Correlates of serum holo-Transcobalamin in the elderly general population

Holo-Transcobalamin (holo-TC) is the biologically active form of vitamin B12, an essential vitamin that is only contained in animal derived food products. While severe vitamin B12 deficiency has well known clinical consequences, the relation of holo-TC within the physiological range to various metabolic and lifestyle parameters in the general population is largely unknown.

We aimed to identify cross-sectional metabolic, lifestyle, and dietary correlates of serum holo-TC in a population-based sample.

Serum holo-TC was measured by electro-chemiluminescence in n = 788 individuals (44.0% females, age 61.3 [52.8; 70.2] years). Significant metabolic and lifestyle correlates of serum holo-TC were identified in a backward selection process and included in a final linear regression model. We used a validated Food Frequency Questionnaire to determine daily dietary intake of dairy products, eggs, fish and seafood, and meat and meat products. Associations of food group intake with holo-TC were tested in multivariable-adjusted analyses, both continuously by linear regression models and across holo-TC tertiles by ANCOVA.

Median serum holo-TC was measured at 83.6 [66.9; 115.2] pmol/L. We identified a 10% increase in alanine aminotransferase, total cholesterol, diastolic blood pressure, or alcohol consumption to confer a 2.03% [1.46; 2.60], 4.58% [1.79; 7.45], -2.66% [-4.78; -0.48], or -0.25% [-0.45; -0.05] change in serum holo-TC, respectively. Compared to no supplementation, vitamin B complex supplementation conferred 19.59% [9.72; 30.34] and females compared to males showed 11.55% [5.38; 18.08] higher serum holo-TC levels. Furthermore, a higher consumption of dairy products (in males and females) and fish and seafood (in males) was associated with significantly higher levels of serum holo-TC.

Vitamin B complex supplementation, dairy products and fish and seafood were identified as major sources of vitamin B12 uptake being reflected in serum holo-TC. Furthermore, sex, total cholesterol, a biomarker of liver function, diastolic blood pressure, and alcohol consumption were associated with serum holo-TC in the northern German population.