and mortality risk in patients with preexisting coronary heart disease: a prospective cohort study. Nutr J 2023; 22:63. [PMID: 38017447 PMCID: PMC10685606 DOI: 10.1186/s12937-023-00900-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The inconsistent relationship between Vitamin B12 (B12), methylmalonic acid (MMA, marker of B12 deficiency) and mortality was poorly understood, especially in patients with coronary heart disease (CHD). This study aims to investigate the association of serum MMA, and B12-related biomarkers (serum level, dietary intake, supplement use, and sensibility to B12) with all-cause and cardiovascular mortality in adults with CHD. METHODS The data of this study were from a subcohort within the US National Health and Nutrition Examination Survey (NHANES). We included adults with preexisting CHD with serum MMA and B12, and dietary B12 intake measurements at recruitment. All participants were followed up until 31 December 2019. Weighted Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% CI of mortality risk. RESULTS Overall, 1755 individuals (weighted mean [SE] age, 65.2 [0.5] years; 1047 men [weighted 58.5%]) with CHD were included, with geometric mean levels of serum MMA 182.4 nmol/L, serum B12 494.5 pg/ml, and dietary B12 intake 4.42 mg/day, and percentage of B12 supplements use 39.1%. During a median follow-up of 7.92 years, 980 patients died. Serum B12 concentration, dietary B12 intake and supplements use were not significantly associated with mortality risk (each p ≥ 0.388). In contrast, individuals in the top tertile of MMA had multivariable-adjusted HRs (95% CIs) of 1.70 (1.31-2.20) for all-cause mortality, and 2.00 (1.39-2.89) for cardiovascular mortality (both p trend < 0.001) compared to those in the bottom tertile of MMA. MMA-related mortality risk was particularly higher among participants with sufficient serum B12 (p < 0.001). CHD patients with increased levels of both MMA and B12 had a doubled mortality risk compared to those with lower MMA and B12 (p < 0.001). CONCLUSION MMA accumulation but not serum or dietary vitamin B12 was associated with increased cardiovascular mortality risk among patients with CHD. This paradox may be related to decreased response to vitamin B12.
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Affiliation(s)
- Junchen Guo
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - XiaoXuan Liu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Zeng Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Rongzhe Lu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Yige Liu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Yiying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, 154000, China
| | - Wei Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin, 150000, China
| | - Shaohong Fang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China
| | - Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China.
| | - Bo Yu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150000, China.
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Wu S, Chang W, Xie Z, Yao B, Wang X, Yang C. Association of Serum Vitamin B 12 and Circulating Methylmalonic Acid Levels with All-Cause and Cardiovascular Disease Mortality among Individuals with Chronic Kidney Disease. Nutrients 2023; 15:2980. [PMID: 37447305 DOI: 10.3390/nu15132980] [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: 05/17/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: it is unclear whether serum vitamin B12 and circulating methylmalonic acid (MMA) are related with a poor prognosis among individuals with chronic kidney disease (CKD); (2) Methods: this prospective cohort study included 2589 individuals with CKD who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004, and from 2011 to 2014, respectively. Hazard ratios (HRs) and 95% Cis for the associations of MMA and vitamin B12 levels with the risk of all-cause and cardiovascular disease (CVD) mortality were calculated using multivariable Cox proportional hazards regression models. Restricted cubic spline analyses were used to examine the non-linear association of MMA levels with all-cause and CVD mortality. (3) Results: among the 2589 participants, we identified 1192 all-cause deaths and 446 CVD deaths, respectively, with a median follow-up of 7.7 years. Compared with participants with MMA < 123 nmol/L, those with MMA ≥ 240 nmol/L had an increased all-cause and CVD mortality in the multivariable-adjusted model [HR (95% CI), 2.01 (1.54-2.62) and 1.76 (1.18-2.63), respectively]; (4) Conclusions: higher circulating MMA levels were found to be strongly associated with an elevated all-cause and CVD mortality among individuals with CKD, while serum vitamin B12 levels were not associated.
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Affiliation(s)
- Shiyi Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China
| | - Wenling Chang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China
| | - Zhihao Xie
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China
| | - Boshuang Yao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China
| | - Xiaoyu Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, China
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Du M, Wu S, Su C, Wang X, Li B, Lin Y, Yuan S, Chen Y, Zhu C, Wei H. Serum Vitamin B12 is a Promising Auxiliary Index for the Diagnosis of Methylmalonic Acidemia in Children: A Single Center Study in China. Clin Chim Acta 2023; 546:117409. [PMID: 37217112 DOI: 10.1016/j.cca.2023.117409] [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: 02/17/2023] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIMS Vitamin B12 (cobalamin, VitB12) is an essential coenzyme of methylmalonyl-CoA mutase and methionine synthase. Variations in VitB12 metabolism, absorption, transport, or intake may cause changes in methylmalonic acidemia (MMA) biomarkers. We aimed to investigate whether serum Vitamin B12 levels could be used in the early detection of MMA. MATERIALS AND METHODS We included 241 children with MMA and 241 healthy matched controls. We measured serum VitB12 levels by an enzyme immunoassay and investigated the relationship between abnormal VitB12 levels and hematologic parameters as potential risk factors for MMA symptoms. RESULTS Compared with controls, the serum levels of VitB12 were increased in the MMA group (p < 0.001). Serum VitB12 distinguished patients with MMA from healthy children (p < 0.001). Serum VitB12 combined with homocysteine and ammonia identified cblC and mut type MMA, respectively (p < 0.001). Homocysteine, folate, ammonia, NLR, and red blood cells contributed to serum VitB12 in cblC type MMA (p < 0.001); homocysteine, ammonia, and red blood cells, contributed in mut type MMA (p < 0.001); and elevated VitB12 was an independent predictor of MMA clinical onset (p < 0.001). CONCLUSION Serum VitB12 can be used as an early diagnostic biomarker for MMA in children.
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Affiliation(s)
- Mengmeng Du
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China; Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience, Zhengzhou University, Zhengzhou, China.
| | - Shengnan Wu
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China.
| | - Chang Su
- Department of Endocrinology, Genetic and Metabolism, Beijing Children's Hospital, Capital Medical University, Beijing, China.
| | - Xiaohong Wang
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China.
| | - Bingbing Li
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience, Zhengzhou University, Zhengzhou, China.
| | - Yifan Lin
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China.
| | - Shuxian Yuan
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China.
| | - Yongxing Chen
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China.
| | - Changlian Zhu
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China; Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden.
| | - Haiyan Wei
- Children's Hospital Affiliated to Zhengzhou University, Department of Endocrinology, Genetics and Metabolism, Henan Children's Hospital, Zhengz- hou Children's Hospital, Zhengzhou, China.
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Zhu X, Tang Y, Cheang I, Gao R, Liao S, Yao W, Zhou Y, Zhang H, Li X. Nonlinear associations of serum cobalamin with risk of all-cause and cardiovascular mortality in hypertensive adults. Hypertens Res 2023; 46:1276-1286. [PMID: 36805030 DOI: 10.1038/s41440-023-01218-w] [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: 08/11/2022] [Revised: 12/14/2022] [Accepted: 12/30/2022] [Indexed: 02/22/2023]
Abstract
Our study aims to evaluate the associations between the serum cobalamin (vitamin B12) and related biomarkers with mortality in hypertensive adults. Data on serum cobalamin from the National Health and Nutrition Examination Survey (NHANES) 1999-2006 and 2011-2014 were included. Mortality status was linked to National Death Index mortality data through 31 December, 2019. Cox regression and restricted cubic spline (RCS) analyses were used to determine the hazard ratios (HRs) and 95% CIs for mortality risk. A total of 9934 hypertensive adults were included in the analysis (mean age, 58.1 ± 17.5 years; 4899 [49.3%] men). At 11.0 years of mean follow-up, 935 cardiovascular deaths and 3096 all-cause deaths were identified. Compared to the third quartiles, the first and fourth quartiles of serum cobalamin were associated with risk of cardiovascular mortality, with multivariable-adjusted HRs of 1.26 (1.05-1.53) and 1.40 (1.17-1.68). Similar results were observed in the relationship between serum cobalamin and all-cause mortality. These results were supported by the RCS analysis. The inflection points for the nonlinear associations of serum cobalamin with cardiovascular and all-cause mortality were 649.9 pg/mL and 577.2 pg/mL, respectively. In addition, compared with the second quartile of circulating methylmalonic acid (MMA, a cobalamin-deficiency marker), this association with the fourth quartile was evident for an increased rate of cardiovascular and all-cause mortality, with 111% (HR = 2.11, 1.71-2.61) and 73% (HR = 1.73, 1.55-1.93) increase. Findings suggest that both lower and higher serum cobalamin concentrations were associated with a higher risk of cardiovascular and all-cause mortality in hypertensive adults. This study was a prospective cohort study that included serum cobalamin data from 9934 hypertensive adults from the NHANES from 1999-2006 and 20011-2014. Findings suggested that both lower and higher serum cobalamin concentrations were associated with a higher risk of cardiovascular and all-cause mortality in hypertensive adults.
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Affiliation(s)
- Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Yuan Tang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Rongrong Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Haifeng Zhang
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Suzhou, 215002, China.
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.
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Batista KS, Cintra VM, Lucena PAF, Manhães-de-Castro R, Toscano AE, Costa LP, Queiroz MEBS, de Andrade SM, Guzman-Quevedo O, Aquino JDS. The role of vitamin B12 in viral infections: a comprehensive review of its relationship with the muscle-gut-brain axis and implications for SARS-CoV-2 infection. Nutr Rev 2022; 80:561-578. [PMID: 34791425 PMCID: PMC8689946 DOI: 10.1093/nutrit/nuab092] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This comprehensive review establishes the role of vitamin B12 as adjunct therapy for viral infections in the treatment and persistent symptoms of COVID-19, focusing on symptoms related to the muscle-gut-brain axis. Vitamin B12 can help balance immune responses to better fight viral infections. Furthermore, data from randomized clinical trials and meta-analysis indicate that vitamin B12 in the forms of methylcobalamin and cyanocobalamin may increase serum vitamin B12 levels, and resulted in decreased serum methylmalonic acid and homocysteine concentrations, and decreased pain intensity, memory loss, and impaired concentration. Among studies, there is much variation in vitamin B12 doses, chemical forms, supplementation time, and administration routes. Larger randomized clinical trials of vitamin B12 supplementation and analysis of markers such as total vitamin B12, holotranscobalamin, total homocysteine and methylmalonic acid, total folic acid, and, if possible, polymorphisms and methylation of genes need to be conducted with people with and without COVID-19 or who have had COVID-19 to facilitate the proper vitamin B12 form to be administered in individual treatment.
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Affiliation(s)
- Kamila S Batista
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Vanessa M Cintra
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Paulo A F Lucena
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Raul Manhães-de-Castro
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Ana E Toscano
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Larissa P Costa
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Maria E B S Queiroz
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Suellen M de Andrade
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Omar Guzman-Quevedo
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Jailane de S Aquino
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
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9
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Wang S, Wang Y, Wan X, Guo J, Zhang Y, Tian M, Fang S, Yu B. Cobalamin Intake and Related Biomarkers: Examining Associations With Mortality Risk Among Adults With Type 2 Diabetes in NHANES. Diabetes Care 2022; 45:276-284. [PMID: 34862259 PMCID: PMC8914415 DOI: 10.2337/dc21-1674] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/07/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Despite that periodical monitoring of cobalamin (vitamin B12) in metformin-treated patients with diabetes is recommended, cobalamin-associated mortality benefits or risks remain unclear. We investigated the association between cobalamin intake and related biomarkers and mortality risk in adults with diabetes using metformin or not. RESEARCH DESIGN AND METHODS This study included 3,277 adults with type 2 diabetes from the National Health and Nutrition Examination Survey (NHANES) and followed up until 31 December 2015. Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs for mortality risk. RESULTS Among 3,277 participants, 865 all-cause deaths occurred during a median follow-up of 7.02 years. There was no robust relationship between all-cause mortality and serum cobalamin or intake of foods or cobalamin supplements, regardless of metformin treatment (each P ≥ 0.120). The doubling of methylmalonic acid (MMA), a cobalamin-deficiency marker, was significantly associated with higher all-cause (HR 1.31 [95% CI 1.18-1.45], P < 0.001) and cardiac (HR 1.38 [95% CI 1.14-1.67], P = 0.001) mortality. Cobalamin sensitivity was assessed by the combination of binary B12low/high and MMAlow/high (cutoff values: cobalamin 400 pg/mL, MMA 250 nmol/L). Patients with decreased cobalamin sensitivity (MMAhighB12high) had the highest mortality risk. The multivariable-adjusted HRs (95% CIs) of all-cause mortality in MMAlowB12low, MMAlowB12high, MMAhighB12low, and MMAhighB12high groups were 1.00 (reference), 0.98 (0.75-1.28), 1.49 (1.16-1.92), and 1.96 (1.38-2.78), respectively. That association was especially significant in metformin nonusers. CONCLUSIONS Serum and dietary cobalamin were not associated with reduced mortality. Decreased cobalamin sensitivity was significantly associated with all-cause and cardiac mortality, particularly among metformin nonusers.
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Affiliation(s)
- Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.,The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Ye Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.,The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Xin Wan
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.,The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Junchen Guo
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.,The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Yiying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Maoyi Tian
- School of Public Health, Harbin Medical University, Harbin, China.,The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Shaohong Fang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.,The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Bo Yu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.,The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
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10
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Folic acid and vitamin B12 as biomarkers of morbidity and mortality in patients with septic shock. NUTR HOSP 2022; 39:247-255. [DOI: 10.20960/nh.03505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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11
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Xu K, Liu X, Liu J, Zhang Y, Ding X, Li L, Sun J. Association between serum vitamin B12 and risk of all-cause mortality in elderly adults: a prospective cohort study. BMC Geriatr 2021; 21:497. [PMID: 34530742 PMCID: PMC8447618 DOI: 10.1186/s12877-021-02443-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND PURPOSE Results from previous studies that linking vitamin B12 to risk of chronic diseases or mortality are inconsistent. We hereby explore the association between serum concentration of vitamin B12 and all-cause mortality risk in elderly adults. METHODS Participants aged over 65 years in the Chinese Longitudinal Healthy Longevity Survey were included in present prospective cohort study. Serum vitamin B12 was assessed at the 2011-2012 and 2014 wave, respectively. Participants were divided into three groups based on two cut-off points - 10th and 90th percentiles of vitamin B12 concentrations - in the whole population. Cox regression model was used to calculate the hazard ratio (HR) and 95 % confidence intervals (95 % CIs), and restricted cubic spline function was further modelled to investigate their dose-response associations. RESULTS Among 2,086 participants [mean ± SD: 87.74 ± 11.24 years, 908 (43.53 %) males], 943 (45.21 %) died during an average follow-up of 3.34 (SD: 1.63) years. Comparing with participants with middle concentration of serum vitamin B12, participants with high concentration had an increased risk of all-cause mortality [HR (95 %CIs): 1.30 (1.03-1.64)], whereas participants with low concentration had an insignificantly decreased risk of all-cause mortality (0.96, 0.76-1.20). The positive association between high concentration of serum vitamin B12 and all-cause mortality was also observed among the male and in a series of sensitivity analyses. In the dose-response analysis, a J-shape pattern was observed, but the non-linear association was only significant in males (Pnon-linearity = 0.0351). CONCLUSIONS High concentration of serum vitamin B12 was associated with an increased risk of all-cause mortality in a J-shaped pattern. The precise mechanisms underlying the association remain to be explored.
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Affiliation(s)
- Kangjun Xu
- Department of Public Health, Shenyang Medical College, Liaoning, China
| | - Xiyu Liu
- Department of Public Health, Shenyang Medical College, Liaoning, China
| | - Jiaxin Liu
- Department of Public Health, Shenyang Medical College, Liaoning, China
| | - Yingying Zhang
- Department of Public Health, Shenyang Medical College, Liaoning, China
| | - Xiaohui Ding
- Department of Public Health, Shenyang Medical College, Liaoning, China
| | - Lin Li
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jiangwei Sun
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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12
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Lacombe V, Chabrun F, Lacout C, Ghali A, Capitain O, Patsouris A, Lavigne C, Urbanski G. Persistent elevation of plasma vitamin B12 is strongly associated with solid cancer. Sci Rep 2021; 11:13361. [PMID: 34172805 PMCID: PMC8233305 DOI: 10.1038/s41598-021-92945-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/15/2021] [Indexed: 12/17/2022] Open
Abstract
Elevated plasma vitamin B12 has been associated with solid cancers, based on a single B12 measurement. We evaluated the incidence of solid cancers following B12 measurement in patients with persistent elevated B12, compared to patients without elevated B12 and to patients with non-persistent elevated B12. The study population included patients with at least two plasma B12 measurements without already known elevated-B12-related causes. Patients with elevated plasma B12 (≥ 1000 ng/L) at first measurement (n = 344) were matched for age and sex with patients having 2 normal B12 measurements (< 1000 ng/L) (NN group, n = 344). The patients with elevated plasma B12 at first measurement were split into 2 groups, according to the presence (EE group, n = 144) or the absence (EN group, n = 200) of persistent elevated plasma B12 at second measurement. We compared the cancer-free survival during 60 months between the groups after adjustment for the other elevated-B12-related causes in a survival competing risk model. Compared to the NN group, a persistent elevated plasma B12 ≥ 1000 ng/mL was strongly associated with the occurrence of solid cancer (HR 5.90 [95% CI 2.79-12.45], p < 0.001), contrary to non-persistent plasma B12 elevation (p = 0.29). These results could help to select patients in whom the screening for solid cancers would be of interest.
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Affiliation(s)
- Valentin Lacombe
- Department of Internal Medicine and Clinical Immunology, Angers University Hospital, Angers, France
| | - Floris Chabrun
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Carole Lacout
- Department of Internal Medicine and Clinical Immunology, Angers University Hospital, Angers, France
| | - Alaa Ghali
- Department of Internal Medicine and Clinical Immunology, Angers University Hospital, Angers, France
| | | | | | - Christian Lavigne
- Department of Internal Medicine and Clinical Immunology, Angers University Hospital, Angers, France
| | - Geoffrey Urbanski
- Department of Internal Medicine and Clinical Immunology, Angers University Hospital, Angers, France.
- Department of Internal Medicine and Clinical Immunology, Angers University Hospital, 4 rue Larrey, 49000, Angers, France.
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13
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Lacombe V, Patsouris A, Delattre E, Lacout C, Urbanski G. Evolution of plasma vitamin B 12 in patients with solid cancers during curative versus supportive care. Arch Med Sci 2021; 17:1811-1815. [PMID: 34900064 PMCID: PMC8641499 DOI: 10.5114/aoms/140974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/06/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The direction of the causal link between solid cancers and elevated plasma vitamin B12 (B12) remains uncertain. METHODS We retrospectively included patients having two B12 measurements with a B12 initially ≥ 1000 ng/l and a solid cancer diagnosed between the measurements. Patients were included in the Curative or Supportive group according to their treatments. RESULTS B12 changes over time differed between groups (p = 0.001): +157.4 ng/l/month in the Supportive care group versus -171.6 ng/l/month in the Curative care group. CONCLUSIONS The decrease of plasma B12 in cases of curative care could suggest that this B12 elevation is secondary to solid cancers.
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Affiliation(s)
- Valentin Lacombe
- Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Anne Patsouris
- Medical Oncology, Ouest Cancerology Institute, Angers, France
| | - Estelle Delattre
- Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Carole Lacout
- Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Geoffrey Urbanski
- Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
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Calderon-Ospina CA, Nava-Mesa MO, Paez-Hurtado AM. Update on Safety Profiles of Vitamins B1, B6, and B12: A Narrative Review. Ther Clin Risk Manag 2020; 16:1275-1288. [PMID: 33376337 PMCID: PMC7764703 DOI: 10.2147/tcrm.s274122] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022] Open
Abstract
The neurotropic B vitamins B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin) are essential for proper functioning of the nervous system. Deficiencies may induce neurological disorders like peripheral neuropathy (PN) and mainly occur in vulnerable populations (eg, elderly, diabetics, alcoholics). As epidemiologic cohort studies raised safety concerns about vitamin B6/B12 intake being potentially associated with increased risks of hip fracture (HF) and lung cancer (LC), we explored these aspects and performed comprehensive literature searches. However, we suggest not to neglect actual high-risk factors (eg, smoking in LC, higher age in HF) by focusing on individual nutrients, but to examine the complex interaction of numerous factors involved in disease development. Because it warrants continued consideration, we also provide an update on neurotoxicity associated with vitamin B6. We consider that neurological side effects due to vitamin B6 intake are rare and only occur with high daily doses and/or longer treatment duration. The benefit-risk ratio of high-dose treatment with neurotropic B vitamins in indications like PN is therefore considered advantageous, particularly if dosing recommendations are followed and serum levels monitored.
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Affiliation(s)
- Carlos-Alberto Calderon-Ospina
- Center for Research in Genetics and Genomics (CIGGUR), GENIUROS Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Mauricio Orlando Nava-Mesa
- Neuroscience Research Group (NEUROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Ana María Paez-Hurtado
- Neuroscience Research Group (NEUROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Park J, Choi JH, Choi HJ, Hong SH, Park CS, Choi JH, Chae MS. Predictive role of vitamin B 12 in acute kidney injury in living donor liver transplantation: a propensity score matching analysis. BMJ Open 2020; 10:e038990. [PMID: 33191257 PMCID: PMC7668363 DOI: 10.1136/bmjopen-2020-038990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We examine the association between vitamin B12 level and risk for acute kidney injury (AKI) in patients undergoing living donor liver transplantation (LDLT). DESIGN Retrospective observational cohort study. SETTING University hospital, from January 2009 to December 2018. PARTICIPANTS A total of 591 patients who underwent elective LDLT were analysed in this study. Those with a preoperative history of kidney dysfunction, vitamin B12 supplementation due to alcoholism, low vitamin B12 (<200 pg/mL) or missing laboratory data were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES The population was classified into AKI and non-AKI groups according to Kidney Disease Improving Global Outcomes (KDIGO) criteria, and associations between perioperative factors and AKI were analysed. After 1:1 propensity score (PS) matching, the association between high vitamin B12 (>900 pg/mL) and postoperative AKI was evaluated. RESULTS Preoperative vitamin B12 was higher in the AKI group. Potentially significant perioperative factors from univariate analyses were entered into multivariate analyses, including preoperative factors (vitamin B12, diabetes), intraoperative factors (hourly urine output) and donor graft fatty change in LDLT patients. PS matching analyses with adjustment using PS revealed that high serum vitamin B12 (>900 pg/mL) was associated with risk for AKI, and the risk was 2.8-fold higher in patients with high vitamin B12 than in those with normal vitamin B12. Higher vitamin B12 was also related to a higher AKI stage. In addition, inflammatory factors (C reactive protein, white blood cells and albumin) were associated with vitamin B12 level. CONCLUSIONS Our study may improve the accuracy of predicting postoperative AKI by introducing preoperative vitamin B12 into risk assessments for patients undergoing LDLT.
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Affiliation(s)
- Jaesik Park
- Anesthesiology and Pain Medicine, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
| | - Jung Hee Choi
- Anesthesiology and Pain Medicine, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
| | - Ho Joong Choi
- Surgery, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
| | - Sang Hyun Hong
- Anesthesiology and Pain Medicine, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
| | - Chul Soo Park
- Anesthesiology and Pain Medicine, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
| | - Jong Ho Choi
- Anesthesiology and Pain Medicine, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
| | - Min Suk Chae
- Anesthesiology and Pain Medicine, Catholic University of Korea College of Medicine, Seoul, The Republic of Korea
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Abstract
BACKGROUND There is conflicting evidence in the literature on the association between (elevated) serum B12 concentrations and subsequent disease or mortality. We evaluated in the NHANES general population the association of serum B12 concentrations as well as vitamin B12 supplement intake with all-cause, cardiovascular, and cancer-related mortality, while taking into account demographic and lifestyle factors and significant other diseases which are known to be associated with poorer outcome. METHODS The main outcomes of our study were all-cause mortality, cardiovascular mortality, and cancer-related mortality. Mortality status and cause of death were determined by NHANES-linked National Death Index public access files through December 31, 2015. The association of serum B12 concentrations and vitamin B12 supplement intake with mortality was assessed with Cox proportional hazard (PH) models, with adjustment for a number of relevant demographic and lifestyle factors and comorbidity. RESULTS The final study population of 24,262 participants had a mean age of 48 (SD 19) years; 50.1% were males. The median follow-up duration was 109 months (range 1-201 months). On the census day of December 31, 2015, 3023 participants were determined as deceased (12.5%). The fully adjusted Cox PH model indicated that low serum B12 concentrations < 140 pmol/l were associated with a small increase in all-cause (hazard ratio, HR 1.39, 95% CI 1.08-1.78, p = 0.011) and cardiovascular (HR 1.64, 95% CI 1.08-2.47, p = 0.020) mortality. Similarly, high serum B12 concentrations > 700 pmol/l were associated with an increase in cardiovascular mortality only (HR 1.45, 95% CI 1.01-2.06, p = 0.042). Participants with a diagnosis of hypertension, dyslipidemia, CVD, and cancer more frequently used vitamin B12-containing supplements than those without these diagnoses. We could not demonstrate an association between vitamin B12 supplement intake and mortality, when adjusted for comorbidity. CONCLUSIONS In the general population of NHANES, low serum B12 concentrations were associated with a moderate increase in all-cause mortality. There was a small but significant increase in cardiovascular mortality in the groups with low or high serum B12. High intake of vitamin B12 in the form of supplements was not associated with any adverse effect on mortality and therefore can be regarded as safe.
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17
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Obesity Drives Delayed Infarct Expansion, Inflammation, and Distinct Gene Networks in a Mouse Stroke Model. Transl Stroke Res 2020; 12:331-346. [PMID: 32588199 DOI: 10.1007/s12975-020-00826-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 01/11/2023]
Abstract
Obesity is associated with chronic peripheral inflammation, is a risk factor for stroke, and causes increased infarct sizes. To characterize how obesity increases infarct size, we fed a high-fat diet to wild-type C57BL/6J mice for either 6 weeks or 15 weeks and then induced distal middle cerebral artery strokes. We found that infarct expansion happened late after stroke. There were no differences in cortical neuroinflammation (astrogliosis, microgliosis, or pro-inflammatory cytokines) either prior to or 10 h after stroke, and also no differences in stroke size at 10 h. However, by 3 days after stroke, animals fed a high-fat diet had a dramatic increase in microgliosis and astrogliosis that was associated with larger strokes and worsened functional recovery. RNA sequencing revealed a dramatic increase in inflammatory genes in the high-fat diet-fed animals 3 days after stroke that were not present prior to stroke. Genetic pathways unique to diet-induced obesity were primarily related to adaptive immunity, extracellular matrix components, cell migration, and vasculogenesis. The late appearance of neuroinflammation and infarct expansion indicates that there may be a therapeutic window between 10 and 36 h after stroke where inflammation and obesity-specific transcriptional programs could be targeted to improve outcomes in people with obesity and stroke.
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Luthra NS, Marcus AH, Hills NK, Christine CW. Vitamin B12 measurements across neurodegenerative disorders. JOURNAL OF CLINICAL MOVEMENT DISORDERS 2020; 7:3. [PMID: 32257364 PMCID: PMC7066740 DOI: 10.1186/s40734-020-00085-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/04/2020] [Indexed: 01/14/2023]
Abstract
Background Vitamin B12 deficiency causes a number of neurological features including cognitive and psychiatric disturbances, gait instability, neuropathy, and autonomic dysfunction. Clinical recognition of B12 deficiency in neurodegenerative disorders is more challenging because it causes defects that overlap with expected disease progression. We sought to determine whether B12 levels at the time of diagnosis in patients with Parkinson’s disease (PD) differed from those in patients with other neurodegenerative disorders. Methods We performed a cross-sectional analysis of B12 levels obtained around the time of diagnosis in patients with PD, Multiple System Atrophy (MSA), Dementia with Lewy Bodies (DLB), Alzheimer’s disease (AD), Progressive Supranuclear Palsy (PSP), Frontotemporal Dementia (FTD), or Mild Cognitive Impairment (MCI). We also evaluated the rate of B12 decline in PD, AD, and MCI. Results In multivariable analysis adjusted for age, sex, and B12 supplementation, we found that B12 levels were significantly lower at time of diagnosis in patients with PD than in patients with PSP, FTD, and DLB. In PD, AD, and MCI, the rate of B12 decline ranged from − 17 to − 47 pg/ml/year, much greater than that reported for the elderly population. Conclusions Further studies are needed to determine whether comorbid B12 deficiency affects progression of these disorders.
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Affiliation(s)
- Nijee S Luthra
- 1Department of Neurology, University of California, San Francisco, 1635 Divisadero, Suite 520-530, San Francisco, CA 94115 USA
| | - Ariane H Marcus
- 2Department of Neurology, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA 94122 USA
| | - Nancy K Hills
- 3Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA 94158 USA
| | - Chadwick W Christine
- 2Department of Neurology, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA 94122 USA
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Strength of the Association of Elevated Vitamin B12 and Solid Cancers: An Adjusted Case-Control Study. J Clin Med 2020; 9:jcm9020474. [PMID: 32050436 PMCID: PMC7073937 DOI: 10.3390/jcm9020474] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 02/05/2023] Open
Abstract
The association between elevated plasma vitamin B12 (B12) level and solid cancers has been documented by two national registries. However, their design did not allow for the adjustment for other conditions associated with elevated B12. The objectives of this study were to confirm this association after the adjustment for all causes of elevated B12, and to study the variations according to the increasing B12 level, the type of cancers, and the presence of metastases. We compared 785 patients with B12 ≥ 1000 ng/L with 785 controls matched for sex and age with B12 < 1000 ng/L. Analyses were adjusted for the causes of elevated B12: myeloid blood malignancies, acute or chronic liver diseases, chronic kidney failure, autoimmune or inflammatory diseases, and excessive B12 supplementation. A B12 ≥ 1000 ng/L was associated with the presence of solid cancer without metastases (OR 1.96 [95%CI: 1.18 to 3.25]) and with metastases (OR 4.21 [95%CI: 2.67 to 6.64]) after adjustment for all elevated B12-related causes. The strength of the association rose with the increasing B12 level, in particular in cases of metastases. No association between liver cancers and elevated B12 level was found after adjustment for chronic liver diseases. In conclusion, unexplained elevated B12 levels should be examined as a possible marker of solid cancer.
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20
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Flores-Guerrero JL, Minović I, Groothof D, Gruppen EG, Riphagen IJ, Kootstra-Ros J, Muller Kobold A, Hak E, Navis G, Gansevoort RT, de Borst MH, Dullaart RPF, Bakker SJL. Association of Plasma Concentration of Vitamin B12 With All-Cause Mortality in the General Population in the Netherlands. JAMA Netw Open 2020; 3:e1919274. [PMID: 31940038 PMCID: PMC6991261 DOI: 10.1001/jamanetworkopen.2019.19274] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Higher plasma concentrations of vitamin B12 have been associated with mortality in elderly and hospitalized populations, including patients with chronic kidney disease, but the association of plasma concentrations of vitamin B12 with mortality in the general population remains unclear. OBJECTIVE To investigate the association of plasma concentrations of vitamin B12 with all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study used post hoc analysis to examine data from participants of the Prevention of Renal and Vascular End-stage Disease Study in Groningen, the Netherlands. Participants included individuals who completed the second screening visit beginning January 1, 2001, excluding those who were missing values of vitamin B12 plasma concentrations or used vitamin B12 supplementation. Follow-up time was defined between the beginning of the second screening round to end of follow-up on January 1, 2011. Data analysis was conducted from October 2, 2018, to February 22, 2019. EXPOSURES Plasma vitamin B12 concentration level. MAIN OUTCOMES AND MEASURES Death as recorded by the Central Bureau of Statistics of Groningen, the Netherlands. RESULTS A total of 5571 participants (mean [SD] age, 53.5 [12.0] years; 2830 [50.8%] men) were included in analyses. Median (interquartile range) plasma concentration of vitamin B12 was 394.42 (310.38-497.42) pg/mL. During the median (interquartile range) of 8.2 (7.7-8.9) years of follow-up, 226 participants (4.1%) died. According to quartiles of the distribution of plasma vitamin B12 concentration levels, mortality rates were 33.8 deaths per 10 000 person-years for the quartile with the lowest plasma concentration of vitamin B12 and 65.7 deaths per 10 000 person-years for the quartile with the highest plasma concentration of vitamin B12. After adjustment for multiple clinical and laboratory variables, Cox regression analyses found a significant association between higher vitamin B12 plasma concentration level and increased risk of all-cause mortality (hazard ratio per 1-SD increase, 1.25 [95% CI, 1.06-1.47]; P = .006). CONCLUSIONS AND RELEVANCE These findings suggest that higher levels of plasma concentrations of vitamin B12 were associated with increased risk of all-cause mortality after adjusting for age, sex, renal function, and other clinical and laboratory variables. The mechanisms underlying this association remain to be established.
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Affiliation(s)
- Jose L. Flores-Guerrero
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Isidor Minović
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
- University Medical Center Groningen, Department of Laboratory Medicine, University of Groningen, Groningen, the Netherlands
| | - Dion Groothof
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Eke G. Gruppen
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Ineke J. Riphagen
- University Medical Center Groningen, Department of Laboratory Medicine, University of Groningen, Groningen, the Netherlands
| | - Jenny Kootstra-Ros
- University Medical Center Groningen, Department of Laboratory Medicine, University of Groningen, Groningen, the Netherlands
| | - Anneke Muller Kobold
- University Medical Center Groningen, Department of Laboratory Medicine, University of Groningen, Groningen, the Netherlands
| | - Eelko Hak
- Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Gerjan Navis
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Ron T. Gansevoort
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Martin H. de Borst
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Robin P. F. Dullaart
- University Medical Center Groningen, Division of Endocrinology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Stephan J. L. Bakker
- University Medical Center Groningen, Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
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Gebremicael G, Alemayehu M, Sileshi M, Geto Z, Gebreegziabxier A, Tefera H, Ashenafi N, Tadese C, Wolde M, Kassa D. The serum concentration of vitamin B 12 as a biomarker of therapeutic response in tuberculosis patients with and without human immunodeficiency virus (HIV) infection. Int J Gen Med 2019; 12:353-361. [PMID: 31571974 PMCID: PMC6759284 DOI: 10.2147/ijgm.s218799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Prior to clinical trials of new tuberculosis (TB) drugs or therapeutic vaccines, it is necessary to develop monitoring tools to predict treatment outcomes in TB patients. METHODS Micronutrients concentration level was determined from a total of 262 study participants with five clinical groups: 57 TB patients coinfected with HIV (HIV+TB+), 87 active TB Patients (TB cases), 71 HIV infected without active and latent TB infection (HIV+TST-), 22 latent TB infection (TST+) and 25 healthy controls (TST-). Vitamin A concentration was measured using high-performance liquid chromatography (HPLC), whereas iron and vitamin B12 concentrations were measured using Cobas® 6000 analyzer. RESULT The serum concentration levels of iron, vitamin A and vitamin B12 had a significant difference between active TB and latent (LTBI) or healthy controls. Six months after treatment, the serum concentration levels of vitamin A, vitamin B12 and iron in tuberculosis became indistinguishable from the levels of LTBIs and healthy control individuals. The concentration levels of iron and vitamin B12 in HIV+TB+patients at the end of TB treatment were normalized to the levels observed in healthy controls (TST-) regardless of HAART treatment. However, the concentration level of vitamin A in HIV+TB+patients HAART untreated at the end of TB treatment was not normalized to the levels observed in healthy controls (TST-) or HAART untreated HIV+TST-. CONCLUSION Detecting serum concentration levels of vitamin B12 and vitamin A might be used as a biomarker of the diagnostic method of active TB regardless of HIV-infected individuals. Moreover, detecting serum concentration of vitamin B12 might also be used for TB treatment responses monitoring biomarker in TB-HIV-co-infected individuals regardless of HAART (in)eligibility and therapy.
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Affiliation(s)
- Gebremedhin Gebremicael
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Mihret Alemayehu
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Meron Sileshi
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Zeleke Geto
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Atsbeha Gebreegziabxier
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Hulumtaye Tefera
- Nutrition and Food Science Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Nigat Ashenafi
- Nutrition and Food Science Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Chere Tadese
- Nutrition and Food Science Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Mistire Wolde
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Desta Kassa
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
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Pavlov CS, Damulin IV, Shulpekova YO, Andreev EA. Neurological disorders in vitamin B12 deficiency. TERAPEVT ARKH 2019; 91:122-129. [PMID: 31094486 DOI: 10.26442/00403660.2019.04.000116] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The review discusses thesteps of vitamin B12 metabolism and its role in maintaining of neurological functions. The term "vitamin B12 (cobalamin)" refers to several substances (cobalamins) of a very similar structure. Cobalamin enters the body with animal products. On the peripherу cobalamin circulates only in binding with proteins transcobalamin I and II (complex cobalamin-transcobalamin II is designated as "holotranscobalamin"). Holotranscobalamin is absorbed by different cells, whereas transcobalamin I-binded vitamin B12 - only by liver and kidneys. Two forms of cobalamin were identified as coenzymes of cellular reactions which are methylcobalamin (in cytoplasm) and hydroxyadenosylcobalamin (in mitochondria). The main causes of cobalamin deficiency are related to inadequate intake of animal products, autoimmune gastritis, pancreatic insufficiency, terminal ileum disease, syndrome of intestinal bacterial overgrowth. Relative deficiency may be seen in excessive binding of vitamin B12 to transcobalamin I. Cobalamin deficiency most significantly affects functions of blood, nervous system and inflammatory response. Anemia occurs in 13-15% of cases; macrocytosis is an early sign. The average size of neutrophils and monocytes is the most sensitive marker of megaloblastic hematopoiesis. The demands in vitamin B12 are particularly high in nervous tissue. Hypovitaminosis is accompanied by pathological lesions both in white and gray brain matter. Several types of neurological manifestations are described: subacute combined degeneration of spinal cord (funicular myelinosis), sensomotor polyneuropathy, optic nerve neuropathy, cognitive disorders. The whole range of neuropsychiatric disorders with vitamin B12 deficiency has not been studied well enough. Due to certain diagnostic difficulties they are often regarded as "cryptogenic", "reactive", "vascular» origin. Normal or decreased total plasma cobalamin level could not a reliable marker of vitamin deficiency. In difficult cases the content of holotranscobalamin, methylmalonic acid / homocysteine, and folate in the blood serum should be investigated besides carefully analysis of clinical manifestations.
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Affiliation(s)
- Ch S Pavlov
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - I V Damulin
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Yu O Shulpekova
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - E A Andreev
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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da Rosa MI, Beck WO, Colonetti T, Budni J, Falchetti ACB, Colonetti L, Coral AS, Meller FO. Association of vitamin D and vitamin B 12 with cognitive impairment in elderly aged 80 years or older: a cross-sectional study. J Hum Nutr Diet 2019; 32:518-524. [PMID: 30821057 DOI: 10.1111/jhn.12636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The present study aimed to assess the association of vitamin D and vitamin B12 with cognitive impairment in elderly people. METHODS The data were obtained from a cross-sectional study that included individuals aged 80 years or older living in the urban and rural areas of the cities of Siderópolis and Treviso in the state of Santa Catarina, Brazil. In total, 165 elderly people were included in the analysis. The outcome of cognitive decline was assessed by the Mini-Mental State Examination. Vitamin D and vitamin B12 levels were measured from blood samples. The socio-demographic, anthropometric and health variables used in the analysis were collected from a questionnaire. Crude and adjusted analyses of the relationship between vitamins D and B12 and cognitive decline were performed using a Poisson regression model. RESULTS The prevalence of cognitive decline was 35.2%. In the adjusted model, individuals who had vitamin D levels >19 ng mL-1 showed a lower prevalence of cognitive decline (prevalence ratio = 0.59; 95% confidence interval = 0.39-0.87). Those participants who had vitamin B12 levels of ≥496 pg mL-1 had a higher prevalence of cognitive decline (prevalence ratio = 1.90; 95% confidence interval = 1.08-3.36). CONCLUSIONS The present study showed that individuals aged ≥80 years who had vitamin D levels of ≤18 ng mL-1 had a higher prevalence of cognitive decline even after adjustment for potential confounders. In addition, the study demonstrated that vitamin B12 levels of ≥496 pg mL-1 in this population were also a risk factor for cognitive decline. A cross-sectional analysis does not enable the inference of a cause-effect relationship and additional studies are needed to understand these relationships.
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Affiliation(s)
- M I da Rosa
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil.,Graduate Program in Public Health, University of Extreme South Catarinense, Criciuma, Brazil
| | - W O Beck
- Graduate Program in Public Health, University of Extreme South Catarinense, Criciuma, Brazil
| | - T Colonetti
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - J Budni
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - A C B Falchetti
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - L Colonetti
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - A S Coral
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - F O Meller
- Graduate Program in Public Health, University of Extreme South Catarinense, Criciuma, Brazil
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Łukaszyk E, Bień-Barkowska K, Bień B. Cognitive Functioning of Geriatric Patients: Is Hypovitaminosis D the Next Marker of Cognitive Dysfunction and Dementia? Nutrients 2018; 10:nu10081104. [PMID: 30115862 PMCID: PMC6115732 DOI: 10.3390/nu10081104] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/03/2018] [Accepted: 08/14/2018] [Indexed: 02/06/2023] Open
Abstract
The study objective is to investigate whether vitamin D is associated with the cognitive function of geriatric patients. This cross-sectional study involved 357 patients hospitalized in the geriatric ward who complained of memory problems (mean age: 82.3 years). The level of cognitive function was measured with the Mini-Mental State Examination (MMSE) and the clinical diagnosis of dementia was established according to the International Classification of Diseases (ICD-10) criteria. The serum 25-hydroxy vitamin D was measured with liquid chromatography-tandem mass spectrometry. The iterative Bayesian model averaging (BMA) procedure was applied to linear and logistic regression models in order to identify the best set of factors describing cognitive dysfunction and dementia, respectively. According to BMA, there is strong evidence that higher vitamin D levels, higher body mass index (BMI), and higher mobility function measured with the Timed Up and Go (TUG) test are independently associated with better cognitive performance and lower risk of dementia. Additionally, there is strong evidence that fewer years of education and lower vitamin B12 plasma levels independently describe worse cognitive performance. However, vitamin B12 levels higher than 800 pg/mL is negatively associated with the MMSE performance. Hypovitaminosis D in geriatric patients is an underrated marker of cognitive dysfunction and dementia.
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Affiliation(s)
- Ewelina Łukaszyk
- Department of Geriatrics, Medical University of Bialystok, Fabryczna 27, 15-471 Bialystok, Poland.
- Geriatric Ward, Hospital of the Ministry of Interior and Administration in Bialystok, Fabryczna 27, 15-471 Bialystok, Poland.
| | - Katarzyna Bień-Barkowska
- Institute of Econometrics, Warsaw School of Economics, Madalińskiego 6/8, 02-513 Warsaw, Poland.
| | - Barbara Bień
- Department of Geriatrics, Medical University of Bialystok, Fabryczna 27, 15-471 Bialystok, Poland.
- Geriatric Ward, Hospital of the Ministry of Interior and Administration in Bialystok, Fabryczna 27, 15-471 Bialystok, Poland.
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Fisher A, Fisher L, Srikusalanukul W, Smith PN. Usefulness of simple biomarkers at admission as independent indicators and predictors of in-hospital mortality in older hip fracture patients. Injury 2018; 49:829-840. [PMID: 29559183 DOI: 10.1016/j.injury.2018.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/07/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The data on predictive value of the routinely obtained preoperative biochemical parameters in hip fracture (HF) patients are limited. The aims of this study were to examine in older HF patients (1) the relationships between a broad set of routine laboratory parameters at admission and in-hospital mortality, and (2) evaluate the prognostic value the biomarkers and clinical characteristics (alone or in combination) provide to predict a fatal outcome. PATIENTS AND METHODS In 1820 consecutive patients with low-trauma osteoporotic HF aged >60 years (mean age 82.8 ± 8.1 years; 76.4% women; 65% community-dwelling) 35 laboratory variables along with 20 clinical and socio-demographic characteristics at admission were analysed. The validation cohort included data on 455 older (≥60 years of age) HF patients (mean age 82.1 ± 8.0 years, 72.1% women). RESULTS The mortality rate was 6% (n = 109). On univariate analysis 14 laboratory and 8 clinical parameters have been associated with in-hospital mortality. Multiple regression analyses determined 7 variables at admission as independent indicators of a fatal outcome: 4 biomarkers (albumin <33 g/L; alanine aminotransferase/gamma-glutamyl transferase ratio [GGT/ALT] >2.5; parathyroid hormone [PTH] >6.8 pmol/L; 25(OH)vitamin D < 25 nmol/L) and 3 pre-fracture clinical conditions (history of myocardial infarction, chronic kidney disease [GFR <60 ml/min/1.73 m2] and chronic obstructive pulmonary disease); the area under the receiver operating characteristic curve (AUC) was 0.75 (95%CI 0.70-0.80). The risk of in-hospital death was 1.6-2.6 times higher in subjects with any of these risk factors (RFs), and increased by 2.6-6.0-fold in patients with any two RFs (versus no RFs). The mortality rate increased stepwise as the number of RFs increased (from 0.43% -none RF to 16.8%- ≥4RF). The prognostic value of a single RF was low (AUC ≤0.635) but combination of 2 or more RFs improved the prediction significantly; AUC reached 0.84(95%CI 0.77-0.90) when ≥4 RFs (versus 0-1RF) were present. In the validated and main cohorts the number of predicted by 1, 2, 3 or ≥4 RFs and observed deaths were practically similar. CONCLUSIONS In HF patients, seven easily identifiable at admission characteristics, including 4 biomarkers, are strong and independent indicators of in-hospital mortality and can be used for risk stratification and individualised management.
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Affiliation(s)
- Alexander Fisher
- Department of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra, Australia; Department of Orthopaedic Surgery, The Canberra Hospital, ACT Health, Canberra, Australia; Australian National University Medical School, Canberra, ACT, Australia.
| | - Leon Fisher
- Frankston Hospital, Peninsula Health, Melbourne, Australia
| | - Wichat Srikusalanukul
- Department of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra, Australia
| | - Paul N Smith
- Department of Orthopaedic Surgery, The Canberra Hospital, ACT Health, Canberra, Australia; Australian National University Medical School, Canberra, ACT, Australia
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