Cobalamin related parameters and disease patterns in patients with increased serum cobalamin levels.
Cobalamin related parameters and disease patterns in patients with increased serum cobalamin levels.
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DOI：
10.1371/journal.pone.0045979
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Nexo E
中科院分区：
文献类型：
--
作者：
Arendt JF;Nexo E
血清钴胺素水平的测量通常用于诊断钴胺素缺乏症。令人惊讶的是，大约 15% 的患者钴胺素水平较高，但其临床意义尚未达成共识。转诊进行血清钴胺素测量的 18 岁以上医院治疗患者被纳入低（<200 pmol/L，n = 200 [6%]）、正常（200–600，n = 202 [6%]）高（601–1000，n = 217）患者组[钴胺素补充百分比] [27%]）和非常高的（>1000，n = 199 [53%]）钴胺素水平。分析了总转钴胺素和钴胺素饱和（全）转钴胺素、总 haptocorrin、可溶性 TC 受体、sCD320 和甲基丙二酸。有关诊断和医疗处方的数据是通过医疗档案和奥胡斯大学处方数据库获得的。在未补充钴胺素的患者中，与钴胺素水平低/正常的组相比，钴胺素水平高/极高的组中总haptocorrin和全转钴胺素水平中值显着较高。各组中总转钴胺素和 sCD320 水平的中位数相似。许多诊断与极高的 Cbl 水平显着相关（比值比（95% 置信区间））：酗酒（5.74 (2.76–11.96)）、肝病（8.53 (3.59–20.23)）和癌症（5.48 (2.85–10.55)）。在患有酗酒、癌症、肝病、肾病、自身免疫病和支气管肺疾病的患者中，haptocorrin 水平升高。未发现与 sCD320 以及总转钴胺素水平和全转钴胺素水平之间的临床关联。在未补充维生素B1的患者中，高钴胺素水平与高haptocorrin水平以及多种诊断相关，包括酗酒、肝病和癌症。我们的研究强调临床医生在诊断过程中应考虑高血清钴胺素水平。
Measurement of serum cobalamin levels is routinely used to diagnose cobalamin deficiency. Surprisingly, approximately 15% of patients have high cobalamin levels and no consensus exists regarding the clinical implications. Hospital-treated patients above 18 years of age referred for serum cobalamin measurement were included in groups of patients [percentage cobalamin supplemented] with low (<200 pmol/L, n = 200 [6%]), normal (200–600, n = 202 [6%]) high (601–1000, n = 217 [27%]) and very high (>1000, n = 199 [53%]) cobalamin levels. Total and cobalamin-saturated (holo) transcobalamin, total haptocorrin, soluble TC receptor, sCD320, and methylmalonic acid were analyzed. Data on diagnoses and medical prescriptions was obtained through medical files and the Aarhus University Prescription Database. Among patients not cobalamin supplemented median total haptocorrin and holo transcobalamin levels were markedly higher in the groups with high/very high cobalamin levels compared to groups with low/normal cobalamin levels. Median total transcobalamin and sCD320 levels were similar across the groups. A number of diagnoses were significantly associated to very high Cbl levels (odds ratio (95% confidence interval)): alcoholism (5.74 (2.76–11.96)), liver disease (8.53 (3.59–20.23)), and cancer (5.48 (2.85–10.55)). Elevated haptocorrin levels were seen in patients with alcoholism, cancer, liver-, renal-, autoimmune-, and bronchopulmonary disease. No clinical associations to sCD320 and total and holo transcobalamin levels were found. In non-supplemented patients, high cobalamin levels were associated to high haptocorrin levels, and several diagnoses, including alcoholism, liver disease and cancer. Our study emphasizes that clinicians should take high serum cobalamin levels into consideration in the diagnostic process.
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影响因子：
--
作者：
Boisson, F;Fremont, S;Nicolas, JP
通讯作者：
Nicolas, JP
影响因子：
3.9
作者：
Ehrenstein, Vera;Antonsen, Sussie;Pedersen, Lars
通讯作者：
Pedersen, Lars
影响因子：
39.2
作者：
Levey, Andrew S.;Coresh, Josef;Van Lente, Frederick
通讯作者：
Van Lente, Frederick
DOI：
10.1046/j.1365-2257.2001.00134.x
发表时间：
2001-12-01
期刊：
CLINICAL AND LABORATORY HAEMATOLOGY
影响因子：
--
作者：
Carmel, R;Vasireddy, H;George, K
通讯作者：
George, K
影响因子：
0.9
作者：
Chiche, L.;Jean, R.;Durand, J. -M.
通讯作者：
Durand, J. -M.