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
{"title":"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。","authors":"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","doi":"10.1016/j.ajcnut.2025.06.029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vitamin B12 is a crucial micronutrient for infant growth and development.</p><p><strong>Objective: </strong>To describe vitamin B12 status in Norwegian infants aged 6-15 weeks using multiple biomarkers and cut-off approaches, and to identify its predictors.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong>NCT05005897.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Infant Vitamin B12 Status and its Predictors - Cross-Sectional Baseline Results from an Ongoing Randomized Controlled Trial.\",\"authors\":\"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\",\"doi\":\"10.1016/j.ajcnut.2025.06.029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Vitamin B12 is a crucial micronutrient for infant growth and development.</p><p><strong>Objective: </strong>To describe vitamin B12 status in Norwegian infants aged 6-15 weeks using multiple biomarkers and cut-off approaches, and to identify its predictors.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong>NCT05005897.</p>\",\"PeriodicalId\":50813,\"journal\":{\"name\":\"American Journal of Clinical Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajcnut.2025.06.029\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajcnut.2025.06.029","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Infant Vitamin B12 Status and its Predictors - Cross-Sectional Baseline Results from an Ongoing Randomized Controlled Trial.
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.
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.
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