Vitamin B12 absorption and factors associated with the response to long-term oral B12 supplementation: a secondary analysis of data from a B12-deficient Indian rural community.

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

European Journal of Clinical Nutrition Pub Date : 2026-09-21 DOI:10.1038/s41430-026-01825-z

Chittaranjan S Yajnik, Urmila S Deshmukh, Dattatray S Bhat, Rucha Sh Wagh, Onkar A Deshmukh, Rasika Ladkat, Lindsay D Plank, Souvik Bandyopadhyay, Caroline H Fall, Helga Refsum, Elaine C Rush

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引用次数: 0

Abstract

Background: The absorption of oral vitamin B12 (B-12) and predictors of its long-term supplementation are not well understood in populations with B-12 insufficiency.

Objective: In a secondary data analysis of a B-12 absorption study and a supplementation trial in a B-12 insufficient rural Indian community, we examined (i) the distribution of plasma holotranscobalamin (holoTC) responses during an absorption test, and (ii) predictors of B-12 status during long-term, oral supplementation with physiological and near-physiological doses of B-12.

Methods: Participants in the Pune Maternal Nutrition Study first underwent a B-12 absorption study (CobaSorb protocol) and subsequently participated in a 12-month double-blind randomized controlled trial of daily oral B-12 (0, 2, or 10 µg cyanocobalamin) and folic acid (0 or 200 µg). Plasma holoTC responses during absorption test were characterized, and linear mixed-effects models used to identify predictors of B-12 absorption and response during long-term supplementation.

Results: Participants (313) included children (n = 109, mean age 9 y, weight 21.9 kg, BMI 13.6 kg/m²), mothers (n = 108, 30 y, 47.7 kg, 19.3 kg/m²), and fathers (n = 96, 37 y, 59.3 kg, 21.4 kg/m²). The holoTC response during the absorption test was positively associated with the B-12 dose (10 or 2 µg) and negatively with body weight. Improvements in B-12 status (plasma B-12, tHcy, combined B-12 indicator: 2cB12) after supplementation were positively predicted by baseline biomarker concentration, holoTC response during absorption test, B-12 dose, and compliance.

Conclusions: The holoTC response during B-12 absorption test predicted subsequent biomarker responses to long-term B-12 supplementation, linking absorptive capacity with metabolic correction. These findings provide a mechanistic framework for understanding variability in response to oral B-12 replenishment.

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维生素B12吸收及与长期口服B12补充反应相关的因素：对B12缺乏的印度农村社区数据的二次分析

背景：口服维生素B12 （B-12）的吸收及其长期补充的预测因素在B-12不足人群中尚不清楚。目的：在B-12吸收研究和补充试验的二级数据分析中，我们检查了(i)在吸收试验中血浆全反钴胺素（holoTC）反应的分布，以及（ii）长期口服生理和接近生理剂量B-12的B-12状态的预测因子。方法：普纳产妇营养研究的参与者首先进行了B-12吸收研究（CobaSorb方案），随后参加了一项为期12个月的双盲随机对照试验，每天口服B-12（0、2或10µg氰钴胺素）和叶酸（0或200µg）。对吸收试验期间的等离子体全息反应进行了表征，并使用线性混合效应模型来确定长期补充期间B-12吸收和反应的预测因子。结果：参与者（313）包括儿童（n = 109，平均年龄9岁，体重21.9 kg, BMI 13.6 kg/m2），母亲（n = 108, 30岁，47.7 kg, 19.3 kg/m2）和父亲（n = 96, 37岁，59.3 kg, 21.4 kg/m2）。吸收试验中holoTC反应与B-12剂量（10或2µg）呈正相关，与体重负相关。补充后B-12状态（血浆B-12、tHcy、联合B-12指标：2cB12）的改善可以通过基线生物标志物浓度、吸收试验期间的holoTC反应、B-12剂量和依从性来积极预测。结论：B-12吸收试验中的holoTC反应预测了长期补充B-12后的生物标志物反应，将吸收能力与代谢纠正联系起来。这些发现为理解口服B-12补充反应的变异性提供了一个机制框架。

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

European Journal of Clinical Nutrition 医学-营养学

CiteScore

10.60

自引率

2.10%

发文量

189

审稿时长

3-6 weeks

期刊介绍： The European Journal of Clinical Nutrition (EJCN) is an international, peer-reviewed journal covering all aspects of human and clinical nutrition. The journal welcomes original research, reviews, case reports and brief communications based on clinical, metabolic and epidemiological studies that describe methodologies, mechanisms, associations and benefits of nutritional interventions for clinical disease and health promotion. Topics of interest include but are not limited to: Nutrition and Health (including climate and ecological aspects) Metabolism & Metabolomics Genomics and personalized strategies in nutrition Nutrition during the early life cycle Health issues and nutrition in the elderly Phenotyping in clinical nutrition Nutrition in acute and chronic diseases The double burden of ''malnutrition'': Under-nutrition and Obesity Prevention of Non Communicable Diseases (NCD)