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Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians.
Am J Clin Nutr. 2001 Aug; 74(2):233-41.AJ

Abstract

BACKGROUND

In India, most people adhere to a vegetarian diet, which may lead to cobalamin deficiency.

OBJECTIVE

The objective was to examine indicators of cobalamin status in Asian Indians.

DESIGN

The study population included 204 men and women aged 27-55 y from Pune, Maharashtra, India, categorized into 4 groups: patients with cardiovascular disease (CVD) and diabetes, patients with CVD but no diabetes, patients with diabetes but no CVD, and healthy subjects. Data on medical history, lifestyle, and diet were obtained by interviews and questionnaires. Blood samples were collected for measurement of serum or plasma total cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine (tHcy) and hemetologic indexes.

RESULTS

MMA, tHcy, total cobalamin, and holoTC did not differ significantly among the 4 groups; therefore, the data were pooled. Total cobalamin showed a strong inverse correlation with tHcy (r = -0.59) and MMA (r = -0.54). Forty-seven percent of the subjects had cobalamin deficiency (total cobalamin <150 pmol/L), 73% had low holoTC (<35 pmol/L), 77% had hyperhomocysteinemia (tHcy >15 micromol/L), and 73% had elevated serum MMA (>0.26 micromol/L). These indicators of impaired cobalamin status were observed in both vegetarians and nonvegetarians. Folate deficiency was rare and only 2.5% of the subjects were homozygous for the MTHFR 677C-->T polymorphism.

CONCLUSIONS

About 75% of the subjects had metabolic signs of cobalamin deficiency, which was only partly explained by the vegetarian diet. If impaired cobalamin status is confirmed in other parts of India, it may have important health implications.

Authors+Show Affiliations

Department of Pharmacology and the Locus for Homocysteine and Related Vitamins, University of Bergen, Norway. helga.refsum@farm.uib.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11470726

Citation

Refsum, H, et al. "Hyperhomocysteinemia and Elevated Methylmalonic Acid Indicate a High Prevalence of Cobalamin Deficiency in Asian Indians." The American Journal of Clinical Nutrition, vol. 74, no. 2, 2001, pp. 233-41.
Refsum H, Yajnik CS, Gadkari M, et al. Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr. 2001;74(2):233-41.
Refsum, H., Yajnik, C. S., Gadkari, M., Schneede, J., Vollset, S. E., Orning, L., Guttormsen, A. B., Joglekar, A., Sayyad, M. G., Ulvik, A., & Ueland, P. M. (2001). Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. The American Journal of Clinical Nutrition, 74(2), 233-41.
Refsum H, et al. Hyperhomocysteinemia and Elevated Methylmalonic Acid Indicate a High Prevalence of Cobalamin Deficiency in Asian Indians. Am J Clin Nutr. 2001;74(2):233-41. PubMed PMID: 11470726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. AU - Refsum,H, AU - Yajnik,C S, AU - Gadkari,M, AU - Schneede,J, AU - Vollset,S E, AU - Orning,L, AU - Guttormsen,A B, AU - Joglekar,A, AU - Sayyad,M G, AU - Ulvik,A, AU - Ueland,P M, PY - 2001/7/27/pubmed PY - 2001/8/24/medline PY - 2001/7/27/entrez SP - 233 EP - 41 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 74 IS - 2 N2 - BACKGROUND: In India, most people adhere to a vegetarian diet, which may lead to cobalamin deficiency. OBJECTIVE: The objective was to examine indicators of cobalamin status in Asian Indians. DESIGN: The study population included 204 men and women aged 27-55 y from Pune, Maharashtra, India, categorized into 4 groups: patients with cardiovascular disease (CVD) and diabetes, patients with CVD but no diabetes, patients with diabetes but no CVD, and healthy subjects. Data on medical history, lifestyle, and diet were obtained by interviews and questionnaires. Blood samples were collected for measurement of serum or plasma total cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine (tHcy) and hemetologic indexes. RESULTS: MMA, tHcy, total cobalamin, and holoTC did not differ significantly among the 4 groups; therefore, the data were pooled. Total cobalamin showed a strong inverse correlation with tHcy (r = -0.59) and MMA (r = -0.54). Forty-seven percent of the subjects had cobalamin deficiency (total cobalamin <150 pmol/L), 73% had low holoTC (<35 pmol/L), 77% had hyperhomocysteinemia (tHcy >15 micromol/L), and 73% had elevated serum MMA (>0.26 micromol/L). These indicators of impaired cobalamin status were observed in both vegetarians and nonvegetarians. Folate deficiency was rare and only 2.5% of the subjects were homozygous for the MTHFR 677C-->T polymorphism. CONCLUSIONS: About 75% of the subjects had metabolic signs of cobalamin deficiency, which was only partly explained by the vegetarian diet. If impaired cobalamin status is confirmed in other parts of India, it may have important health implications. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/11470726/Hyperhomocysteinemia_and_elevated_methylmalonic_acid_indicate_a_high_prevalence_of_cobalamin_deficiency_in_Asian_Indians_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/74.2.233 DB - PRIME DP - Unbound Medicine ER -