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Are vitamin B-12 measurements adequate for evaluating its deficiency in individuals?
Sedat Özdemir1, Selda Demirtaş2
1Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey. Email: drsedatozdemir@gmail.com, sedat.ozdemir@saglik.gov.tr.
Background And Objectives:
Measurement of vitamin B-12 deficiency using different methods may cause diagnostic difficulties. In order to rapidly and safely diagnose vitamin B-12 deficiency, it is important to determine the reference ranges of serum B-12 and its related biomarkers such as homocysteine, holotranscobalamine (holo-TC) and methylmalonic acid (MMA). This study aimed to determine reference interval (RI)s for serum vitamin B-12 and related markers.
Methods And Study Design:
Samples were collected from 404 young-to-middle-aged healthy adults aged 18-65 years. Vitamin B-12, homocysteine, holotranscobalamin, folate were analyzed using the Arcitect i2000 device. Plasma MMA was analyzed by LC/MS. RIs were then evaluated accordingly.
Results:
Vitamin B-12, folate, homocysteine, holotranscobalamin and plasma MMA were 139-619 pg/mL, 3.0-14.7 ng/mL, 5.6-18.4 μmol/L, 10.7-101 pmol/L, and 0.01-0.8 μmol/L, respectively. Age group-specific RIs were also generated.
Conclusions:
This study revealed that the diagnosis of vitamin B-12 deficiency should not only be based on serum vitamin B-12 levels, but also of folate, homocysteine, holotranscobalamin and MMA levels; all which are related to vitamin B-12 metabolism.

