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Age-specific reference ranges are needed to interpret serum methylmalonic acid concentrations in the US population
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July 01 2019
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Source: Am J Clin Nutr. 110(1):158-168
[PDF-554.20 KB]
Details:
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Alternative Title:Am J Clin Nutr
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Personal Author:
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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.
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Pubmed ID:31127807
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Pubmed Central ID:PMC7941258
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Volume:110
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Issue:1
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