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Continuous reference intervals for holotranscobalamin, homocysteine and folate in a healthy paediatric cohort

Joel D Smith1, Vasiliki Karlaftis2,3, Stephen Hearps2

  • 1Department of Laboratory Services, The Royal Children's Hospital, Parkville, VIC, Australia.

Annals of Clinical Biochemistry
|August 20, 2024
PubMed

Insights

Establishing reference intervals for vitamin B12 and folate markers in children is crucial. This study provides continuous reference intervals for holotranscobalamin, homocysteine, and red cell folate in healthy children aged 30 days to 18 years.

Area of Science:

  • Pediatric Nutrition
  • Clinical Biochemistry
  • Developmental Pediatrics

Background:

  • Vitamin B12 and folate deficiencies are significant concerns in pediatric populations.
  • Accurate reference intervals (RIs) for assessing vitamin B12 and folate metabolism in healthy children are limited.
  • Understanding age-related changes in these markers is essential for proper diagnosis.

Purpose of the Study:

  • To establish continuous, age-specific reference intervals for key vitamin B12 and folate metabolites in children.
  • To characterize the dynamic changes in holotranscobalamin, homocysteine, and red cell folate levels throughout childhood and adolescence.
  • To provide clinicians with reliable data for assessing vitamin B12 and folate status in pediatric patients.

Main Methods:

  • Analysis of blood samples from 378 healthy children aged 30 days to under 18 years.
  • Derivation of continuous 95th percentile reference intervals for holotranscobalamin, homocysteine, and red cell folate.
  • Longitudinal assessment of marker concentrations across different developmental stages.

Main Results:

  • Holotranscobalamin levels were lowest at birth, increased in early childhood, and decreased after ages 4-6 years.
  • Red cell folate levels were highest in early life, declining steadily into adulthood.
  • Total homocysteine levels were elevated in infancy, reached a minimum at age 2, and then increased towards adulthood.

Conclusions:

  • Continuous 95th percentile reference intervals for holotranscobalamin, homocysteine, and red cell folate were successfully established for children aged 30 days to <18 years.
  • These markers exhibit significant dynamic changes during childhood and adolescence.
  • The established RIs will aid clinicians in the accurate assessment of vitamin B12 and folate status in children and adolescents.
Abstract

Keywords:
Nutritionclinical studies

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