Modeling patients' methylmalonic acid levels using probabilistic fuzzy systems

Abstract

Vitamin B12 deficiency is a common disorder with severe impacts on hematological and neurological disorders. Identifying vitamin B12 deficiency is not straightforward since blood vitamin B12 levels are not representative for actual vitamin B12 status in tissue. Instead, methylmalonic acid (MMA) levels in the plasma are used as indicators of vitamin B12 deficiency. MMA concentrations increase starting from the early course of vitamin B12 deficiency but they may also be high regardless of vitamin B12 deficiency due to renal failure (measured by eGFR). In this paper we propose the use of probabilistic fuzzy systems (PFS) to explore the relationship between MMA plasma levels with vitamin B12 and kidney function. We propose a PFS model for the analysis of overall MMA properties for all patients and also specific MMA properties for individual patients. We show that this PFS model leads to accurate MMA interval predictions. We further show that the proposed model can be used to assess a change in the eGFR level to a normal eGFR level, and its effect on the patient's MMA distribution.