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Saila Loikas, Pertti Koskinen, Kerttu Irjala, Minna Löppönen, Raimo Isoaho, Sirkka-Liisa Kivelä, Tarja-Terttu Pelliniemi

Renal impairment compromises the use of total homocysteine and methylmalonic acid but not total vitamin B₁₂ and holotranscobalamin in screening for vitamin B₁₂ deficiency in the aged

Keywords: aged, holotranscobalamin, homocysteine, renal impairment, screening, vitamin B12 deficiency

Background: Vitamin B₁₂ deficiency and renal impairment are common in the aged, and therefore the screening test for vitamin B₁₂ deficiency should not be affected by renal function. Renal impairment has been associated with increased concentrations of plasma total homocysteine and methylmalonic acid, as well as increased total vitamin B₁₂ and holotranscobalamin concentrations.

Methods: The effect of renal impairment on vitamin B₁₂-related biochemical variables was assessed in 1011 aged subjects.

Results: Renal function as indicated by serum cystatin C correlated strongly with plasma total homocysteine (r_s=0.53, p<0.001) and serum methylmalonic acid (r_s=0.27, p<0.001), but not with serum total vitamin B₁₂ (r_s=?0.04, p=0.227) or holotranscobalamin (r_s=?0.01, p=0.817).

Conclusions: Either total vitamin B₁₂ or holotranscobalamin rather than homocysteine or methylmalonic acid should be used when screening an aged population prone to renal impairment.

Clin Chem Lab Med 2007;45:197–201.

Clinical Chemical Laboratory Medicine, Walter de Gruyter

Print ISSN: 1434-6621
Volume: 45, 02/2007
Pages: 197 - 201

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