Dominic J Harrington, Emma Stevenson, Agata Sobczyńska-Malefora
{"title":"评估维生素 B12 状态的实验室生物标志物的应用和解释。","authors":"Dominic J Harrington, Emma Stevenson, Agata Sobczyńska-Malefora","doi":"10.1177/00045632241292432","DOIUrl":null,"url":null,"abstract":"<p><p>Vitamin B<sub>12</sub> (cobalamin; B<sub>12</sub>) is an essential micronutrient, but deficiency is common. The prompt diagnosis and treatment of B<sub>12</sub> deficiency protects against megaloblastic anaemia, neuropathy and neuropsychiatric changes. Biomarkers of B<sub>12</sub> status include the measurement of serum B<sub>12</sub> (also known as total B<sub>12</sub> or serum cobalamin), holotranscobalamin (holoTC or 'active B12'), methylmalonic acid (MMA) and total plasma homocysteine (Hcy). There is no 'gold standard' test for deficiency and the sensitivity and specificity of each biomarker for the evaluation of B<sub>12</sub> status is affected by analytical and biological factors that may confer a high degree of diagnostic uncertainty. Limited access to technical and clinical expertise can lead to an over-reliance on the serum B<sub>12</sub> test, which is readily available and highly automated. In some cases, the sequential use of different B<sub>12</sub> status biomarkers or the calculation of a composite B<sub>12</sub> status score, derived from a panel of B<sub>12</sub> biomarkers and adjusted for folate status and age, can be used to detect deficient states that may otherwise be overlooked when using a single biomarker approach. This review summarizes the utility of B<sub>12</sub>-related biomarkers and describes approaches to their application and interpretation.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632241292432"},"PeriodicalIF":2.1000,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The application and interpretation of laboratory biomarkers for the evaluation of vitamin B12 status.\",\"authors\":\"Dominic J Harrington, Emma Stevenson, Agata Sobczyńska-Malefora\",\"doi\":\"10.1177/00045632241292432\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Vitamin B<sub>12</sub> (cobalamin; B<sub>12</sub>) is an essential micronutrient, but deficiency is common. The prompt diagnosis and treatment of B<sub>12</sub> deficiency protects against megaloblastic anaemia, neuropathy and neuropsychiatric changes. Biomarkers of B<sub>12</sub> status include the measurement of serum B<sub>12</sub> (also known as total B<sub>12</sub> or serum cobalamin), holotranscobalamin (holoTC or 'active B12'), methylmalonic acid (MMA) and total plasma homocysteine (Hcy). There is no 'gold standard' test for deficiency and the sensitivity and specificity of each biomarker for the evaluation of B<sub>12</sub> status is affected by analytical and biological factors that may confer a high degree of diagnostic uncertainty. Limited access to technical and clinical expertise can lead to an over-reliance on the serum B<sub>12</sub> test, which is readily available and highly automated. In some cases, the sequential use of different B<sub>12</sub> status biomarkers or the calculation of a composite B<sub>12</sub> status score, derived from a panel of B<sub>12</sub> biomarkers and adjusted for folate status and age, can be used to detect deficient states that may otherwise be overlooked when using a single biomarker approach. This review summarizes the utility of B<sub>12</sub>-related biomarkers and describes approaches to their application and interpretation.</p>\",\"PeriodicalId\":8005,\"journal\":{\"name\":\"Annals of Clinical Biochemistry\",\"volume\":\" \",\"pages\":\"45632241292432\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-10-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Clinical Biochemistry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00045632241292432\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Clinical Biochemistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00045632241292432","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
The application and interpretation of laboratory biomarkers for the evaluation of vitamin B12 status.
Vitamin B12 (cobalamin; B12) is an essential micronutrient, but deficiency is common. The prompt diagnosis and treatment of B12 deficiency protects against megaloblastic anaemia, neuropathy and neuropsychiatric changes. Biomarkers of B12 status include the measurement of serum B12 (also known as total B12 or serum cobalamin), holotranscobalamin (holoTC or 'active B12'), methylmalonic acid (MMA) and total plasma homocysteine (Hcy). There is no 'gold standard' test for deficiency and the sensitivity and specificity of each biomarker for the evaluation of B12 status is affected by analytical and biological factors that may confer a high degree of diagnostic uncertainty. Limited access to technical and clinical expertise can lead to an over-reliance on the serum B12 test, which is readily available and highly automated. In some cases, the sequential use of different B12 status biomarkers or the calculation of a composite B12 status score, derived from a panel of B12 biomarkers and adjusted for folate status and age, can be used to detect deficient states that may otherwise be overlooked when using a single biomarker approach. This review summarizes the utility of B12-related biomarkers and describes approaches to their application and interpretation.
期刊介绍：
Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine.
Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals.
Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).
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