Abstract
OBJECTIVES
The performance of holotranscobalamin (holoTC) was compared with the other markers of vitamin B12 deficiency, and the influence of age, renal function, and thyroid status was examined.
DESIGN AND INTERVENTIONS
We examined 937 individuals not treated with vitamin B12 but in whom vitamin B12 deficiency was suspected because of a plasma methylmalonic acid (MMA) above 0.28 micromol L(-1) within the past 4 years. Besides laboratory tests, a structured interview and a neurological examination were performed amongst 534 individuals. Amongst these, 140 individuals qualified for a randomized trial (MMA 0.40-2.00 micromol L(-1)). They were randomized to injections with vitamin B12 or placebo and re-examined after 3 months.
SETTING
One university hospital in Aarhus, Denmark.
RESULTS
The ROC curves indicate that holoTC (AUC: 0.90) compared favourable with plasma vitamin B12 (AUC: 0.85) for identifying individuals likely to have vitamin B12 deficiency (MMA > or =0.75 micromol L(-1) and plasma total homocysteine (tHcy) > or =15 micromol L(-1)), and further that holoTC (AUC: 0.91) might replace combined testing with plasma vitamin B12 and the metabolites. No association was observed between the biochemical markers and symptoms and signs possibly related to vitamin B12 deficiency. HoloTC, TC saturation, plasma vitamin B12, MMA, and tHcy were significantly associated with plasma creatinine (all with P <0.001). Only tHcy was significantly associated with thyroid stimulating hormone (P=0.02).
CONCLUSIONS
HoloTC shows promise as first-line tests for diagnosing early vitamin B12 deficiency.
Pub Type(s)
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
TY - JOUR
T1 - Holotranscobalamin--a first choice assay for diagnosing early vitamin B deficiency?
AU - Hvas,A-M,
AU - Nexo,E,
PY - 2005/2/18/pubmed
PY - 2005/4/1/medline
PY - 2005/2/18/entrez
SP - 289
EP - 98
JF - Journal of internal medicine
JO - J Intern Med
VL - 257
IS - 3
N2 - OBJECTIVES: The performance of holotranscobalamin (holoTC) was compared with the other markers of vitamin B12 deficiency, and the influence of age, renal function, and thyroid status was examined. DESIGN AND INTERVENTIONS: We examined 937 individuals not treated with vitamin B12 but in whom vitamin B12 deficiency was suspected because of a plasma methylmalonic acid (MMA) above 0.28 micromol L(-1) within the past 4 years. Besides laboratory tests, a structured interview and a neurological examination were performed amongst 534 individuals. Amongst these, 140 individuals qualified for a randomized trial (MMA 0.40-2.00 micromol L(-1)). They were randomized to injections with vitamin B12 or placebo and re-examined after 3 months. SETTING: One university hospital in Aarhus, Denmark. RESULTS: The ROC curves indicate that holoTC (AUC: 0.90) compared favourable with plasma vitamin B12 (AUC: 0.85) for identifying individuals likely to have vitamin B12 deficiency (MMA > or =0.75 micromol L(-1) and plasma total homocysteine (tHcy) > or =15 micromol L(-1)), and further that holoTC (AUC: 0.91) might replace combined testing with plasma vitamin B12 and the metabolites. No association was observed between the biochemical markers and symptoms and signs possibly related to vitamin B12 deficiency. HoloTC, TC saturation, plasma vitamin B12, MMA, and tHcy were significantly associated with plasma creatinine (all with P <0.001). Only tHcy was significantly associated with thyroid stimulating hormone (P=0.02). CONCLUSIONS: HoloTC shows promise as first-line tests for diagnosing early vitamin B12 deficiency.
SN - 0954-6820
UR - https://www.unboundmedicine.com/medline/citation/15715686/Holotranscobalamin__a_first_choice_assay_for_diagnosing_early_vitamin_B_deficiency
DB - PRIME
DP - Unbound Medicine
ER -
