High prevalence of cobalamin deficiency in Guatemalan schoolchildren: associations with low plasma holotranscobalamin II and elevated serum methylmalonic acid and plasma homocysteine concentrations
High prevalence of cobalamin deficiency in Guatemalan schoolchildren: associations with low plasma holotranscobalamin II and elevated serum methylmalonic acid and plasma homocysteine concentrations
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DOI：
10.1093/ajcn/77.2.433
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发表时间：
2003-02-01
影响因子：
7.1
通讯作者：
Allen, LH
中科院分区：
文献类型：
--
作者：
Rogers, LM;Boy, E;Allen, LH
背景资料：在危地马拉、墨西哥和委内瑞拉进行的研究发现，婴儿和儿童血浆钴胺素（维生素B-12）浓度低的情况普遍存在。目前尚不清楚这些低钴胺素浓度是否伴随着代谢functions.Objective：我们试图评估钴胺素缺乏症在危地马拉儿童的患病率，通过使用敏感和特异性的标志物deficiency.Design：儿童（n = 553）进行了筛选低血浆钴胺素。血浆钴胺素水平低（< 162 pmol/L）的患者在年龄、年级和性别上与边缘（162-221 pmol/L）和适当（> 221 pmol/L）浓度的患者相匹配。在这个匹配的子集（n = 180），额外的生化指标钴胺素缺乏症measured.Results：553名儿童筛选，11%的低血浆钴胺素和额外的22%有边际浓度。血清甲基丙二酸（MMA），血浆同型半胱氨酸，或两者升高的患病率显着高于儿童低和边缘血浆钴胺素比儿童足够的血浆钴胺素。与其他人群报告的值相比，所有组的平均血清MMA均较高。平均血浆全转钴胺素II浓度显着较低，而不是边缘或足够的血浆钴胺素的儿童。然而，全转钴胺素II是一个不太敏感的指标钴胺素耗尽比MMA。结论：钴胺素缺乏症的生化标志物证实，钴胺素状态的儿童低和边缘血浆钴胺素是不足以支持正常的代谢功能。
Background: Studies conducted in Guatemala, Mexico, and Venezuela have found high prevalences of low plasma cobalamin (vitamin B-12) concentrations in infants and children. It is not known whether these low cobalamin concentrations are accompanied by altered metabolic functions.Objective: We sought to assess the prevalence of cobalamin deficiency in Guatemalan children by using sensitive and specific markers of deficiency.Design: Children (n = 553) were screened for low plasma cobalamin. Those with low plasma cobalamin (< 162 pmol/L) were matched by age, grade, and sex to those with marginal (162-221 pmol/L) and adequate (> 221 pmol/L) concentrations. In this matched subset (n = 180), additional biochemical indicators of cobalamin deficiency were measured.Results: Of the 553 children screened, 11% had low plasma cobalamin and an additional 22% had marginal concentrations. The prevalences of elevated serum methylmalonic acid (MMA), plasma homocysteine, or both were significantly higher in children with low and marginal plasma cobalamin than in children with adequate plasma cobalamin. Mean serum MMA was high in all groups compared with values reported in other populations. Mean plasma holotranscobalamin II concentrations were significantly lower in children with low rather than marginal or adequate plasma cobalamin. However, holotranscobalamin II was a less sensitive indicator of cobalamin depletion than was MMA.Conclusion: Biochemical markers of cobalamin deficiency confirmed that the cobalamin status of children with low and marginal plasma cobalamin is inadequate to support normal metabolic function.