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Methylmalonic Acid and Homocysteine as Indicators of Vitamin B12 Deficiency in Patients with Gastric Cancer after Gastrectomy.
Nutrients. 2019 Feb 21; 11(2)N

Abstract

Vitamin B12 deficiency is a common complication in patients after gastrectomy. Elevated methylmalonic acid (MMA) and homocysteine are better indications of vitamin B12 deficiency than vitamin B12 serum level. We compared MMA and homocysteine levels of patients with gastric cancer after gastrectomy (n = 151) with controls (n = 142) and evaluated the prevalence of vitamin B12 deficiency using MMA and homocysteine in patients. MMA and homocysteine levels were significantly higher (p < 0.05) in patients with gastric cancer after gastrectomy. Of the 151 patients assessed after gastrectomy, 32 patients (21.2%) were vitamin B12 deficient as defined by serum MMA levels > 350 nmol/L, and 8 patients (5.3%) were vitamin B12 deficient as defined by serum homocysteine levels > 15 μmol/L. Both MMA and homocysteine levels were elevated in 7 patients. Among 33 patients with elevated MMA or homocysteine levels, 8 patients (24.2%) were vitamin B12 deficient based on a serum vitamin B12 level < 200 pg/mL. Additionally, levels of MMA and homocysteine were compared pre- and post-gastrectomy in 27 patients. The median MMA level was higher in patients with post-gastrectomy compared to pre-gastrectomy, while the median serum homocysteine level was not significantly different. These results indicate that using serum vitamin B12 levels alone may fail to detect vitamin B12 deficiency. Additional assessments of MMA and homocysteine levels are useful to evaluate possible vitamin B12 deficiency in patients who underwent a gastrectomy, and MMA is a better indicator than homocysteine to detect early changes in vitamin B12 levels.

Authors+Show Affiliations

GC genome, 107, Ihyeon-ro 30beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do 16924, Korea. saemi.lee@greencross.com. Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. saemi.lee@greencross.com.Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. jongwon1234.oh@samsung.com.Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. miryung.chun@samsung.com.Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. suddenbz@skku.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30795564

Citation

Lee, Sae-Mi, et al. "Methylmalonic Acid and Homocysteine as Indicators of Vitamin B12 Deficiency in Patients With Gastric Cancer After Gastrectomy." Nutrients, vol. 11, no. 2, 2019.
Lee SM, Oh J, Chun MR, et al. Methylmalonic Acid and Homocysteine as Indicators of Vitamin B12 Deficiency in Patients with Gastric Cancer after Gastrectomy. Nutrients. 2019;11(2).
Lee, S. M., Oh, J., Chun, M. R., & Lee, S. Y. (2019). Methylmalonic Acid and Homocysteine as Indicators of Vitamin B12 Deficiency in Patients with Gastric Cancer after Gastrectomy. Nutrients, 11(2). https://doi.org/10.3390/nu11020450
Lee SM, et al. Methylmalonic Acid and Homocysteine as Indicators of Vitamin B12 Deficiency in Patients With Gastric Cancer After Gastrectomy. Nutrients. 2019 Feb 21;11(2) PubMed PMID: 30795564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Methylmalonic Acid and Homocysteine as Indicators of Vitamin B12 Deficiency in Patients with Gastric Cancer after Gastrectomy. AU - Lee,Sae-Mi, AU - Oh,Jongwon, AU - Chun,Mi-Ryung, AU - Lee,Soo-Youn, Y1 - 2019/02/21/ PY - 2019/02/08/received PY - 2019/02/15/revised PY - 2019/02/19/accepted PY - 2019/2/24/entrez PY - 2019/2/24/pubmed PY - 2019/4/23/medline KW - gastrectomy KW - gastric cancer KW - homocysteine KW - methylmalonic acid KW - vitamin B12 JF - Nutrients JO - Nutrients VL - 11 IS - 2 N2 - Vitamin B12 deficiency is a common complication in patients after gastrectomy. Elevated methylmalonic acid (MMA) and homocysteine are better indications of vitamin B12 deficiency than vitamin B12 serum level. We compared MMA and homocysteine levels of patients with gastric cancer after gastrectomy (n = 151) with controls (n = 142) and evaluated the prevalence of vitamin B12 deficiency using MMA and homocysteine in patients. MMA and homocysteine levels were significantly higher (p < 0.05) in patients with gastric cancer after gastrectomy. Of the 151 patients assessed after gastrectomy, 32 patients (21.2%) were vitamin B12 deficient as defined by serum MMA levels > 350 nmol/L, and 8 patients (5.3%) were vitamin B12 deficient as defined by serum homocysteine levels > 15 μmol/L. Both MMA and homocysteine levels were elevated in 7 patients. Among 33 patients with elevated MMA or homocysteine levels, 8 patients (24.2%) were vitamin B12 deficient based on a serum vitamin B12 level < 200 pg/mL. Additionally, levels of MMA and homocysteine were compared pre- and post-gastrectomy in 27 patients. The median MMA level was higher in patients with post-gastrectomy compared to pre-gastrectomy, while the median serum homocysteine level was not significantly different. These results indicate that using serum vitamin B12 levels alone may fail to detect vitamin B12 deficiency. Additional assessments of MMA and homocysteine levels are useful to evaluate possible vitamin B12 deficiency in patients who underwent a gastrectomy, and MMA is a better indicator than homocysteine to detect early changes in vitamin B12 levels. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/30795564/Methylmalonic_Acid_and_Homocysteine_as_Indicators_of_Vitamin_B12_Deficiency_in_Patients_with_Gastric_Cancer_after_Gastrectomy_ L2 - https://www.mdpi.com/resolver?pii=nu11020450 DB - PRIME DP - Unbound Medicine ER -