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Role of serum holotranscobalamin (holoTC) in the diagnosis of patients with low serum cobalamin. Comparison with methylmalonic acid and homocysteine.
Ann Hematol. 2014 Apr; 93(4):565-9.AH

Abstract

Plasma holotranscobalamin (holoTC) transports active cobalamin. Decreased levels of holoTC have been considered to be the earliest marker of cobalamin (Cbl) deficiency. In this work, holoTC was evaluated in low or borderline serum Cbl (LB12) and a concordance analysis was carried out with methylmalonic acid (MMA) and homocysteine (Hcy). Levels of Cbl, holoTC, MMA, and Hcy were investigated in a reference group in 106 patients with LB12 (≤200 pmol/l) and in 27 with folate deficiency (FOL). HoloTC levels were evaluated by an automated immunoassay (Active B12, Abbott Lab, Abbott Park, IL, USA). Lower levels of holoTC were observed in both LB12 and FOL groups (reference group vs LB12; p < 0.0001. Reference group vs FOL; p = 0.002). HoloTC levels were lower in LB12 than in FOL (p = 0.001). In LB12, concordance between Hcy and MMA was 82.1 % (chi-square test, p < 0.001; Kappa Index, 0.64, p < 0.0001). Concordance between Hcy and holoTC was 62 % (chi-square test, p = 0.006; Kappa index, 0.245, p = 0.006). Concordance between holoTC and MMA was 55.6 % (p = 0.233). Some cases with LB12 and elevated MMA did not show decreased holoTC. By contrast, MMA and Hcy were not increased in some patients with low holoTC and LB12. In conclusion, levels of holoTC were decreased in LB12 and FOL. In LB12 patients, holoTC concordance with MMA was poor. MMA/Hcy levels were not increased in a significant number of subjects with LB12 and low holoTC. This profile was found in iron deficiency. The significance of these changes remains to be clarified.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Remacha AF
Hematology Department, Hospital de Sant Pau, Avda Padre Claret 167, Barcelona, 08025, Spain, aremacha@santpau.cat.
Sardà MP
No affiliation info available
Canals C
No affiliation info available
Queraltò JM
No affiliation info available
Zapico E
No affiliation info available
Remacha J
No affiliation info available
Carrascosa C
No affiliation info available

MeSH

AdultAgedAged, 80 and overBiomarkersFemaleHomocysteineHumansMaleMethylmalonic AcidMiddle AgedTranscobalaminsVitamin B 12Vitamin B 12 DeficiencyYoung Adult

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24057896

Citation

Remacha, A F., et al. "Role of Serum Holotranscobalamin (holoTC) in the Diagnosis of Patients With Low Serum Cobalamin. Comparison With Methylmalonic Acid and Homocysteine." Annals of Hematology, vol. 93, no. 4, 2014, pp. 565-9.
Remacha AF, Sardà MP, Canals C, et al. Role of serum holotranscobalamin (holoTC) in the diagnosis of patients with low serum cobalamin. Comparison with methylmalonic acid and homocysteine. Ann Hematol. 2014;93(4):565-9.
Remacha, A. F., Sardà, M. P., Canals, C., Queraltò, J. M., Zapico, E., Remacha, J., & Carrascosa, C. (2014). Role of serum holotranscobalamin (holoTC) in the diagnosis of patients with low serum cobalamin. Comparison with methylmalonic acid and homocysteine. Annals of Hematology, 93(4), 565-9. https://doi.org/10.1007/s00277-013-1905-z
Remacha AF, et al. Role of Serum Holotranscobalamin (holoTC) in the Diagnosis of Patients With Low Serum Cobalamin. Comparison With Methylmalonic Acid and Homocysteine. Ann Hematol. 2014;93(4):565-9. PubMed PMID: 24057896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of serum holotranscobalamin (holoTC) in the diagnosis of patients with low serum cobalamin. Comparison with methylmalonic acid and homocysteine. AU - Remacha,A F, AU - Sardà,M P, AU - Canals,C, AU - Queraltò,J M, AU - Zapico,E, AU - Remacha,J, AU - Carrascosa,C, Y1 - 2013/09/21/ PY - 2013/06/20/received PY - 2013/09/10/accepted PY - 2013/9/24/entrez PY - 2013/9/24/pubmed PY - 2014/4/29/medline SP - 565 EP - 9 JF - Annals of hematology JO - Ann Hematol VL - 93 IS - 4 N2 - Plasma holotranscobalamin (holoTC) transports active cobalamin. Decreased levels of holoTC have been considered to be the earliest marker of cobalamin (Cbl) deficiency. In this work, holoTC was evaluated in low or borderline serum Cbl (LB12) and a concordance analysis was carried out with methylmalonic acid (MMA) and homocysteine (Hcy). Levels of Cbl, holoTC, MMA, and Hcy were investigated in a reference group in 106 patients with LB12 (≤200 pmol/l) and in 27 with folate deficiency (FOL). HoloTC levels were evaluated by an automated immunoassay (Active B12, Abbott Lab, Abbott Park, IL, USA). Lower levels of holoTC were observed in both LB12 and FOL groups (reference group vs LB12; p < 0.0001. Reference group vs FOL; p = 0.002). HoloTC levels were lower in LB12 than in FOL (p = 0.001). In LB12, concordance between Hcy and MMA was 82.1 % (chi-square test, p < 0.001; Kappa Index, 0.64, p < 0.0001). Concordance between Hcy and holoTC was 62 % (chi-square test, p = 0.006; Kappa index, 0.245, p = 0.006). Concordance between holoTC and MMA was 55.6 % (p = 0.233). Some cases with LB12 and elevated MMA did not show decreased holoTC. By contrast, MMA and Hcy were not increased in some patients with low holoTC and LB12. In conclusion, levels of holoTC were decreased in LB12 and FOL. In LB12 patients, holoTC concordance with MMA was poor. MMA/Hcy levels were not increased in a significant number of subjects with LB12 and low holoTC. This profile was found in iron deficiency. The significance of these changes remains to be clarified. SN - 1432-0584 UR - https://www.unboundmedicine.com/medline/citation/24057896/Role_of_serum_holotranscobalamin__holoTC__in_the_diagnosis_of_patients_with_low_serum_cobalamin__Comparison_with_methylmalonic_acid_and_homocysteine_ L2 - https://dx.doi.org/10.1007/s00277-013-1905-z DB - PRIME DP - Unbound Medicine ER -