Age-specific reference ranges are needed to interpret serum methylmalonic acid concentrations in the US population

Details

• Alternative Title:
  Am J Clin Nutr
• Personal Author:
  Mineva, Ekaterina M. ; Sternberg, Maya R. ; Zhang, Mindy ; Aoki, Yutaka ; Storandt, Renee ; Bailey, Regan L. ; Pfeiffer, Christine M.
• Description:
  Background:
  
  Serum vitamin B-12 is measured to evaluate vitamin B-12 status. Serum methylmalonic acid (MMA) is a specific functional indicator of vitamin B-12 status, however, concentrations increase with impaired renal function.
  
  Objective:
  
  Our main objective was to describe the distribution of serum vitamin B-12 and MMA in US adults, and estimate age-specific reference intervals for serum MMA in a healthy subpopulation with replete vitamin B-12 status and normal renal function.
  
  Design:
  
  We examined cross-sectional data for serum vitamin B-12 and MMA in adults participating in the National Health and Nutrition Examination Survey from 2011–2014. Vitamin B-12 was measured by electrochemiluminescence assay and MMA by isotope-dilution LC-MS/MS.
  
  Results:
  
  In both bivariate and multivariate analyses, age, race/Hispanic origin, and vitamin B-12 supplement use were generally significantly associated with serum vitamin B-12 and MMA concentrations. Serum MMA concentrations increased with age, particularly in persons ≥70 y. Non-Hispanic white persons had lower vitamin B-12 and higher MMA concentrations compared with non-Hispanic black persons. Shorter fasting times and impaired renal function were significantly associated with higher serum MMA concentrations, but not with serum vitamin B-12 concentrations after controlling for covariates. The central 95% reference intervals for serum vitamin B-12 and MMA concentrations were widest for persons ≥70 y compared with younger age groups. Compared with the overall population, the central 95% reference intervals for serum MMA concentrations were considerably narrower for a vitamin B-12 replete subpopulation with normal renal function, but still age-dependent. Serum vitamin B-12 showed little, while serum MMA showed notable increases with impaired renal function.
  
  Conclusions:
  
  The higher serum MMA concentrations throughout the entire distribution in older persons (especially persons ≥70 y) who are vitamin B-12 replete and have normal renal function indicate the need for age-specific MMA reference intervals to better interpret the vitamin B-12 status in epidemiologic research.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Age Factors Biomarkers Ethnicity Female Humans Kidney Male Methylmalonic Acid Middle Aged Nutrition Surveys Reference Values Sensitivity And Specificity Vitamin B 12 Vitamin B 12 Deficiency Young Adult

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• Source:
  Am J Clin Nutr. 110(1):158-168
• Pubmed ID:
  31127807
• Pubmed Central ID:
  PMC7941258
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Name as Subject:
  National Health and Nutrition Examination Survey (U.S.)
• Place as Subject:
  United States
• Volume:
  110
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e11fb15b35ebeacdd2630e492125b4a74bd09172295efac345db25a69f7ff14c
• Download URL:
  https://stacks.cdc.gov/view/cdc/103892/cdc_103892_DS1.pdf
• File Type:
  [PDF - 554.20 KB ]