Infant Vitamin B12 Status and its Predictors - Cross-Sectional Baseline Results from an Ongoing Randomized Controlled Trial.

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-07-01 DOI:10.1016/j.ajcnut.2025.06.029

Sol Maja G Bjørkevoll, Maria O'Keeffe, Carolien Konijnenberg, Beate S Solvik, Alida F Sødal, Siri Kaldenbach, Adrian McCann, Per M Ueland, Ingrid Kvestad, Elisabeth Ersvær, Mads N Holten-Andersen, Kjersti S Bakken, Tor A Strand

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引用次数: 0

Abstract

Background: Vitamin B12 is a crucial micronutrient for infant growth and development.

Objective: To describe vitamin B12 status in Norwegian infants aged 6-15 weeks using multiple biomarkers and cut-off approaches, and to identify its predictors.

Methods: From November 2021 through August 2024, infants aged 6-15 weeks and their mothers were recruited from public health clinics in Innlandet County, Norway, as part of an ongoing randomized controlled trial. Plasma cobalamin and methylmalonic acid (MMA) concentrations were analyzed among all infants in the cohort (n=644) and total-homocysteine (tHcy) concentrations were analyzed in a subgroup (n=358). The combined indicator for vitamin B12 status (cB12) was calculated by the Fedosov's equation. Low status was defined using multiple cut-off approaches. Potential predictors of infant vitamin B12 status were evaluated using regression models.

Results: Mean (standard deviation (SD)) infant age was 9.1 (1.8) weeks. The median (interquartile range) concentrations were: cobalamin 242 (192, 322) pmol/L, tHcy 7.4 (6.2, 9.4) μmol/L, and MMA 0.34 (0.21, 0.77) μmol/L. The mean (SD) cB12 was -0.5 (0.7). Eight percent had cobalamin <148 pmol/L, and 40% <221 pmol/L. Sixty-seven percent had tHcy >6.5 μmol/L, 19% >10 μmol/L, and 4% >13 μmol/L. Sixty-four percent had MMA>0.26 μmol/L. Exclusively breastfed infants had 40% lower cobalamin and 30% higher tHcy compared to non-breastfed infants. Partially breastfed infants had 21% lower cobalamin, and 12% higher tHcy compared to non-breastfed infants.

Conclusion: A substantial proportion of Norwegian infants have biochemical signs of low vitamin B12 status, regardless of the cut-off. Lower status was observed in partially and exclusively breastfed infants, compared to non-breastfed infants. However, it is unclear whether these biomarker patterns have clinical significance. Further research is needed to determine consequences of low vitamin B12 biomarker concentrations in early infancy.

Trial registration: NCT05005897.

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婴儿维生素B12状况及其预测因素——一项正在进行的随机对照试验的横断面基线结果。

背景：维生素B12是婴儿生长发育的重要微量营养素。目的：使用多种生物标志物和截止方法描述挪威6-15周婴儿的维生素B12状况，并确定其预测因素。方法：从2021年11月到2024年8月，作为一项正在进行的随机对照试验的一部分，从挪威因兰代县的公共卫生诊所招募了6-15周的婴儿及其母亲。对队列中所有婴儿（n=644）的血浆钴胺素和甲基丙二酸（MMA）浓度进行分析，并对一个亚组（n=358）的总同型半胱氨酸（tHcy）浓度进行分析。维生素B12状态的综合指标（cB12）由费多索夫方程计算。使用多个截止方法定义低状态。使用回归模型评估婴儿维生素B12状态的潜在预测因素。结果：平均（标准差（SD））婴儿年龄为9.1（1.8）周。中位浓度（四分位数范围）为：钴胺素242(192、322)μmol/L, tHcy 7.4(6.2、9.4)μmol/L, MMA 0.34(0.21、0.77)μmol/L。平均（SD） cB12为-0.5（0.7）。8%的人钴胺素为6.5 μmol/L， 19%的人钴胺素为10 μmol/L， 4%的人钴胺素为13 μmol/L。MMA浓度为0.26 μmol/L的占64%。与非母乳喂养的婴儿相比，纯母乳喂养的婴儿钴胺素含量低40%，高30%。与非母乳喂养的婴儿相比，部分母乳喂养的婴儿钴胺素含量低21%，钴胺素含量高12%。结论：相当比例的挪威婴儿有低维生素B12状态的生化迹象，无论临界值如何。与非母乳喂养的婴儿相比，部分母乳喂养和完全母乳喂养的婴儿的状态较低。然而，尚不清楚这些生物标志物模式是否具有临床意义。需要进一步的研究来确定婴儿早期维生素B12生物标志物浓度低的后果。试验注册：NCT05005897。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.