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Background: Maternal nutritional deficiency is linked with several adverse outcomes in offspring but the link between maternal vitamin B12 levels and offspring schizophrenia remains unexplored., Methods: In this nationwide population-based nested case-control design, 1145 schizophrenia cases were born between 1987-1997 and diagnosed by 2017 and each case were matched with a control. Maternal vitamin B12 levels during the first and early second trimesters of pregnancy were measured using chemiluminescence microparticle immunoassay from maternal sera. Conditional logistic regression was used to examine the association between maternal vitamin B12 levels and offspring schizophrenia., Results: Low maternal vitamin B12 levels were not associated with offspring schizophrenia in unadjusted (OR 1.04, 95% CI 0.88-1.24) or adjusted analyses (aOR 1.14, 95% CI 0.95-1.37). When analyzed by quintiles, no significant association was observed between the lowest versus highest quintile of maternal vitamin B12 levels and schizophrenia in unadjusted (OR 1.01, 95% CI 0.78-1.30) or adjusted analyses (OR 0.89, 95% CI 0.68-1.17)., Conclusion: Maternal vitamin B12 levels in early pregnancy were not associated with offspring schizophrenia. Future studies measuring both genetic and environmental factors are required to elucidate the role of maternal vitamin B12 deficiency in schizophrenia and its potential pathways to influence schizophrenia in offspring., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Background&aims: Folate and vitamin B12 are vitamins involved in one carbon metabolism. Carotid intima-media thickness (cIMT) is a non-invasive test and an early atherosclerosis marker. The relationship between these vitamins and cIMT is not well established. This study aimed to investigate the association between baseline vitamins and cIMT changes during a median follow-up of 8 years., Methods: Prospective cohort study involving 5061 ELSA-Brasil participants from São Paulo state aged 35-74 years at baseline. Serum folate and vitamin B12 levels and dietary intake were assessed at baseline. Ultrasound cIMT measurements were performed at baseline and wave 3. Linear mixed-effects models, adjusted for covariables, assessed the association between vitamins at baseline and changes in cIMT., Results: 4260 participants were included; mean (SD) age was 51.4 (8.9) years and 54.5 % were women. Folate (0.02 %) and vitamin B12 (2.6 %) deficiencies were almost nonexistent. Participants in the 4th quartile of serum folate had a slower cIMT increase during 8 years of follow-up than those in the 1st quartile (1st vs. 4th quartile comparison: β (95 % CI): -0.015 (-0.026; -0.004), P: 0.006 for model 3). These findings remained the same after sensitivity analysis for overall dietary supplements and specifically multivitamins use. No association was found between vitamin B12 biomarker and the outcome. Dietary folate intake was also not associated with cIMT changes., Conclusion: In this population exposed to mandatory folic acid food fortification, prevalence of vitamins deficiencies was very low. Highest quartile of serum folate seemed to slow down the increment of cIMT measurements over time., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background and Aims: Vitamin B12 deficiency has been associated with neuropsychiatric symptoms (NPS), but the relationship between vitamin B12 and NPS remains unclear prior to the onset of dementia. The study aims to examine the association between vitamin B12 and NPS in dementia-free Asian older adults., Methods: This is a cross-sectional population-based study where multi-ethnic community-dwelling Asian participants (i.e. Chinese, Malay, Indian) aged ≥60 years underwent comprehensive neuropsychological and clinical assessments including the examination of clinical history and the collection of blood samples. NPS and subsyndromes were evaluated using the Neuropsychiatric Inventory (NPI). Serum vitamin B12 and homocysteine (Hcy) concentration were measured by competitive immunoassays. To analyse the relationship between vitamin B12 and NPS, hierarchical linear regression, multinomial regression and moderation analyses were performed., Results: A total of 798 dementia-free individuals (age = 69.7 ± 6.5 years old, F = 408 (51.1 %)) were included in the current study. There were 80 (10 %) individuals with clinically relevant NPS (i.e. NPI scores ≥4). Higher vitamin B12 was associated with lower NPI total scores (p = 0.030) and apathy (p = 0.005), after controlling for age, sex, ethnicity, cognitive functioning, socioeconomic status and Hcy concentration. Participants with higher vitamin B12 was also less likely to have clinically relevant apathy (p = 0.007). The moderation effect of Hcy and cognitive functioning on the inverse association between vitamin B12 and NPS was observed., Conclusions: A protective effect of vitamin B12 on NPS and subsyndromes was observed in a multi-ethnic Asian cohort of dementia-free individuals. Future longitudinal studies are required to further elucidate the pathophysiological mechanisms between vitamin B12 and NPS in diverse ethnic groups., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Vitamin B 12 (cobalamin; B 12 ) is an essential micronutrient, but deficiency is common. The prompt diagnosis and treatment of B 12 deficiency protects against megaloblastic anaemia, neuropathy and neuropsychiatric changes. Biomarkers of B 12 status include the measurement of serum B 12 (also known as total B 12 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 12 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 12 test, which is readily available and highly automated. In some cases, the sequential use of different B 12 status biomarkers or the calculation of a composite B 12 status score, derived from a panel of B 12 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 12 -related biomarkers and describes approaches to their application and interpretation., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Objectives: To determine the proportion of children with severe acute malnutrition (SAM) having vitamin B12 deficiency, its clinical predictors, and its association with development., Methods: In this cross-sectional study, 100 children between 1 mo to 59 mo [mean (SD) age 17 (12.75) mo; 55 males], with diagnosis of SAM as per WHO criteria, were included. Serum vitamin B12, serum folate, and serum ferritin levels were measured by chemiluminescence immunometric assay method, while serum Homocysteine (Hcy) level was measured by enzymatic cycling method. Development assessment was done by Denver Development Screening Tool (DDST-II)., Results: The mean (SD) serum vitamin B12 (cobalamin) levels were 296.52 (246.95) pg/mL; 45% children were vitamin B12 deficient (<203 pg/mL). Hyperhomocysteinemia (>14 µmol/L) was present in 39 (39%), and among these 69% (27/39) children had concomitant low serum vitamin B12 levels. Severe anemia and hypoproteinemia were significantly and independently associated with vitamin B12 deficiency [aOR (95% CI) 3.22 (1.13, 10) and 10 (1.66, 58.82), respectively]. Out of 45 children who were vitamin B12 deficient, 93%, 87%, 62% and 80% had gross motor, fine-motor, language and adaptive-cognitive delay, respectively. Vitamin B12 level was significantly associated (P <0.001) with developmental delay., Conclusions: There is a high prevalence of vitamin B12 deficiency in children with SAM, which is also associated with development delay across all domains (except language) in these children., Competing Interests: Declarations. Conflict of Interest: None., (© 2023. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation.)

Vitamin B12 is an essential micronutrient required for the proper functioning of the human body. Vitamin B12 deficiency is primarily causative of various neurolological disorders alongwith recurrence of oral ulcers and burning sensations which are early signs of condition such as pernicious anemia. Other complications associated with Vitamin B12 deficiency include risk of heart failure due to anemia, risk of developing autoimmune disorders and gastric cancer. Therefore, to obstruct these communal health issues, early detection of Vit B12 is highly needed. However, screening of vitamin B12 insufficiency is hindered by the low sensitivity of the conventional vitamin B12 test. Holotranscobalamin (holoTC) is an early indicator of the negative vitamin B12 balance as it is the first protein to decline in the serum. We report a novel impedimetric immunosensor based on flower-like poly (3,4-ethylenedioxythiophene) (PEDOT) nanostructural film impregnated with silver molybdate nanoparticles (Ag 2 MoO₄ NPs) deposited on fluorine-doped tin oxide electrode. The prepared electrodes were characterized by Field emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), and electrochemical studies. The activated anti-holoTC antibody was immobilized and optimized to capture the target in a response time of 15 min. The electrochemical performance of the sensor was carried out by using the electrochemical impedance spectroscopy technique (EIS) and a good linear relationship between ΔR ct and holoTC was obtained in the range from 0.1 pg mL -1 to 100 ng mL -1 with a detection limit of 0.093 pg mL -1 . The proposed sensor was successfully applied in human serum samples for holoTC detection. The experimental results showed that the immunosensor is highly selective towards holoTC and presented an acceptable stability of 20 days with reproducibility RSD ≤4%. To the best of our knowledge, this is the first developed electrochemical immunosensor for holoTC detection., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Obesity is a risk factor for diabetes mellitus, which commonly coexists with pancreatitis in cats. However, obesity has not previously been associated with pancreatitis in cats., Objectives: To evaluate factors affecting serum concentrations of pancreatic lipase immunoreactivity (fPLI), trypsin-like immunoreactivity (fTLI), cobalamin and folate in clinically healthy lean, overweight and obese, or diabetic cats., Animals: Seventy-nine client-owned cats (27 healthy lean [LN, BCS 4-5/9], 30 healthy overweight and obese [OW, BCS 7-9/9], and 22 diabetic [DM]) were included., Methods: Cross-sectional study. The cats underwent physical examination, and blood tests. Linear regression models compared differences in fPLI, fTLI, cobalamin, and folate concentrations. Fisher's exact test assessed the proportions of cats with fPLI and fTLI indicative of pancreatitis, and hypocobalaminemia. A random forest algorithm identified explanatory variables for cats having fPLI levels indicative of pancreatitis., Results: No LN cats, while 6/30 (20%) of OW and 10/22 (45%) of DM cats had fPLI concentrations indicative of pancreatitis. Body condition score (P = .02) and body weight (P = .002) were positively associated with fPLI levels in LN and OW cats. Higher fPLI, and lower cobalamin concentrations were associated with higher age across groups., Conclusions and Clinical Importance: Body condition score and body weight were associated with higher fPLI levels in nondiabetic cats. A larger proportion of OW and DM cats had fPLI concentrations indicative of pancreatitis compared to LN cats. Whether this indicates subclinical pancreatitis remains to be determined. Hypocobalaminemia was less frequent in OW compared to DM cats., (© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Objective: This systematic review and meta-analysis aimed to evaluate the vitamin B12 status and intake of Seventh-day Adventists following a plant-based diet and compare it with omnivore controls to investigate their susceptibility for vitamin B12 deficiency., Data Source: Peer-reviewed articles were identified through a comprehensive search in PubMed, Scopus, and Google Scholar databases from inception up to the year 2024 using specific keywords related to vitamin B12 and Seventh-day Adventists., Study Inclusion and Exclusion Criteria: Observational studies published in the English language were included if they reported on vitamin B12 status or intake among plant-based Adventists and compared it with omnivore controls who may or may not have been Adventists. Studies that did not present distinguishable results for vegetarian/vegan from omnivore Adventists or only reported on food item intake without specific vitamin B12 data were excluded., Data Extraction: Two independent reviewers extracted data on study characteristics, vitamin B12 intake, and serum levels using a customised data extraction form, resolving discrepancies through consultation with a third reviewer., Data Synthesis: A meta-analysis was conducted using random-effect models due to anticipated heterogeneity, without any subgroup analysis due to the low number of studies. Sensitivity analysis was performed using the 'leave-on-out' method to assess individual study influence on overall effect size and heterogeneity., Results: Four studies met inclusion criteria, encompassing 1994 participants. Meta-analysis showed no significant differences in serum vitamin B12 levels (MD: -9.85 pmol/L; 95% CI: -45.64 to 25.94 pmol/L; P = 0.54, I 2 = 50%) or daily intake (MD: 3.31 mcg/d; 95% CI: -4.70 to 11.32 mcg/d; P = 0.42, I 2 = 90%) between plant-based Adventists and omnivore controls, although there was high heterogeneity between the studies., Conclusion: Adventists following a vegan or vegetarian diet did not demonstrate increased risk of vitamin B12 deficiency due to the widespread consumption of fortified foods and supplements. The findings underscore the importance of supplementation and the consumption of fortified foods for maintaining adequate B12 status among vegan or vegetarian Adventists but highlight the need for further studies to confirm these observations in diverse geographical areas., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Recurrent pregnancy loss (RPL) seriously affects women's reproductive and mental health, and the incidence has increased in recent years. Insulin resistance (IR) acts as a significant contributing factor to RPL. Studies suggest that vitamin B12, folate intake, and homocysteine are correlated with IR, but the exact nature remains controversial and requires further investigation. In this study, we aimed to assess the levels and correlations between vitamin B12-folate-homocysteine and insulin resistance in RPL patients., Study Design: 73 control subjects and 256 RPL patients (144 RPL patients without IR and 112 RPL patients with IR) were included in this observational retrospective cross-sectional study. The differences in vitamin B12, folate, and homocysteine levels between RPL patients with and without IR were analyzed using a Student's t-test. Pearson correlations were utilized to examine the correlation between vitamin B12-folate-homocysteine and glucose and lipid metabolism parameters. Multivariable linear regressions were used to assess the independent correlation of each factor with HOMA-IR., Results: Compared to the control subjects, RPL patients exhibited lower vitamin B12 (p < 0.001) and folate (p < 0.001), and higher homocysteine (p = 0.001). RPL patients with IR described decreases in vitamin B12 (p = 0.003) and folate (p = 0.028), and increases in homocysteine (p = 0.033) as RPL patients without IR. Vitamin B12 in RPL patients was significantly negatively correlated with homocysteine (r = -0.348, p < 0.001), HOMA-IR (r = -0.214, p < 0.001), BMI (r = -0.160, p = 0.017), TG (r = -0.148, p = 0.039) and CHO (r = -0.149, p = 0.038) and positively correlated with folate (r = 0.217, p < 0.001). In multivariable linear regressions, after adjusting for age, strong correlations were observed between vitamin B12 (β = -0.197, p = 0.010), BMI (β = 0.466, p < 0.001), and HOMA-IR in RPL patients., Conclusion: Vitamin B12 is significantly correlated with IR in RPL patients. Circulating vitamin B12-folate-homocysteine metabolism could be a window of the pathological process of IR, obesity, and lipid metabolism disorders in RPL patients., Competing Interests: Declaration of competing interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: There is a growing body of evidence on associations between one-carbon metabolism (OCM) and diabetes-related parameters., Objectives: For this reason, we aimed to examine the associations of plasma choline, betaine, trimethylamine N-oxide (TMAO), glutathione (GSH), serum folate, vitamin B12, dihydrofolate reductase (rs70991108) genotype, methylenetetrahydrofolate reductase (MTHFR) (rs180113) genotype, methylenetetrahydrofolate dehydrogenase (MTHFD1) (rs2236225) genotype, and phosphatidylethanolamine N-methyltransferase (rs7946 and rs12325817) genotype with fasting glucose level, insulin level, and diabetes-related indices., Methods: The study group consisted of 421 Polish adults aged 20-40 y. Food intake was assessed using a 3-d food diary. Plasma concentrations of choline, betaine, and TMAO were determined by ultra-high-performance liquid chromatography-electrospray ionization mass spectrometry. The total plasma GSH level was measured by high-performance liquid chromatography. Insulin, folate, and vitamin B12 concentrations were estimated by enzyme-linked immunosorbent assay method. Genotyping was performed with TaqMan probes., Results: GSH level was negatively associated with insulin (β = -0.11, P < 0.05) and gamma-glutamyl transferase (GGTP) (β = -0.12, P < 0.05), and positively associated with fasting glucose (β = 0.11, P < 0.05). Betaine intake was negatively associated with serum insulin concentration (β = -0.13, P < 0.05) and HOMA-IR (β = -0.12, P < 0.05). Choline intake was negatively associated with insulin (β = -0.17, P < 0.01). Serum folate level was negatively associated with GGTP (β = -0.11; P < 0.05). The methylenetetrahydrofolate reductase (MTHFR) CC genotype was associated with higher serum insulin levels (β = 0.15; P < 0.01) and higher HOMA-IR (β = 0.15, P < 0.01), whereas the MTHFD1 AA genotype was negatively associated with Quantitative Insulin Sensitivity Check Index (β = -0.11, P < 0.05)., Conclusions: Our findings suggest that higher GSH level and higher intake of betaine, B 12 , and choline, as well as the TT genotype of MTHFR and the AA genotype of MTHFD1, are associated with lower diabetes-related parameters among adults., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: In dogs, data on reference intervals (RIs) for cobalamin, markers of metabolism (markersB 12 met), age and sex effects are limited., Hypothesis/objectives: Establish RI for serum cobalamin, homocysteine, and methylmalonic acid (sMMA) concentrations, urinary methylmalonic acid-to-creatinine ratio (uMMA:crea), and determine effects of sex and age., Methods: Prospective study using healthy dogs (1-10 years). Cobalamin and markersB 12 met were determined using chemiluminescence immunoassay (cobalamin) and liquid chromatography/tandem mass spectrometry (homocysteine, sMMA, uMMA:crea). In dogs with outlying data, changes in health, markersB 12 met, and onset of gastrointestinal signs were reevaluated after 9-15 months., Results: Twelve of 120 healthy dogs had abnormal uMMA:crea ratios. No other cobalamin analyte outliers were found. Outlying data re-examination (odRE) was performed in 10/12 dogs. Chronic gastrointestinal signs occurred in 64% of odRE-dogs, whereas 36% remained healthy. In total, 112 dogs (67 females, 45 males; median ages, 3.5 and 3.75 years, respectively) were included in RI analyses. Reference intervals were 178.5-851 pmol/L (cobalamin), 5.8-29.0 μmol/L (homocysteine), 45.3-159.5 μg/L (sMMA), and ≤22.4 mg/g (uMMA:crea). Only age affected cobalamin concentrations (significant decrease). Compared by sex and neuter status, intact male dogs had significantly higher uMMA:crea ratios (median, 13.5; range, 1.9-83.6 mg/g) than the other groups (median, 2.5; range, 0.7-9.7 mg/g; P < .0001). Sex-specific RI were ≤58.9 mg/g (intact male) vs ≤5.2 mg/g (females and neutered males)., Conclusion and Clinical Importance: Intact male dogs had significantly higher uMMA:crea ratios than the other groups. Thus, sex-specific RI are recommended for uMMA:crea. Because of the wide distribution of uMMA:crea ratios, careful interpretation in intact male dogs is advised., (© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

This review provides an analysis of the current literature on the health and nutrition of blood donors, examining key aspects that affect the quality of donated blood and the well-being of donors. The review discusses effective iron absorption facilitated by key nutrients and presents evidence on the importance of a balanced diet rich in essential nutrients, such as vitamin B12 and folic acid. The review examines the differences in iron levels between men and women and highlights the role of sex hormones in regulating iron metabolism. In addition, the review discusses the link between psycho-emotional well-being and diet, showing that proper dietary habits can improve mental health, reduce stress, and enhance the donation experience. This article provides practical recommendations to support donor well-being and the effectiveness of blood donation programmes worldwide. By highlighting the differences between a modern diet and a diet tailored specifically for blood donors, we aim to emphasise the importance of a nutrient-dense diet for blood donors, which is critical for effective recovery and overall health maintenance. It is important to understand and incorporate different nutrient-dense foods that influence iron absorption for optimal health in blood donors. Donor health is also influenced by regular physical activity and psycho-emotional well-being. The 'healthy donor effect' and its implications for maintaining higher standards of donor health are explored in this review. This article highlights the fact that the diet of blood donors is influenced by gender, as men and women have different nutritional needs and physiological responses, particularly with regard to iron levels and recovery. The importance of enhancing or inhibiting iron absorption provides valuable evidence for food fortification as a cost-effective solution to reduce iron deficiency in blood donors., Competing Interests: The author has no relevant interests to declare., (© Copyright by the Author(s). Published by Cell Physiol Biochem Press.)

Introduction: Serum folate and vitamin B 12 levels correlate with the prevalence of fatty liver disease, but it is not clear how they affect mortality. Therefore, this study aimed to investigate the association of serum folate and vitamin B 12 concentrations with all-cause mortality in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD)., Methods: MASLD subjects were from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States, and mortality follow-up data were obtained by linkage to death records from the National Death Index. Multivariable Cox proportional regression models and restricted cubic spline (RCS) models were used to evaluate the association of serum folate/vitamin B 12 with all-cause mortality in the MASLD population., Results: 3,636 and 2,125 MASLD individuals were included in the analyses related to serum folate and vitamin B 12 , respectively. During a follow-up period of more than 20 years, the RCS models demonstrated significant nonlinear associations of both serum folate ( P < 0.001) and vitamin B 12 ( P =0.016) with all-cause mortality in MASLD. When their serum concentrations were below the median level, the risk of all-cause mortality decreased with increasing concentration, reaching a lowest risk around the median level, and then leveled off. In the multivariable cox regression model, for vitamin B 12 , the risk of all-cause mortality was reduced by 42% and 28% in the third and fourth quartile groups, respectively, compared with the lowest quartile group (hazard ratio [HR]=0.58, 95% CI: 0.39-0.86, P =0.008; HR =0.72, 95% CI: 0.54-0.96, P =0.026, respectively). For folate, the risk of all-cause mortality was reduced by 28% in the third quartile compared with the lowest quartile (HR =0.72, 95% CI: 0.57-0.91, P =0.005)., Conclusion: This longitudinal cohort study suggests that low serum folate and vitamin B 12 levels in patients with MASLD are significantly associated with an elevated risk of all-cause mortality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhu, Liao, Du, Lv and Deng.)

Background: Pernicious anemia (PA) is believed to be highly prevalent in Western countries but has rarely been reported in China. The study explores whether PA, an autoimmune disease, is an uncommon cause of cobalamin (vitamin B12) deficiency anemia in China., Methods: Clinical and hematological data were collected from 90 cobalamin deficiency-caused megaloblastic anemia (MA) patients between July 2014 and December 2021. Through anti-intrinsic factor antibody (IFA) and anti-parietal cell antibody (PCA) testing, PA was distinguished from other causes of cobalamin deficiency leading to MA. Meanwhile, 30 healthy controls (HCs) were included to estimate the positive rates of IFA and PCA., Results: Of the 30 HCs, only one tested positive for IFA, and all 30 tested negative for PCA. Among the 90 patients with cobalamin deficiency-caused MA, 76.7% were positive for IFA, and 47.8% were positive for PCA; a total of 76 patients (84.4%) were diagnosed with PA. The mean follow-up time was 41.0 ± 16.3 months. During the follow-up period, no case relapsed among the continuous cobalamin-supply treatment patients, while 24.4% of patients relapsed due to the interruption of maintenance cobalamin-supplement therapy (the median recurrence time was 54.0 ± 17.7 months)., Conclusions: The proportion of PA in cobalamin deficiency-caused MA patients in Hainan province was higher than 80%, which was more common than expected. Therefore, screening for IFA, PCA, endoscopic biopsy, and thyroid-related parameters are recommended for all cobalamin deficiency-caused MA patients. Furthermore, maintenance cobalamin-supplement therapy is important for PA patients.

Aim: This study aimed to compare the effects of Ballroom Dancing (BD) versus Walking Training (WT) on the physical fitness performance in physically independent older women with adequate or inadequate levels of vitamins B12 and D., Methods: Forty-three sedentary women aged 68.5 ± 6.5 years, were allocated to the BD (n = 23) or WT (n = 20) groups. They took part in a 12-week intervention, performed 3 times a week, for about 50 minutes with moderate effort intensity. Data were collected through Short Physical Performance Battery (SPPB), 6 minutes Walk Test (6MWT), Hand Grip Test (HGT), Isokinetic tests for lower limbs and blood tests to detect serum levels of vitamins B12 and D., Results: The BD group performed better after the intervention in relation to the WT in the Sit and Stand Test (SST) (BD pre = 3.1 score vs post = 3.8 score; WT pre = 2.8 score vs post = 3.4 score; P  = .02) and in the Peak Torque 180° extension (PKTOQ 180° extension) (BD pre = 56.7 Nm vs post = 61.2 Nm, WT pre = 56.7 Nm vs post = 56.1; P  < .01)., Conclusion: A time effect was observed in all other variables, with the exception of HGT. Both interventions improved physical fitness performance, regardless of the adequacy of vitamins B12 and D, but the older women from BD obtained significant improvements in more variables than the WT., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Hyperhomocysteinemia can be due to various abnormalities of the complex interaction of methionine, folate and vitamin B12. It has been known to be a cardiovascular risk factor. This study aims to review the clinical presentation, underlying causes and clinical outcome in paediatric patients diagnosed with significant hyperhomocysteinemia in Malaysia., Design and Methods: Data were obtained from the medical records and the laboratory information system. Paediatric patients with significant hyperhomocysteinemia were identified from a selective high-risk screening of 96,721 patients, performed between 2010 and 2022. Inclusion criteria for the study were paediatric patients with significant hyperhomocysteinemia (>40 µmol/L)., Results: Sixteen patients were identified. The average total homocysteine (tHcy) and methionine were 269 µmol/L and 499 µmol/L in cystathionine β-synthase deficiency (CBS), 127 µmol/L and 29 µmol/L in patients with remethylation defects and 390 µmol/L and 4 µmol/L in congenital B12 deficiency. We found c.609G>A as the most prevalent mutation in MMACHC gene and possible novel mutations for CBS (c.402del, c.1333C>T and c.1031T>G) and MTHFR genes (c.266T>A and c.1249del). Further subclassification revealed CBS was 5/16 patients (31 %), remethylation defects was 9/16 (56 %) and congenital B12 deficiency was 2/16 (13 %). All patients received standard treatment and regular monitoring of the main biomarkers. The average age at the time of diagnosis were 9.2 years (CBS) and 1.2 years (remethylation defects). Congenital B12 deficiency had slight delay in milestones, remethylation defects had mild to moderate learning disabilities, CBS had variable degree of intellectual disability, delayed milestones, ophthalmological abnormalities, and thrombosis at an early adolescent/adulthood., Conclusions: The majority of significant hyperhomocysteinemia in Malaysian children was due to remethylation defects. Screening for hyperhomocysteinemia in Malaysian children is recommended for earlier treatment and improved clinical outcome., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Incidence of esophageal and gastric cancer has been linked to low B-vitamin status. We conducted matched nested case-control studies of incident esophageal squamous cell carcinoma (ESCC; 340 case-control pairs) and gastric cancer (GC; 352 case-control pairs) within the Golestan Cohort Study. The primary exposure was plasma biomarkers: riboflavin and flavin mononucleotide (FMN) (vitamin B2), pyridoxal phosphate (PLP) (B6), cobalamin (B12), para-aminobenzoylglutamate (pABG) (folate), and total homocysteine (tHcy); and indicators for deficiency: 3-hydroxykyurenine-ratio (HK-r for vitamin B6) and methylmalonic acid (MMA for B12). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression adjusting for matching factors and potential confounders. High proportions of participants had low B-vitamin and high tHcy levels. None of the measured vitamin B levels was associated with the risk of ESCC and GC, but elevated level of MMA was marginally associated with ESCC (OR = 1.42, 95% CI = 0.99-2.04) and associated with GC (OR = 1.53, 95% CI = 1.05-2.22). Risk of GC was higher for the highest versus lowest quartile of HK-r (OR = 1.95, 95%CI = 1.19-3.21) and for elevated versus non-elevated HK-r level (OR = 1.59, 95% CI = 1.13-2.25). Risk of ESCC (OR = 2.81, 95% CI = 1.54-5.13) and gastric cancer (OR = 2.09, 95%CI = 1.17-3.73) was higher for the highest versus lowest quartile of tHcy. In conclusion, insufficient vitamin B12 was associated with higher risk of ESCC and GC, and insufficient vitamin B6 status was associated with higher risk of GC in this population with prevalent low plasma B-vitamin status. Higher level of tHcy, a global indicator of OCM function, was associated with higher risk of ESCC and GC., (© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Objectives: To determine the prevalence of vitamin B12 deficiency in a Tunisian population with type 2 diabetes (T2D) on metformin treatment for more than three years and to identify its risk factors. Methods: This is a cross-sectional study conducted on 257 patients with T2D treated with metformin for at least three years. Patients were divided into two groups according to their vitamin B12 status. Low vitamin B12 was defined as ≤ 203 pg/mL. Results: The mean age of the patients was 59.8  ±  7.9 years. The mean duration of metformin use was 10.2  ±  5.2 years. The mean vitamin B12 level was 294.9  ±  156.4 pg/mL. The prevalence of vitamin B12 deficiency was 28.4%. Male gender, HbA1c < 7% and hyperhomocysteinemia were significantly associated with vitamin B12 deficiency (respectively p   =  0.02, p  < 0.001, p  < 0.001). Homocysteine level was negatively correlated with vitamin B12 level ( r   =  -0.2, p   =  0.001). Dose and duration of metformin treatment, peripheral neuropathy and anemia were not associated with vitamin B12 deficiency. On multivariate analysis, HbA1c < 7% and hyperhomocysteinemia were independently associated with vitamin B12 deficiency (respectively OR = 3.2, 95%CI  =  [1.6-6.3] and OR = 2.3, 95%CI  =  [1.2-4.2]). Discussion: The prevalence of vitamin B12 deficiency in patients with T2D on metformin treatment was high. Hyperhomocysteinemia is associated with vitamin B12 deficiency suggesting that the deficit occurs at the tissue level., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To outline the prevalence of vitamin D and vitamin B 12 deficiencies in enuretic children., Methods: An analytical descriptive study was conducted on enuretic children who were followed up at the outpatient clinic for nocturnal enuresis at the Children's Hospital, Cairo University. Sociodemographic and clinical data were recorded. The levels of vitamin D and vitamin B 12 were assessed and correlated with the severity of enuresis., Results: Two hundred and eighty-eight children were enrolled. Insufficiency of Vitamin D predominated ( n  = 139; 48.3%). Vitamin D deficiency was present in 31.3%, n  = 90 and it was normal in 20.5%, n  = 59). Vitamin B 12 deficiency was observed in 25% of the studied children, n  = 72). The one-sample Wilcoxon signed-rank test was significant for both vitamins (P value =0.001). Vitamin D showed a stronger inverse correlation with the number of enuresis episodes per day than vitamin B 12 (-0.680 vs. -0.219 respectively). A cut-off of 13.7 ng/ml for vitamin D was detected, below which the child was predicted to have failed dry nights. Using multivariate logistic regression, higher vitamin D levels and behavioural treatment coexistence were significant protective factors for the absence of dry nights., Conclusion: Low levels of vitamin D and B 12 were detected in children with primary nocturnal enuresis, which could be considered a burden on the clinical severity of enuresis.

Background: Single-nucleotide polymorphism (SNP) allele frequencies, dietary habits, and folate status and their associations vary across ethnic populations. Little is known about the SNPs accounting for variations of folate-related biomarkers for Chinese preparing-for-pregnant females., Objectives: We aimed to identify SNPs contributing to RBC and serum folate, vitamin B-12, and homocysteine concentrations in Chinese female preconception population., Methods: A genome-wide association study was conducted on 1000 randomly selected preconception Chinese women from the Shanghai Preconception Cohort. SNPs were genotyped using Illumina chips, and associations with biomarkers were assessed using simple linear regression models under the assumption of an additive genetic model. Genome-wide significance was considered at P < 10 -7 ., Results: The MTHFR rs1801133 was the major genetic coding variant contributing to RBC folate, serum folate, and homocysteine concentrations (P = 2.28 × 10 -16 ; P = 8.85 × 10 -8 , and P = 2.46 × 10 -13 , repsectively). It is associated with increased RBC folate (β: 0.154 per additional risk allele after log transform), decreased serum folate (β: -0.951 per additional risk allele), and increased serum homocysteine concentrations (β: 1.153 per additional risk allele). The predominant SNP associated with serum folate was rs147162222 in NTRK2 (P = 2.55 × 10 -8 ), although that associated with homocysteine was rs77025184 located between PDE7B and LINC00271 (P = 4.91 × 10 -17 ). For vitamin B-12, FUT2 rs1047781 was the dominant genetic variant (P = 1.59 × 10 -10 ). The numbers of signals with a P value of <10 -7 for RBC folate, serum folate, vitamin B-12, and homocysteine were 12, 18, 8, and 614, respectively., Conclusions: This study represents the first genome-wide association study focusing on folate-related biomarkers in a Chinese preparing-for-pregnant female population. The contributions of dominent SNPs to each biomarker are partly different from other populations. The rs1801133 (C677T) in MTHFR is the predominant genetic variant contributing to RBC folate and rs1047781 (A385T) in FUT2 as the primary one explaining vitamin B-12. Notably, the intronic rs147162222 and noncoding rs77025184 are the predominant SNPs for serum folate and homocysteine, respectively., Competing Interests: Conflict of interest GH reports financial support was provided by the National Key Research and Development Program of China (grant numbers 2021YFC2701000 and 2016YFC1000500); CAMS Innovation Fund for Medical Sciences (grant number 2019-I2M-5-002); and National Natural Science Foundation of China (grant number 82270312). The other authors report no conflicts of interest., (Copyright © 2024. Published by Elsevier Inc.)

Aim: The etiology of telogen effluvium (TE) includes situations that may cause physiological stress, surgical trauma, inflammatory, infectious, iatrogenic causes, medications and nutritional deficiencies. TE has been associated with iron deficiency, vitamin B12 deficiency and thyroid diseases. In recent years, the use of over-the-counter food supplements containing vitamins and minerals such as biotin, vitamin D, zinc (Zn), copper (Cu) and selenium (Se) has been increasing in TE patients. The aim of this study is to investigate whether there are differences in nutritional status, vitamin and mineral levels by comparing individuals with TE and a control group., Materials and Methods: This case-control study included 90 female patients diagnosed with chronic telogen effluvium (CTE), and 90 female controls volunteered to participate in the study who consulted for reasons other than TE. Both groups aged 18 and over and applied to dermatology polyclinic between 01.09.2022 and 01.09.2023. A detailed anamnesis was taken from all patients, a hair pull test was performed, and TE was diagnosed after a dermoscopic examination was performed on all areas of the scalp. Then, serum vitamin D, Zn, Cu, Se levels and biotin levels in serum and urine were measured. Hemoglobin (Hb), ferritin, vitamin B12 and thyroid function tests were retrospectively scanned from the hospital database., Results: It was determined that Zn levels were significantly lower in CTE patients than in controls. Se levels were found to be significantly higher in patients than in controls. There was no difference in Hb, ferritin, vitamin B12, thyroid function tests, vitamin D, Cu levels, serum and urine biotin levels between the two groups. Zn, Cu/Zn and Se levels were found to have statistically significant diagnostic performance in predicting the diagnosis of CTE. Cu/Zn ratio and Se value were found to be significant predictors of CTE., Conclusion: This study shows us that nutritional deficiencies are not as common as thought in patients diagnosed with TE. Other causes that may cause TE should be investigated by a detailed anamnesis and a good physical examination. After all, tests for suspected conditions should be performed and individualized treatment options should be created for each patient., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Purpose: To investigate the bioavailability of vitamin B 12 from nori and to evaluate the required dosage for improving vitamin B 12 nutritional status in vegetarians not using supplements., Methods: The study design is an open-label, parallel, dose-response randomized controlled trial. Thirty vegetarians were assigned to control (no nori), low-dose (5 g nori, aiming to provide 2.4 µg vitamin B 12 per day), or high-dose (8 g nori, aiming to provide 4 µg vitamin B 12 per day) groups. The primary outcome was changes in vitamin B 12 status as measured by serum vitamin B 12 , holotranscobalamin (holoTC), homocysteine (Hcy), and methylmalonic acid (MMA), and a combined score of these four markers (4cB12 score) during the four-week intervention. Dietary vitamin B 12 intakes were assessed at baseline and end of the trial with a 17-item food frequency questionnaire designed for vitamin B 12 assessment. General linear model was used to compare least square means of changes in each biomarker of vitamin B 12 status, among the three groups, while adjusting for respective baseline biomarker., Results: After adjusting for baseline status, nori consumption led to significant improvement in serum vitamin B 12 (among-group P-value = 0.0029), holoTC (P = 0.0127), Hcy (P = 0.0225), and 4cB12 (P = 0.0094). Changes in MMA did not differ significantly across groups, but showed within-group pre-post improvement in the low-dose group (median [p25, p75] = -339 [-461, -198] nmol/L). Vitamin B 12 status appeared to plateau at low dose (5 g of nori), which compared with control group, improved serum vitamin B 12 (lease square mean [95% CI] = + 59 [25, 93] pmol/L, P = 0.0014); holoTC (+ 28.2 [10.1, 46.3] pmol/L, P = 0.0035); Hcy (-3.7 [-6.8, -0.6] µmol/L, p = 0.0226); and 4cB12 score (+ 0.67 [0.24, 1.09], p = 0.0036). High-dose resulted in similar improvements. There was no significant difference between low-dose and high-dose groups in all biomarkers of vitamin B 12 ., Conclusions: Consuming 5 g of nori per day for 4 weeks significantly improved vitamin B 12 status in vegetarians. A higher dose (8 g) may not confer additional benefits., Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT05614960. Date of registration: November 14th 2022., (© 2024. The Author(s).)

The dietary intake of vitamin B12 among unsupplemented vegans is notably lower compared to both vegetarians and omnivores. Prolonged low intakes of vitamin B12, such as seen in those adhering to a vegan diet, lead to physiological deficiency of vitamin B12 and an elevated risk of B12-related morbidity. However, while serum B12 serves as a conventional biomarker for assessing B12 status, its utility is limited given its sensitivity and specificity in ascribing physiological deficiency of B12 and the functional vitamin B12 status of those adhering to vegan diets is unclear. We conducted a systematic review and meta-analysis using data based on the full panel of biomarkers of vitamin B12 status to test whether adherence to a vegan diet is associated with an elevated risk of functional vitamin B12 deficiency compared to vegetarian or omnivorous diets. In addition, subgroup analysis was carried out to look at the effect of vitamin B12 supplement use on B12 status among vegans. Our search identified 4002 records, of which 19 studies met the inclusion criteria for the systematic review and 17 studies were taken forward for the meta-analysis. Meta-analysis results revealed significantly lower serum B12, pmol/ (-0.72 [-1.26, -0.18]; p = 0.01) and elevated total homocysteine, μmol/L (tHcy) (0.57 [0.26, 0.89]; p < 0.001) concentrations, alongside elevated methylmalonic acid, nmol/L (MMA) (0.28 [-0.01, 0.57]; p = 0.06) and lower holotranscobalamin, pmol/ (HoloTC) (-0.42 [-0.91, 0.07]; p = 0.09) levels among vegan adults compared to omnivores, indicating increased functional B12 deficiency in addition to low vitamin B12 status in vegan adults. There were no differences between vegans and vegetarians in HoloTC (0.04 [-0.28, 0.35]; p = 0.814) or MMA (-0.05 [-0.29, 0.20]; p = 0.708), but differences were found in serum B12 (-0.25 [-0.40, -0.10]; p = 0.001) and for tHcy (0.24 [0.09, 0.39]; p = 0.002) concentrations. Subgroup analyses indicated that the use of vitamin B12 supplements among vegans contributes to significant improvements in all biomarker concentrations compared to their unsupplemented counterparts. Our findings underscore the need for improved strategies to redress poor vitamin B12 status with appropriate B12 supplementation use among those adhering to vegetarian and vegan diets., (© 2024 The Author(s). Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation.)

Despite the importance of one carbon metabolic pathway (OCMP) in modulating the DNA methylation process, only a few population-based studies have explored their relationship among healthy individuals. This study aimed to understand the variations in global DNA methylation levels with respect to selected genetic (CBS 844ins68, MTRR A66G, MTR A2756G, and MTHFR C677T polymorphisms) and biochemical (folate, vitamin B12, and homocysteine) markers associated with OCMP among healthy North Indian adults. The study has been conducted among 1095 individuals of either sex (69.5% females), aged 30-75 years. A sample of 5 mL of blood was collected from each participant. Homocysteine, folate, and vitamin B12 levels were determined using the chemiluminescence technique. Restriction digestion was performed for genotyping MTRR A66G, MTR A2756G, and MTHFR C677T polymorphisms and allele-specific PCR amplification for CBS 844ins68 polymorphism. Global DNA methylation levels were analyzed using ELISA-based colorimetric technique. Of the selected genetic and biochemical markers, the mutant MTRR A66G allele was positively associated with global DNA methylation levels. Further, advanced age was inversely associated with methylation levels. MTRR 66GG genotype group was hypermethylated than other genotypes in folate replete and vitamin B12 deficient group (a condition prevalent among vegetarians), suggesting that the G allele may be more efficient than the wild-type allele in such conditions. Global DNA methylation levels appeared to be more influenced by genetic than biochemical factors. MTRR 66G allele may have a selective advantage in vitamin B12 deficient conditions. Further research should be undertaken to understand how genetics affects epigenetic processes., Competing Interests: Declarations. Competing Interests: The authors have no relevant financial or non-financial interests to disclose. Ethical Approval: All procedures involving human participants were done in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki. The study was approved by the Departmental Ethics Committee, Department of Anthropology, University of Delhi, Delhi-110007, India (Ref No. Anth/2010/455/1). Informed Consent: Informed written consent, typed in the local language, was obtained from each participant prior to their recruitment. Consent to Publish: Not applicable., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Several preliminary studies suggest dietary guanidinoacetic acid (GAA) might impact methyl group availability and/or methylation biomarkers, fueling ongoing debates. This study aimed to explore the relationship between dietary GAA intake and plasma indicators of the methylation cycle in individuals aged one year and older, using data from the 2001-2002 National Health and Nutrition Examination Survey (NHANES)., Methods: Dietary information was obtained from individuals who completed a 24-hour Dietary Recall, with total daily intake of GAA calculated by aggregating all relevant food items. Relevant variables related to the methylation cycle, such as red blood cell (RBC) folate and serum folate, vitamin B12, total homocysteine (tHCy), and methylmalonic acid (MMA), were identified from the NHANES 2001-2002 laboratory assessments., Results: A total of 9,115 individuals (51.3% females) were included in the final analysis. Linear regression unveiled a significant association between higher GAA intake and diminished RBC folate (p < 0.001), serum folate (p < 0.001), and MMA levels (p = 0.007). It also revealed an elevation in tHCy levels with increased GAA intake (p < 0.001). These associations remained significant even after adjusting for demographic variables and dietary factors pertinent to the methylation cycle (p < 0.05)., Conclusion: Our findings suggest that dietary exposure to GAA (resulting in conversion to creatine) could be considered a nutritional factor associated with the consumption of methyl groups in the general population., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

To explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated BP in children and adolescents. Both a nested case control and a cohort study were designed to explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated blood pressure (BP). All the included participants were from primary school. A total of 326 subjects (116:210) in nested case control were from an established cohort. And 270 participants without hypertension at baseline and followed in 2019 in cohort. FA and VB12 levels were lower in the elevated BP group than in the control group, and homocysteine level was higher than that in the control group. In the elevated BP group, overweight/obese children had lower FA than overweight/obese children in the normal BP group. FA was positively correlated with high-density lipoprotein (HDL) and Apo lipoprotein A (APOA), but negatively correlated with triglyceride (TG). FA was significantly correlated with elevated BP in children and adolescents (β = -0.353, P = 0.032), after adjusting VB12, and homocysteine (HCY), and the interaction effect of FA*HCY was significant. Both systolic and diastolic BP levels were statistically lower in the FA high exposure group than in the FA low exposure group in the cohort study. This study found that FA and vitamin B12 deficiency in childhood was correlated with elevated BP levels, which may affect BP by regulating lipid levels, and confirmed the importance of maintaining high levels of FA and vitamin B12 in childhood either by diet or supplementation., Competing Interests: Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The Institutional Review Board at the Children’s Hospital of Chongqing Medical University gave its approval for the study. Informed consent to participate in this study was provided by all of the children and their parents/guardians. Consent for publication: All authors critically reviewed and approved the publication of the final paper., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Fibromyalgia-one of the chronic pain syndromes-characterised by pain, fatigue, and tenderness. The role of certain micronutrients like vitamin D, vitamin B12, and ferritin has been previously investigated in many primary studies aiming to assess both their therapeutic and diagnostic potential in the management of fibromyalgia., Aim: To compare the levels of vitamin D, ferritin, and vitamin B12 between fibromyalgia patients and healthy controls., Methods: Our study protocol was registered prospectively on PROSPERO (CRD42024585826) and was conducted in accordance with the PRISMA guidelines. Literature search, article screening, and data collection were conducted by two independent investigators. The mean difference along with its 95% confidence interval for each of the three outcomes was pooled under a random effects model., Results: Twenty-five studies were included in the final analysis; 22 reported vitamin D levels, 5 reported ferritin levels, and 3 reported vitamin B12 levels. Generally, fibromyalgia patients had lower vitamin D and ferritin levels compared with healthy controls (MD = -3.86, 95% CI [-6.99; -0.73] and -14.78, [-18.95; -10.62], respectively). Vitamin B12 showed no difference between the two groups (-20.70 [-51.57; 10.16])., Conclusion: Vitamin D and ferritin levels were found to be lower in patients with fibromyalgia. Whether vitamin D supplementation improves fibromyalgia symptoms remains under debate. However, we recommend both routine empirical supplementation of vitamin D along with ferritin level testing in all patients. Further studies are needed to confirm whether lower ferritin and vitamin B12 levels contribute to fibromyalgia., (© 2025 John Wiley & Sons Ltd.)

Background/objectives: The bioavailability of crystalline vitamin B 12 (B 12 ) through active absorption is reported to have a maximum capacity of 1.5-2.5 µg per dose. A small passive bioavailability has also been suggested at high doses. The present study aimed to determine the dose-dependency of active B 12 absorption and to quantify its passive absorption at higher doses., Methods: The dose-dependency of crystalline B 12 bioavailability was determined in nine healthy adults, using oral [ 13 C]-cyanocobalamin, in a cross-over design at doses of 2.5, 5, and 10 µg. The dose order was randomised, with a washout of one month. Literature data from was added to the present study data in a meta-analysis of the relation between B 12 bioavailability and dose, to evaluate its pattern at different doses., Results: Bioavailability, as a function of dose, was significantly different between 2.5, 5, and 10 µg doses of [ 13 C]-cyanocobalamin at 50.9 ± 32.5%, 26.7 ± 22.3%, 15.4 ± 13.6%, respectively, ( p < 0.01), while the absolute bioavailability trended upward, at 1.16 ± 0.74 µg, 1.22 ± 1.02 µg, and 1.39 ± 1.23 µg ( p = 0.46). The meta-analysis showed two distinct phases of bioavailability. Up to a dose of 2.6 µg, there was a significant steep positive correlation, with a slope (bioavailability) of 43%/µg suggesting an active process with a maximum of 1.2 µg. At higher doses, the slope was 1%/µg, not significantly different from zero, possibly a passive process., Conclusions: The active bioavailability of crystalline B 12 is not dose-dependent, saturating at ~1.2 µg.

Aims: To assess factors associated with the prevalence of breastfeeding in a cohort of Spanish primiparous pregnant women to whom a health education program was applied., Methods: Prospective, descriptive, and inferential cohort analysis with data obtained from the beginning of pregnancy to the child's year. Prevalence of breastfeeding was classified into periods or categories: (1) "non-breastfeeding"; (2) "breastfeeding until 6 months"; (3) "breastfeeding up to 12 months". The sample was 288 primiparous pregnant women divided into two groups of equal size using as a matching strategy whether they attended the health education sessions with or without an informal caregiver (mother, partner, sister): group A (primiparous women who attended the sessions without an informal caregiver; n = 144) and group B (primiparous women who attended the sessions with an informal caregiver; n = 144)., Results: The best-associated variables with the prevalence of breastfeeding were age, vitamin B 12 variation (postintervention-preintervention), and informal caregiver intervention. This association was statistically significant for breastfeeding up to 12 months of age compared to non-breastfeeding (age ( p = 0.007); vitamin B 12 variation ( p = 0.010); caregiver intervention ( p = 0.008)). The younger the breastfeeding woman, the greater the probability of breastfeeding up to 12 months (β: -0.246 (0.91); OR: 0.782 (0.654-0.935)). The greater the increase in vitamin B 12 after the educational intervention program, the greater the probability of breastfeeding up to 12 months (β: 0.007 (0.003); OR: 1.007 (1.002-1.012)). The absence of an informal caregiver decreased the likelihood that breastfeeding would be maintained until the child's 12 months (β: -0.734 (1.024); OR: 0.065 (0.009-0.483))., Conclusions: The prevalence of breastfeeding up to 12 months, in a cohort of Spanish primiparous women, increased the higher increase in vitamin B 12 levels after applying an educational intervention program to promote breastfeeding. The prevalence of breastfeeding up to 12 months also increased with the presence of the informal caregiver and in young women.

Objective: The objective of our study was to determine the prevalence of anaemia among 14-19 years school going girls, risk factors for it and profile of micronutrient status among rural girls from western state of India., Design: Using a cross-sectional design, we obtained information on socio-demography, menstruation, dietary habits, knowledge and daily consumption of the government recommended iron and folic acid (IFA) tablets, and anthropometry. Blood was collected to assess Hb, red blood cell indices, serumFe, folate and vitamin B 12 levels., Settings: Nagpur district, Maharashtra, India., Participants: A total of 221 girls aged 14-19 years studying in twenty-four government institutes included., Results: 57 % girls were anaemic, 84 % had deficiency of one or more micronutrients and 60 % were malnourished based on body mass index (BMI). The prevalence of Fe, vitamin B 12 and folate deficiency was 37·7 %, 69·8 % and 1·4 %, respectively. Among anaemic girls, Fe and vitamin B 12 deficiency was observed in 45·5 % and 67·5 %, respectively, v . among non-anaemic girls it was 27 % and 73 %, respectively. Fe deficiency was a predictor of anaemia and its severity. Girls residing in non-nuclear family were more likely to have anaemia. The consumption of daily non-vegetarian food and green leafy vegetables was 3 % and 3·6 %, respectively. Only 9 % consumed IFA tablets in the past 2 weeks., Conclusions: Anaemia is common in adolescent girls, particularly associated with Fe and vitamin B 12 deficiency. There is need to reconsider the approach to prevention of anaemia in adolescent girls, particularly before they become pregnant.

Background: Obesity is a serious health problem with increasing incidence. worldwide and remains one of the most important causes of preventable deaths. We aimed to examine the relationship between Vitamin B12 and Folic acid, which have an important role for human life, and homocysteine is widely recognized for its association with the development of cardiovascular disease, although its role as an independent risk factor remains a topic of ongoing debate., Materials and Methods: We evaluated 126 patients who underwent bariatric metabolic surgery between September 2019-September 2020. In addition to demographic characteristics of the patients, weight, Vitamin B12, folate, HbA1c, cholesterol, triglyceride, ferritin, serum iron, albumin levels at preoperative, postoperative 1st month, 6th month, 12th month follow-ups were analyzed., Results: Patients with the desired biochemical parameters at the determined follow-up points were identified and two groups were formed as RYGB(n = 43) and SG(n = 7) patients. When biochemical parameters were analyzed between the groups, homocysteine, HbA1c, HDL Cholesterol, VLDL Cholesterol, Total Cholesterol, Triglycerides, Ferritin, Serum Iron levels showed a statistical difference (p < 0.001). Folate (p = 0.064) and albumin (p = 0.257) did not show a significant difference over time. The change in vitamin B12 (p = 0.409) over time was not significant in the SG group, whereas a significant difference was observed in the RYGB group (p < 0.001). When we established a marginal model to determine the factors affecting the change in homocysteine over time, vitamin B12 and folate values., Conclusions: The relationship between Vitamin B12, folate and homocysteine is important in order to better understand the complications that develop in bariatric metabolic surgery patients, to prevent possible complications and to better manage the process., (© 2024. The Author(s).)

Parkinson's disease (PD) is a complicated neurodegenerative disease that is the most prevalent severe movement disorder worldwide. The research includes studying the levels of hydrogen sulphide (H2S) and cystathionine γ-lyase (CSE) with some biochemical parameters in the serum of patients with PD in Mosul City (Iraq), which include Serotonin (SERT), dopamine (DA), sphingomyelin (SM), vitamin B12, Acetylcholine esterase (AChE), monoamine oxidase (MAO), creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT). Samples reached (100), which included: (40) for the Parkinson's patients group, and (60) for the control group. The results showed there was a significant decrease in the levels of H2S, CSE, SERT, DA, SM, B12 and CK and a significant increase in the activity of MAO, AST, and ALT and no significant difference in AChE activity in serum for Parkinson's patients when compared with the control group. The effect of periods PD revealed, a significant decline of H2S, CSE, SERT, DA, B12, and AChE, while MAO, CK, AST, and ALT showed a significant rise with increased periods of disease, SM showed a non-significant change with periods of disease. The study concluded that H2S gas produced within the body and CSE suffer from low levels within the body, and they also decrease with the increase in the duration of the disease as a result of their use as protective functions in the body against Parkinson's disease. And developing it by observing the levels of the variables measured with it, and stimulating the body to increase their levels (H2S, CSE) in various ways can lead to improving the health condition of patients.

Background: The detection of deficiencies in B 12 and folate children is important. However, despite the availability of various markers to assess B 12 and folate metabolism, there are limited studies describing the reference intervals (RIs) and changes during growth and development for these markers in healthy children., Methods: Using samples collected from 378 children aged 30 days-< 18 years, we derived continuous RIs for holotranscobalamin, homocysteine and red cell folate., Results: The lower RI for holotranscobalamin was lowest at birth, rising during early childhood and then declining following ages 4-6 years whereas red cell folate was highest early in life and then declined steadily towards adulthood. Total homocysteine, reflective of both B 12 and folate status was elevated early in life, reaching a nadir at age 2 and then increasing towards adulthood., Conclusions: Continuous central 95 th percentile RI for holotranscobalamin, homocysteine and red cell folate for children ages 30 days to <18 years were established. Each marker shows dynamic changes throughout childhood and adolescence which will assist clinicians in more appropriately assessing B 12 and folate status in this population., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Folate and cobalamin status, although essential for pregnancy, are not routinely monitored in prenatal care., Objectives: To investigate folate and cobalamin status and determinants throughout pregnancy, in the absence of mandatory folic acid (FA) fortification., Methods: In a cohort study of 831 mothers recruited at <12 gestational weeks (GW), plasma folate, total homocysteine (tHcy), cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA), red blood cell folate (RBCF), and the combined cobalamin status indicator (cB12) were determined at ≤12, 15, 24-27, 34 GW, labor and in the cord. Single nucleotide polymorphisms affecting folate and cobalamin status were determined. FA, cobalamin, micronutrient supplement use, and dietary folate and cobalamin intake (food frequency questionnaire) were recorded. Folate and cobalamin status predictors were assessed by multiple linear regression analysis., Results: Only 36.1% of the participants took FA preconceptionally and 47.4% and 7.3% had suboptimal RBCF (<906 nmol/L) and plasma cobalamin status (≤221 pmol/L), respectively, at ≤12 GW. RBCF determinants included planned pregnancy, FA supplementation, plasma cobalamin, and methylenetetrahydrofolate (MTHFR) 677C>T genotype. Cobalamin supplementation was positively associated with plasma cobalamin and early holoTC. Smoking and BMI were inversely associated with plasma cobalamin and early holoTC, but none were associated with MMA. Only participants with the MTHFR 677TT genotype, exceeding FA supplement recommendations, improved their folate status (interaction term: B (95% CI):0.15 (0.01, 0.29), P = 0.032). Smoking was inversely associated with plasma cobalamin status in participants with the methionine synthase reductase (MTRR) 524CC genotype only (interaction term:0.07 (0.01, 0.04), P = 0.014). Mothers with low early pregnancy cobalamin status and also those with bigger newborns, had lower cobalamin status at labor., Conclusions: Suboptimal early pregnancy folate or cobalamin status affected 47.4% and 7.3% of the participants, respectively. The MTHFR 677TT genotype predicted folate status throughout pregnancy. Smoking and BMI were negatively associated with cobalamin status throughout pregnancy. Clinical Trial Registry number and website where it was obtained: NCT01778205. www., Clinicaltrials: gov., Competing Interests: Conflict of interest The authors have no conflict of interest to disclose., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Cross-sectional and longitudinal studies have inconsistently linked cognitive performance and change over time to an elevated level of homocysteine (Hcy), with few conducted among urban adults., Methods: Longitudinal data [Visit 1 (2004-2009) and Visit 2 (2009-2013)] were analyzed from up to 1430 selected Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) participants. Baseline and follow-up blood Hcy was measured, while 11 cognitive function test scores were assessed at either of these two visits. Overall, sex- and race-stratified associations were evaluated using mixed-effects linear regression models, adjusting for key potential confounders. Interaction effects between Hcy and serum levels of folate and vitamin B-12 were also tested., Results: We found that greater LnHcy v1 was significantly associated with poorer baseline attention based on higher Log e (TRAILS A, in seconds) [β (SE): 0.101 (0.031), P = 0.001]. Heterogeneity was also found by sex and by race. Most notably, among men only, LnHcy v1 was associated with faster decline on the BVRT (# of errors), a measure of visuo-spatial memory (β (SE): 0.297(0.115), P = 0.010, reduced model); while among African American adults only, an elevated and increasing LnHcy over time was associated with faster rate of decline on Log e (TRAILS B, in seconds) [β (SE): +0.012 (0.005), p = 0.008], a measure of executive function. Interactions between Hcy, folate and vitamin B-12 blood exposures were also detected., Conclusions: In summary, sex- and race-specific adverse association between elevated Hcy and cognitive performance over time were detected among middle-aged urban adults, in domains of attention, visuo-spatial memory and executive functioning., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Published by Elsevier B.V.)

Background: Homocysteine (Hcy) is widely recognized as a significant risk factor for cardiovascular and cerebrovascular diseases. However, our research has uncovered a novel perspective, suggesting that elevated levels of Hcy could serve as an indicator for neurological diseases. This article presents a unique case of Subacute Combined Degeneration of the spinal cord(SCD), characterized by high homocysteine levels, yet normal vitamin B 12 and imaging results. This discovery could facilitate early detection and ensure timely referral of patients to specialized departments for further treatment., Competing Interests: Declaration of Competing Interest The authors have declared that no competing interests exist., (Copyright © 2023. Published by Elsevier Inc.)

Introduction: Pregnancy and lactation represent a complex stage from a nutritional point of view, since energy, protein and micronutrient requirements increase during these stages. The literature describes that a well-planned plant-based diet can be sufficient in energy, macronutrients and micronutrients, with the exception of vitamin B12 and possibly n3 polyunsaturated fatty acids, mainly EPA and DHA. During the last few years, adherence to this diet has increased rapidly in the population, so the main objective of this article is to review the current evidence on the intake and concentrations of vitamin B12, EPA and DHA during pregnancy and lactation in women following a plant-based diet. A literature search was performed in PubMed, Scopus, Web of Science and Ovid MedLine using free terms and MESH. Eleven articles were selected in this review. Well-planned vegetarian and vegan diets, with adequate supplementation of vitamin B12, EPA and DHA, are compatible during pregnancy and lactation, being a positive predictor of their content in breast milk. A similar situation was observed in plasma levels in women supplemented with B12. However, it is important to continue with research in this area that considers an adequate dietary anamnesis, integral evaluation of nutritional status, estimation of nutritional requirements and an individualized nutritional plan.

Background/objectives: The aim of this study is to investigate the association between physical and chemical digestion and nutrition markers (serum albumin (ALB), prealbumin (PAB), and vitamin B 12 (B 12 ) levels)., Methods: During a detailed checkup at Fujita Health University, we examined the associations of physical (occlusal force, masticatory performance, and swallowing ability (via the 10-item Eating Assessment Tool, EAT-10)) and chemical ( Helicobacter pylori (HP) eradication history, HP antibody levels, and oral antacid (proton pump inhibitors) use) digestion parameters with serum ALB, PAB, and B 12 levels in 92 individuals (M:67, F:25)., Results: Forty-eight percent of the participants were older than 65 years of age, 19% had decreased occlusal force, 3.2% had decreased masticatory strength, 3.2% had decreased swallowing function, 24% had a history of HP eradication, 23% were HP antibody positive, and 16% were taking oral antacid medication. Additionally, 14% and 11% of the patients had low serum ALB and PAB levels, respectively, and 14% of the patients had B 12 deficiency. Multivariate analysis adjusted for age, sex, body mass index, and C-reactive protein levels revealed that there were no significant associations between the physical digestion parameters and the serum PAB, ALB, or B 12 levels. On the other hand, there was a significant association between oral antacid use and PAB levels (β = -3.3, p = 0.04). Independent of physical or chemical digestion parameters, serum PAB and B 12 levels were significantly associated with protein and B 12 intake, respectively., Conclusions: Oral antacid use may decrease serum PAB levels, indicating protein synthesis.

Hypertension is a significant public health concern and a modifiable risk factor for increased mortality worldwide. It is reported to be influenced by gene-environment interactions and micronutrient intake. This study aims to understand the relationship between global DNA methylation levels and hypertension, independently and in the context of micronutrient status, among rural population in Punjab, India. A total of 2300 individuals, aged 30-75 years, (54.9% females) were screened for blood pressure. Of 2300 screened individuals, 900 (age sex matched 450 cases and 450 controls of hypertension) individuals were selected to examine the relationship between hypertension, global DNA methylation (5mC), and biochemicals (Folate, Vitamin B12, and Homocysteine). Folate, vitamin B12, and homocysteine levels were estimated using chemiluminescence technique. The ELISA-based colorimetric technique was used for performing peripheral blood leucocyte (PBL) global DNA methylation (5mC). Statistical analyses were performed using SPSS version 22.0. Hypertensives were found to have significantly lower levels of global DNA methylation than normotensives (0.65 vs. 0.72 respectively; p-value = 0.01*). Individuals in the 1st quartile of 5mC were at significantly (OR: 1.671; 95% CI: 1.206-2.315; p-value = 0.01*) increased risk for hypertension in comparison to those in the 4th quartile (reference). Further hypertensives on medication with controlled blood pressure (BP) were significantly hypermethylated as compared to hypertensives on medication with uncontrolled BP (0.70 vs. 0.62 respectively; p-value = 0.04*). Folate appeared to mediate global DNA methylation among hypertensives on medication-controlled BP. Further hypertension driven hypomethylation hints towards accelerated biological aging among younger hypertensives. Hypertension may be associated with Global DNA hypomethylation in the studied rural population of Punjab, India. Folate sufficiency may prove to be an aid in improving the methylation levels among the cases of hypertension who were on medication and had controlled BP., (© 2024. The Author(s).)

The folate requirements for beef cattle have not been established. Therefore, we investigated whether rumen-unprotected folic acid supplementation during the fattening period affects carcass traits and nutritional metabolism in Japanese Black beef cattle. Eighteen Beef cattle aged 16 months were divided into three groups: control, low folic acid supplementation (0.43 g DM/day), and high folic acid supplementation (0.86 g DM/day). Treatment was administered for 12 months. Folic acid supplementation dose-dependently increased serum folate levels, suggesting that supplemental folic acid can be absorbed into the body. Folic acid supplementation dose-dependently decreased serum vitamin B 12 levels, while plasma total homocysteine and methylmalonic acid levels-markers for deficiency of folate and/or vitamin B 12 -were unaffected. Thus, the treatment did not clearly affect the nutritional status of these vitamins. Supplementation increased body weight, with no negative effects on other carcass traits. The levels of insulin-like growth factor 1, retinol, albumin, and some amino acids in serum or plasma were affected by supplementation. These results suggest that rumen-unprotected folic acid supplementation during the fattening period could increase the body weight of Japanese Black beef cattle and the mechanism of action may be related to growth-related hormones and/or the metabolism of some nutrients, including folate., (© 2024. The Author(s).)

Folates play a crucial role as cofactors in metabolic pathways, influencing biological methylation and nucleotide synthesis, which has a significant impact on overall health and disease susceptibility. Diabetic nephropathy (DN) is a prevalent and severe complication of diabetes mellitus (DM). The correlation between RBC folate and DN remains unclear currently. This study aims to assess whether RBC folate is associated with DN. Based on data from the NHANES (2011-2018), we conducted a cross-sectional study involving 3070 adults with type 2 DM (T2DM). Demographic factors, levels of folate and vitamin B12, dietary folate intakes, and relevant laboratory data were obtained from all participants. Logistic regression, fitting smooth curves, interaction effects were utilized to support the research objectives. Regression analyses demonstrated a positive relation between RBC folate and DN. (P < 0.001). A positive association between levels of RBC folate and the risk of DN was observed after full adjustment for all the confounding variables (odds ratio: 1.38, 95% confidence interval: 1.27-1.49, P < 0.001). Similar patterns of association were observed for subgroup analysis (all P values for interaction > 0.05). In addition, curve fitting after adjusting for all the confounding variables demonstrated that there was a linear relationship between RBC folate and DN (P for non-linearity = 0.147). Increased RBC folate levels were linked to a higher risk of DN in type 2 diabetes. RBC folate should be considered as a crucial indicator for folate status in DN., (© 2024. The Author(s).)

Per- and polyfluoroalkyl substances (PFAS) constitute a group of synthetic chemicals extensively utilized across various commonplace products. PFAS are known to have various toxic effects on human health. The relationship between PFAS exposure and erythrocytes has been a subject of interest in epidemiological research, but so far, only limited cross-sectional studies have investigated. Additionally, the role of erythrocyte related nutrition indicators on PFAS-induced changes in erythrograms has not been explored. To fill these knowledge gaps, we launched a longitudinal study over a decade, tracking 502 adolescents and young adults aged 12 to 30 from the YOung TAiwanese Cohort (YOTA). Our analysis encompassed 11 types of plasma PFAS, as well as erythrograms and serum levels of ferritin, transferrin saturation, vitamin B12, and folate. Our examination unveiled positive associations between specific average levels of PFAS compounds, including linear perfluorooctanoic acid (PFOA), branched perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS), and transferrin saturation. Furthermore, linear PFOA and both linear and branched PFOS were negatively correlated with vitamin B12 levels. Specifically, we observed that the average linear PFOA demonstrated positive correlations with mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), while average PFNA also exhibited positive associations with hemoglobin (Hb) and hematocrit (Hct) in a multiple linear regression model. Subsequent analysis revealed noteworthy interactions between vitamin B12 and PFNA, as well as folate and PFNA, in the context of their impact on Hb, Hct, and PFNA relationships. Additionally, an interaction with transferrin saturation was identified in the correlation between Hct and PFNA. These findings suggest a plausible link between PFAS exposure and erythrograms among young populations, underscoring the potential involvement of iron status, vitamin B12, and folate in this association. Further studies are imperative to elucidate the precise effects of PFAS on erythrocyte in human subjects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

It has been hypothesized that ultraviolet (UV) radiation can lead to depletion of plasma folate and B 12 vitamin, but few studies have investigated effects of other parameters of solar and geomagnetic activity (SGA). We investigated the association between four SGA parameters-interplanetary magnetic field (IMF), sunspot number (SSN), K p index, and ground shortwave solar radiation (SWR)-and three plasma B-complex vitamins-folate, B 6 , and B 12 -in 910 participants from the Normative Aging Study (NAS) between 1998 and 2017. Mixed-effects regression models were used for 1- to 28-moving day averages of SGA exposure, adjusted for covariates. We compared the impact of SGA in individuals under higher and lower B-complex supplementation (> or < 50th quartile). Our findings show that increases in solar activity variables IMF and SSN were found to be significantly associated with decreases in B 12 vitamin. IMF and SSN were associated with decrease in folate levels, especially in individuals under higher levels of B-complex supplementation. No associations were found for SWR and K p index. To our knowledge, this is the first study that demonstrated the detrimental impact of solar activity on plasma B 12 and folate in a large cohort. These findings have clinical implications during periods of high solar activity., (© 2024. The Author(s).)

Background: Vitamin B12, an indispensable micronutrient, is pivotal in numerous physiological processes, with particular significance during pregnancy and fetal development. The increasing adoption of vegetarian diets and the economic challenges associated with accessing animal-based food sources contribute to the prevalence of vitamin B12 deficiency. This study aims to examine the levels of vitamin B12 and homocysteine in pregnant women upon admission for delivery and to analyze corresponding cord blood samples from their newborn infants in a substantial sample within the Istanbul metropolitan area., Materials and Methods: This cross-sectional multicenter study included women aged ≥16 years admitted for delivery and their newborns ≥34 weeks. The demographic data and the results of complete blood counts within the previous 24 hours before birth were recorded. Vitamin B12 and homocysteine levels were measured in maternal and cord blood samples. The study parameters were compared between the groups based on the mothers' and babies' homocysteine and vitamin B12 levels., Results: The study included 832 pregnant women and 832 neonates. Anemia affected 36% of pregnant women, with a higher frequency in mothers with vitamin B12 deficiency. Seventy-eight mothers and 48.9% of neonates showed Vitamin B12 levels below 200 pg/mL, while elevated homocysteine levels were observed in 30% of mothers and 26% of neonates. Maternal vitamin B12 deficiency was significantly correlated with cord blood B12 deficiency and elevated homocysteine. The median cord blood vitamin B12 level was inversely correlated with the number of previous pregnancies., Conclusion: Vitamin B12 deficiency is extremely common in pregnant women before delivery, significantly correlating to cord blood homocysteine and vitamin B12 levels. However, homocysteine alone is not a reliable marker for maternal vitamin B12 status. Implementing strategies to detect vitamin B12 deficiency and supplying adequate vitamin B12 supplementation during pregnancy holds the potential to enhance maternal and neonatal health in Türkiye., Competing Interests: The authors declare that there is no conflict of interest.

Objectives: The identification of vitamin B12 (B12) deficiency in the newborn may prevent neurological damage and a delay in the normal growth. In this study we characterized the incidence of B12 deficiency in newborns, the costs associated to the clinical diagnosis and management, and the relevance to optimize the use of cobalamin biomarkers during treatment follow-up., Methods: Starting from a continuous case series of 146,470 screened newborns (November, 1st 2021- December, 3rd 2023), the Regional Reference Laboratory for Neonatal Screening identified 87 newborns having altered levels of biomarkers of cobalamin metabolism measured by newborn screening. These subjects were confirmed with a nutritional B12 deficiency of maternal origin by performing the serum B12 measurements and plasma homocysteine (Hcy) both on the newborns and respective mothers. A cost analysis was performed to characterize the costs/year of identifying and managing B12 deficiency cases., Results: At baseline, median (interquartile range) serum B12 levels of 185.0 (142.3-246.0) ng/L and threefold increased plasma Hcy concentrations above the normal level confirmed a severe condition of deficiency in the newborns. After intramuscular B12 supplementation, serum B12 measured at the first follow up visit showed a fivefold increase, and the levels of Hcy returned to normal. From the healthcare perspective, the costs for diagnosing and managing all newborns with B12 deficiency is 188,480 €/year., Conclusions: Preventing B12 depletion in newborns lowers healthcare costs and likely improves their health outcomes. Further studies are however required to address the clinical pathway to identify, treat and monitor pregnant women with marginal and low B12 status, in order to achieve these goals., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background & Aims: Holo-Transcobalamin (holo-TC) is the biologically active form of vitamin B12, a vitamin essential in human metabolism. The association between vitamin B12 (total cobalamin) and mortality risk has been controversially reported, whereas the relation between holo-TC and survival is unknown. In a population-based sample (n = 862, female share 42.8%, median age 62.3 years), we related serum holo-TC to the risk of all-cause mortality., Methods: We measured serum holo-TC by electro-chemiluminescence. Multivariable-adjusted Cox proportional hazards regression models were used to quantify the association between serum holo-TC and all-cause mortality., Results: Over a median follow-up time of 10.9 years, n = 99 individuals died. We did not find significant associations between serum holo-TC and the risk of all-cause mortality (HR: 1.00 [95% CI 0.97-1.03] per 5-point increment in holo-TC), neither in the overall sample, nor in subgroups stratified by sex, diabetes, or hypertension., Conclusion: The biologically active form of vitamin B12, holo-TC, is not related to the risk of all-cause mortality in a moderate-sized sample from the general population., Competing Interests: Declaration of competing interest None of the authors declare a conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: DNA methylation is a major epigenetic phenomenon through which diet affects health and disease. This study aimed to determine the epigenetic influence of the traditional Korean diet (K-diet) on global DNA methylation via one-carbon metabolism., Methods: A crossover study was conducted on 52 women. Two diets, a K-diet, high in plant foods and low in calories and animal fat, and a control diet, similar to the diet currently consumed in Korea, were provided to all subjects alternately for 4 weeks with a 4-week washout period. Clinical parameters were measured before and after each dietary intervention. Nutrient intake was calculated by using a computer-aided nutritional analysis program. One-carbon metabolites in the serum and global DNA methylation in peripheral mononuclear cells were determined using ultra-performance liquid chromatography-tandem mass spectrometry., Results: The K-diet group consumed more folate (669.9 ± 6.7 µg vs. 502.7 ± 3.0, p < 0.001), B6, B12, serine, and choline, and less methionine (992.6 ± 63 vs. 1048.3 mg ± 34.1, p < 0.0001) than the control group did. In the K-diet group, the increment of plasma 5-methyltetrahydrofolate (0.08 µg/mL ± 0.11 vs 0.02 ± 0.10, p < 0.009) and decrement of L-homocysteine (- 70.7 ± 85.0 vs - 39.3 ± 69.4, p < 0.0168) were greater than those of the control group. Global DNA methylation was significantly increased in the K-diet group (6.70 ± 3.02% to 9.45 ± 3.69, p < 0.0001) but not in the control group., Conclusions: A K-diet high in one-carbon nutrients can enhance the global DNA methylation status, suggesting an epigenetic mechanism by which the K-diet conveys health effects. Trial registration Korean Clinical Trial Registry (trial number: KCT0005340, 24/08/2020, retrospectively registered)., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Objectives: Nutrition plays a crucial role in the development and health of the human brain, from early stages to adulthood. The complex process of neurodevelopment necessitates interaction among various factors, with balance in the concentration of vital macronutrients and micronutrients being essential. Regarding micronutrients, vitamin B12 stands out, playing a vital role in the development and functioning of the motor nervous system. The objective was to investigate the influence of reduced levels of vitamin B12 on infant motor development and analyze the effects of supplementation on this aspect of development., Methods: For this purpose, the criteria of the PRISMA method and registration in the PROSPERO database were used. The search was conducted in the following databases: PubMed (Medline), Scopus, PsycINFO, Web of Science, and ScienceDirect. A total of 684 records were initially identified., Results: Of the eight included articles, there was diversity regarding geographical contexts and study designs. The final sample comprised a total of 1,559 participants of both sexes. Studies aimed at correcting low levels of vitamin B12 opted for supplementation, following various protocols that varied in dose, administration method, and duration. At the end of the studies, the serum level of this vitamin ranged from 131 pmol/L to 1141 pmol/L., Conclusion: There is a complex array of factors contributing to reduced levels of vitamin B12, especially in the early stages of life, which significantly impacts infant motor development. Despite methodological variations among studies, evidence suggests that low levels of vitamin B12 may affect motor development and that supplementation could be an effective means of enhancing motor aspects in healthy children. However, due to the diversity of outcomes, it is important to promote comprehensive public policies to encourage appropriate interventions in this area., Competing Interests: Declaration of competing interest The authors declare that they have no financial or personal conflicts of interest that could influence the results or interpretation presented in this work., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: Previous studies reported that vitamin B-12 deficiency is associated with an increased risk of stroke. However, studies examining the association between excessive vitamin B-12 and stroke risk are limited. Our study aimed to investigate the relationship between excessive vitamin B-12 concentrations and risk of stroke and explore whether this association varies according to sex., Methods: Utilizing the Korean Genome Epidemiology Study (KoGES) prospective cohort data, our primary exposure variables were vitamin B-12 plasma concentration and sex. The occurrence of stroke served as the main outcome of interest. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression analysis. An interaction analysis was conducted to assess the interaction effect of vitamin B-12 and sex on stroke incidence., Results: Cox proportional logistic regression analysis, adjusting for confounders, showed that excessive vitamin B-12 did not significantly alter stroke risk (HR: 1.22, 95% CI: 0.82, 1.71) and revealed no significant sex-based differences in stroke risk (HR: 0.90, 95% CI: 0.75, 1.04). However, interaction analysis indicated that excessive vitamin B-12 was linked to a significant increase in stroke risk in males (HR: 1.81, 95% CI: 1.10, 2.99) but not in females (HR: 1.04, 95% CI: 0.66, 1.60), with statistically significant interaction effect (P < 0.01)., Conclusions: Our study demonstrated that although excessive vitamin B-12 alone does not significantly increase stroke risk, it increases risk in males when considering the interaction with sex., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Objectives: The United Nations recommends that women consume ≥5 food groups, also known as the minimum dietary diversity score for women (MDD-W), for nutritional health. This is increasingly unattainable for populations in climate hot zones coping with food insecurity by prioritizing calories over dietary breadth. Breastfeeding mothers may be particularly vulnerable to adverse health impacts of low dietary diversity due to elevated nutritional requirements for lactation. We investigated how the protective effects of MDD-W for folate adequacy varies by MDD-W score and mother-infant life history characteristics., Methods: We conducted a secondary analysis of cross-sectional data from breastfeeding mothers (n = 228) in northern Kenya, surveyed during the 2006 Horn-of-Africa drought. Logistic regression models for adequate dietary folate (and vitamins B12 and B6) and normal homocysteine (folate-replete status) evaluated the effect of MDD-W alone and in interaction with infant/maternal characteristics., Results: MDD-W (as ordinal or dichotomous variable) was positively associated with adequate folate (and vitamin B12). Having male infant was inversely associated with adequate dietary folate. MDD-W was generally unassociated with homocysteine. However, there was an interaction between MDD-W and sex of the infant. Namely, MDD-W ≥ 3 predicted increased probability of normal homocysteine among mothers with female infants but not male infants., Conclusions: Diets consisting of three or more food groups may protect adequate folate intake for many breastfeeding mothers. More research is needed to establish what level of dietary diversity would protect against hyperhomocysteinemia during breastfeeding and what factors promote or hinder the benefit of diversified diets on maternal folate nutrition., (© 2024 The Author(s). American Journal of Human Biology published by Wiley Periodicals LLC.)