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The Controversial Issue of Hypervitaminosis B12 as Prognostic Factor of Mortality: Global Lessons from a Systematic
Edith Valdez-Martínez1, Horacio Márquez-González2, Ricardo Ramírez-Aldana3
1Health Research Council, Mexican Institute of Social Security, Centro Médico Nacional SXXI, Avenida Cuauhtémoc 330, Colonia Doctores, Mexico City 06720, Mexico.
Objective:
To test whether hypervitaminosis B12 is useful for prognosis of all-cause mortality.
Methods:
Meta-analysis of longitudinal, observational, epidemiologic studies. PubMed, Scopus, Web of Science, Google Scholar, and ProQuest One Academic were searched from inception to 30 June 2024. Studies including humans aged ≥18 years with hypervitaminosis B12, and in whom the outcome variable was all-cause mortality, were included. Two reviewers screened, abstracted (using standardized data collection sheet), and appraised articles (ROBINS-E framework) independently. Frequentist and Bayesian approaches were used for the meta-analysis.
Results:
A total of 28 studies were included in the meta-analysis (among the 69,610 participants, 15,815 all-cause deaths were reported). High serum levels of B12 increased marginally the risk of all-cause mortality specifically among chronic diseases (RR = 1.40; 95% IC = 1.05 to 1.85) and hospitalized (RR = 1.57; 95% IC = 1.19 to 2.07). In the meta-regression, these results were not statistically significant. The Bayesian analysis confirmed the risks of the mentioned groups; however, it was limited by the number of studies that contained the necessary information. The methodology applied and the clinical heterogeneity of each included study bring up the idea that artefacts might be involved when mortality is found to be high for hypervitaminosis B12.
Conclusions:
This meta-analysis did not show that hypervitaminosis B12 represents a higher risk of all-cause mortality in adults.
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