Serum Concentrations Of B12 Research Articles

Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus.

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker and methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history, and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing the diagnosis of B12 deficiency. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency, and the treatment goals govern decisions regarding the route and dose of B12 therapy.

Effects of Betaine and Kaempferol On some criteria related to glucose homeostasis in Methionine Over Load Rats -part 2

This study was designed to evaluate the role of Kaempferol(KPF) and Betaine (BET) in attenuating deleterious effects of methionine overload on some parameters related to diabetes in rats. Thirty (30) adult rats were randomly selected and divided equally into five experimental groups and treated for 45 days as the follows: G1:Rats in this group served as control, Rats in all other groups (G2,G3,G4 and G5 were received 100mg/kg B.W of D-L methionine in drinking water, and received orally as follows: Rats in group G3 were given 150 mg/kg b.w. of KPF, rats in group G4were given 250 mg/kg b.w. BET, rats in group G5 were given 150 mg/kg b.w. of KPF , 250 mg/kg b.w. BET. Fasting blood sample were collected by cardiac puncture technique at the end of the experiments and serum were collected for estimation glycemic indices,. C-peptide and B12 concentration. The results of the experiment that showed given D-L methionine for 45 days(G2group) caused disturbance in glycemic indices as detected by elevation in serum glucose and decrease in serum insulin hormone concentration) and decrease in serum C-peptide and B12 concentration. While oral intubation of KPF and BET or their combination caused correction of all recorded parameters.

A recent surge of nitrous oxide misuse around London which merits a public health warning.

Use of nitrous oxide (N2O) gas for recreational purposes by young people is increasingly recognized as a public health hazard in the UK. We looked at the hospital records of patients admitted over the last 4years to a single neurological centre in Essex to determine the demographics, presentation, and management of patients presenting with symptoms of N2O toxicity from its recreational use. Of the 17 patients (mean age = 22.9 ± 3years) admitted between September 2018 and October 2022, 70% were admitted between January and October 2022. All patients reported limb paraesthesiae and 16/17 reported (95%) imbalance; 11/17 (65%) showed objective limb weakness. Serum B12 concentration was low in 9/17 (53%). Plasma methylmalonic acid (n = 7) and homocysteine (n = 8) levels were elevated in all patients tested. Spinal cord Magnetic Resonance Imaging (MRI) imaging was abnormal in 10/17 (59%) patients. Nerve conduction studies were abnormal in 10/13 (77%) patients, with evidence of a symmetric, length-dependent, large fibre neuropathy. There has been a recent surge of cases with neurological complications of recreational N2O abuse in the UK, with a relatively greater rate in 2022. Greater awareness of this condition amongst clinicians and health regulators is urgently required to prevent harm from N2O misuse in young people.

Methylmalonic acid, vitamin B12, and mortality risk in patients with preexisting coronary heart disease: a prospective cohort study

BackgroundThe inconsistent relationship between Vitamin B12 (B12), methylmalonic acid (MMA, marker of B12 deficiency) and mortality was poorly understood, especially in patients with coronary heart disease (CHD). This study aims to investigate the association of serum MMA, and B12-related biomarkers (serum level, dietary intake, supplement use, and sensibility to B12) with all-cause and cardiovascular mortality in adults with CHD.MethodsThe data of this study were from a subcohort within the US National Health and Nutrition Examination Survey (NHANES). We included adults with preexisting CHD with serum MMA and B12, and dietary B12 intake measurements at recruitment. All participants were followed up until 31 December 2019. Weighted Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% CI of mortality risk.ResultsOverall, 1755 individuals (weighted mean [SE] age, 65.2 [0.5] years; 1047 men [weighted 58.5%]) with CHD were included, with geometric mean levels of serum MMA 182.4 nmol/L, serum B12 494.5 pg/ml, and dietary B12 intake 4.42 mg/day, and percentage of B12 supplements use 39.1%. During a median follow-up of 7.92 years, 980 patients died. Serum B12 concentration, dietary B12 intake and supplements use were not significantly associated with mortality risk (each p ≥ 0.388). In contrast, individuals in the top tertile of MMA had multivariable-adjusted HRs (95% CIs) of 1.70 (1.31–2.20) for all-cause mortality, and 2.00 (1.39–2.89) for cardiovascular mortality (both p trend < 0.001) compared to those in the bottom tertile of MMA. MMA-related mortality risk was particularly higher among participants with sufficient serum B12 (p < 0.001). CHD patients with increased levels of both MMA and B12 had a doubled mortality risk compared to those with lower MMA and B12 (p < 0.001).ConclusionMMA accumulation but not serum or dietary vitamin B12 was associated with increased cardiovascular mortality risk among patients with CHD. This paradox may be related to decreased response to vitamin B12.

Impact of Vitamin B12 Insufficiency on the Incidence of Sarcopenia in Korean Community-Dwelling Older Adults: A Two-Year Longitudinal Study

The longitudinal effect of B12 insufficiency on sarcopenia has not yet been investigated in older adults. We aimed to study the impact of B12 levels on alterations in muscle mass, function and strength over two years. Non-sarcopenic older adults (n = 926) aged 70-84 were included. Using the Korean Frailty and Aging Cohort Study, this two-year longitudinal study used data across South Korea. The tools used for assessing muscle criteria were based on the Asian Working Group for Sarcopenia guidelines. Participants were divided into the insufficiency (initial serum B12 concentration < 350 pg/mL) and sufficiency groups (≥350 pg/mL). Logistic regression analyses were performed to evaluate the effect of initial B12 concentration on sarcopenia parameters over a two-year period. In women, multivariate analysis showed that the B12 insufficiency group had a significantly higher incidence of low SPPB scores (odds ratio [OR] = 3.28, 95% confidence interval [CI] = 1.59-6.76) and sarcopenia (OR = 3.72, 95% CI = 1.10-12.62). However, the B12 insufficiency group did not have a greater incidence of sarcopenia or other parameters in men. Our findings suggest B12 insufficiency negatively impacts physical performance and increases the incidence of sarcopenia only in women.

One-carbon metabolite supplementation to heifers for the first 14 d of the estrous cycle alters the plasma and hepatic one-carbon metabolite pool and methionine-folate cycle enzyme transcript abundance in a dose-dependent manner.

The objective of this study was to determine the dose of folate and vitamin B12 in beef heifers fed rumen protected methionine and choline required to maintain increased B12 levels and intermediates of the methionine-folate cycle in circulation. Angus heifers (n = 30; BW = 392.6 ± 12.6 kg) were individually fed and assigned to one of five treatments: 0XNEG: Total mixed ration (TMR) and saline injections at day 0 and 7 of the estrous cycle, 0XPOS: TMR, rumen protected methionine (MET) fed at 0.08% of the diet DM, rumen protected choline (CHOL) fed at 60 g/d, and saline injections at day 0 and 7, 0.5X: TMR, MET, CHOL, 5 mg B12, and 80 mg folate at day 0 and 7, 1X: TMR, MET CHOL, 10 mg vitamin B12, and 160 mg folate at day 0 and 7, and 2X: TMR, MET, CHOL, 20 mg B12, and 320 mg folate at day 0 and 7. All heifers were estrus synchronized but not bred, and blood was collected on day 0, 2, 5, 7, 9, 12, and 14 of a synchronized estrous cycle. Heifers were slaughtered on day 14 of the estrous cycle for liver collection. Serum B12 concentrations were greater in the 0.5X, 1X, and 2X, compared with 0XNEG and 0XPOS on all days after treatment initiation (P < 0.0001). Serum folate concentrations were greater for the 2X treatment at day 5, 7, and 9 of the cycle compared with all other treatments (P ≤ 0.05). There were no differences (P ≥ 0.19) in hepatic methionine-cycle or choline analyte concentrations by treatment. Concentrations of hepatic folate cycle intermediates were always greater (P ≤ 0.04) in the 2X treatment compared with the 0XNEG and 0XPOS heifers. Serum methionine was greater (P = 0.04) in the 0.5X and 2X heifers compared with 0XNEG, and S-adenosylhomocysteine (SAH) tended (P = 0.06) to be greater in the 0.5X heifers and the S-adenosylmethionine (SAM):SAH ratio was decreased (P = 0.05) in the 0.5X treatment compared with the 0XNEG, 0XPOS, and 2X heifers. The hepatic transcript abundance of MAT2A and MAT2B were decreased (P ≤ 0.02) in the 0.5X heifers compared with the 0XNEG, 0XPOS, and 2X heifers. These data support that beef heifers fed rumen protected methionine and choline require 20 mg B12 and 320 mg folate once weekly to maintain increased concentrations of B12 and folate in serum. Furthermore, these data demonstrate that not all supplementation levels are equal in providing positive responses, and that some levels, such as the 0.5X, may result in a stoichiometric imbalance in the one-carbon metabolism pathway that results in a decreased SAM:SAH ratio.

ASSOCIATION OF ADULT OBESITY AND SERUM B12 DEFICIENCY - A CASECONTROL STUDY FROM INDIA

Introduction: Vitamin B12, also known as cobalamin; has been implicated as an important factor in regulating various metabolic processes, thus playing a role in the etiology of obesity. To assess whether obese adults a Objectives: re at an increased risk for vitamin B12 deciency. This study aimed to assess the serum vitamin B12 status of obese Indians to see if there were any associations between body mass index (BMI) and serum B12 concentration. Medicine outpatient at a medical college university hospita Settings: Methods: l. We included 224 adult participants aged ≥19 years. Overweight and obesity were dened as BMI ≥ 25-29.9 kg/m2 and ≥ 30 kg/m2 respectively. The study subjects were divided into 2 groups as normal BMI (&lt; 25 kg/m2) group, and the obese BMI (≥ 25 kg/m2) group. BMI was calculated as weight in kilograms divided by height in meters square. Fasting venous blood samples were taken from the subjects for the estimation of serum B12 concentrations which were measured using the fully automated electrochemiluminescence immunoassay. Low serum B12 was dened concentration &lt; 197 pg/mL, and B12 deciency was dened as concentration below 150 pg/mL. The adjusted odds ratio (OR) and 95% condence interval (CI) were obtained by the binary logistic regression method. The correlation between serum B12 and BMI was calculated using Pearson's correlation coefcient (r) across various BMI categories. Serum B12 level was signicantly lower among obese adults compa Results: red with non-obese adults. There were signicant negative associations between BMI and serum B12 (p =0.004). Pearson correlation coefcient was strongly negatively associated for BMI with serum B12 level (r= -0.703, p&lt;0.00001). Obesity in otherwise healthy adults was associated with Conclusions: an increased risk of serum B12 deciency. A negative association was found between serum B12 concentrations in obese adult subjects. This association was more pronounced with higher grades of obesity; further research at a large scale is needed to understand the underlying mechanisms and its prevalence in the obese population. We recommend that the possibility of vitamin B12 deciency should always be considered in obese adults.

Adequate vitamin B12 and folate status of Norwegian vegans and vegetarians.

Plant-based diets may increase the risk of vitamin B12 deficiency due to limited intake of animal-source foods, while dietary folate increases when adhering to plant-based diets. In this cross-sectional study, we evaluated the B12 and folate status of Norwegian vegans and vegetarians using dietary B12 intake, B12 and folic acid supplement use, and biomarkers (serum B12 (B12), plasma total homocysteine (tHcy), plasma methylmalonic acid (MMA) and serum folate). Vegans (n 115) and vegetarians (n 90) completed a 24-h dietary recall and a FFQ and provided a non-fasting blood sample. cB12, a combined indicator for evaluation of B12 status, was calculated. B12 status was adequate in both vegans and vegetarians according to the cB12 indicator; however 4 % had elevated B12. Serum B12, tHcy, MMA concentrations and the cB12 indicator (overall median: 357 pmol/l, 9·0 µmol/l, 0·18 µmol/l, 1·30 (cB12)) did not differ between vegans and vegetarians, unlike for folate (vegans: 25·8 nmol/l, vegetarians: 21·6 nmol/l, P = 0·027). Serum B12 concentration < 221 pmol/l was found in 14 % of all participants. Vegetarians revealed the highest proportion of participants below the recommended daily intake of 2 µg/d including supplements (40 v. 18 %, P < 0·001). Predictors of higher serum B12 concentrations were average daily supplement use and older age. Folate deficiency (< 10 nmol/l) was uncommon overall (< 2·5 %). The combined indicator cB12 suggested that none of the participants was B12-depleted; however, low serum B12 concentration was found in 14 % of the participants. Folate concentrations were adequate, indicating adequate folate intake in Norwegian vegans and vegetarians.

Blood cell count and morphology, and vitamin B12 concentration in pre- and post-weaned calves

Haematological indicators may resent physiological variation by age. Vitamin B12 promotes haematopoiesis. The aims of this study were: 1) to compare the values of the haematological variables and the concentration of vitamin B12 in pre- or post-weaned veal calves and 2) to identify the possible association between the values of the haematological variables and the concentration of B12 in the blood of veal calves. Blood was collected on the same day from 31 pre-weaned and 31 weaned calves of the Limousine breed from the same farm. The complete blood count, including the blood cell morphology evaluation, was performed and the serum B12, total protein and albumin concentrations were determined. The serum concentration of vitamin B12, the haematocrit (HCT), the haemoglobin concentration (HGB), the platelet count and the lymphocyte count were significantly higher in the weaned calves. A very strong positive correlation was found between the concentration of the vitamin B12 and HCT and HGB before weaning, while these correlations were moderately positive following weaning and in the total population tested as well. The observed variation in the blood cell count and morphology, such as poikilocytosis and the presence of macrocytes and hypersegmented neutrophils, along with the age of the animal seem to be related to the vitamin B12 concentration.

HIGH PREVALENCE OF ELEVATED VITAMIN B12 LEVELS AT A TEACHING HOSPITAL

<h3>Introduction</h3> Measurement of serum vitamin B12 and folate levels is an integral part of the laboratory evaluation at our geriatric psychiatry clinic. While B12 testing is typically done to detect abnormally low B12 levels, in our clinic and elsewhere the tests often detect vitamin B12 abnormalities consisting of high rather than low levels of B12. The apparent high frequency of excessively high levels of vitamin B12 at our clinic led us to explore this issue in a more systematic manner. <h3>Methods</h3> This presentation examined all the B12 results completed at Hackensack Meridian Health- Jersey Shore University Medical Center [JSUMC] in 2018 and 2019. The initial query elicited 15833 test results. All cases whose folate was low (n=58) or unavailable (n=3987) were excluded from further analysis resulting in a sample of 11787 tests. Furthermore, duplicate tests for the same individual were excluded, holding on to the earliest performed test, resulting in a sample of 8901 B12 tests across all ages. This presentation examines the interplay between three variables: Vitamin B12 level, Age, and MCV. All three parameters were examined as continuous as well as categorical variables. The three variables were converted from continuous to categorical variables as follows: B12 level (low 0-179 Pg/Ml = 132 pmol/L; normal 180-914 Pg/Ml (that is 133-677 pmol/l); high 915 Pg/Ml (677 pmo/l) and up), Age (young 0– 17 yrs; adult 18-64; senior 65 and up), MCV (low 0-79.9; normal 80-100; high 100.1 and up). The conversion ratio for vitamin B12 is is 1.35 pg/ml = 1 pmol/l. <h3>Results</h3> 1. 22% of the whole sample had above normal Vitamin B12 levels 2. 27% of Seniors (65 and older) had above normal Vitamin B12 levels 3. B12 levels correlated positively with age; Seniors (65 and older) had significantly higher (by about 20%) B12 levels compared to adults (18-64 of age) 4. 8% of Seniors had high MCV despite normal or above normal plasma B12, suggesting possible functional B12 deficiency 5. 3.3% of Seniors had normal MCV despite B12 deficiency. <h3>Discussion</h3> During a two year period over a quarter of all vitamin B12 tested patients at JSUMC in general, and seniors in particular had above normal B12 levels. Oral B12 supplements may contribute to above normal B12 plasma levels, but the literature is equivocal on this issue. Unfortunately because in this sample specific clinical data was not available regarding the B12 intake in this population, the nature of the relation between oral intake of vitamin B12 supplements and abnormal high plasma B12 levels could not be explored. Several studies have reported on the prevalence of abnormal high vitamin B12 levels: Jammal et al., 2013 found it in 12% of cases, Carmel et al.,2001 in 14% and Chiche et al., 2013 in 18% of patients. Using 914 Pg/Ml as a cutoff point resulted in 27.5 % of JSUMC seniors falling in the above normal range category well above the published results. Above normal vitamin b12 levels are known to be associated with a long list of serious conditions including: 1. Hematological malignancies / blood dyscrasias, 2. Liver diseases, 3. solid organ tumors, 4. Autoimmune disorders 5. Renal disease / kidney failure, 6. Infectious diseases 7. Possibly with excessive b12 supplements intake. 8. Increased all-cause mortality Two recent studies have reported on the relationship between serum B12 concentrations. Wolffenbuttel et al., 2020 found, that there was a small but significant increase in cardiovascular mortality in the groups with low or high serum B12. The 2020 Flores-Guerrero et al., study found "that higher levels of plasma concentrations of vitamin B12 were associated with increased risk of all-cause mortality...". <h3>Conclusions</h3> 1. Over a quarter of the seniors tested at JSUMC had abnormally high vitamin B12 levels. The reason for this higher than expected prevalence requires further exploration. 2. In addition, since elevated B12 levels are known to be associated with a long list of serious medical conditions and a higher mortality rate, this project emphasizes the importance of conducting a careful clinical review for possible serious hidden causes for such findings. 3. High vitamin B12 may be the result of oral intake of large amounts of vitamin B12 supplements, but this information is typically not systematically collected. This project also highlights the importance of collecting accurate quantitative information regarding vitamin supplement intake when completing the medication reconciliation process in routine clinical practice. 1. Andrès E, et al., 2013 PMID: 23447660. 2. Arendt JF, et al., 2013 PMID: 23241600. 3. Carmel R, et al., 2001 PMID: 11843883. 4. Jammal M, et al 2013 PMID: 2314212. 5. Chiche L, et al., 2013 PMID: 23708236. 6. Wolffenbuttel BHR, 2020 PMID: 33032595. 7. Flores-Guerrero JL, 2019 PMID: 31940038.

Relationship between serum B12 concentrations and mortality: experience in NHANES

BackgroundThere is conflicting evidence in the literature on the association between (elevated) serum B12 concentrations and subsequent disease or mortality. We evaluated in the NHANES general population the association of serum B12 concentrations as well as vitamin B12 supplement intake with all-cause, cardiovascular, and cancer-related mortality, while taking into account demographic and lifestyle factors and significant other diseases which are known to be associated with poorer outcome.MethodsThe main outcomes of our study were all-cause mortality, cardiovascular mortality, and cancer-related mortality. Mortality status and cause of death were determined by NHANES-linked National Death Index public access files through December 31, 2015. The association of serum B12 concentrations and vitamin B12 supplement intake with mortality was assessed with Cox proportional hazard (PH) models, with adjustment for a number of relevant demographic and lifestyle factors and comorbidity.ResultsThe final study population of 24,262 participants had a mean age of 48 (SD 19) years; 50.1% were males. The median follow-up duration was 109 months (range 1–201 months). On the census day of December 31, 2015, 3023 participants were determined as deceased (12.5%). The fully adjusted Cox PH model indicated that low serum B12 concentrations < 140 pmol/l were associated with a small increase in all-cause (hazard ratio, HR 1.39, 95% CI 1.08–1.78, p = 0.011) and cardiovascular (HR 1.64, 95% CI 1.08–2.47, p = 0.020) mortality. Similarly, high serum B12 concentrations > 700 pmol/l were associated with an increase in cardiovascular mortality only (HR 1.45, 95% CI 1.01–2.06, p = 0.042). Participants with a diagnosis of hypertension, dyslipidemia, CVD, and cancer more frequently used vitamin B12-containing supplements than those without these diagnoses. We could not demonstrate an association between vitamin B12 supplement intake and mortality, when adjusted for comorbidity.ConclusionsIn the general population of NHANES, low serum B12 concentrations were associated with a moderate increase in all-cause mortality. There was a small but significant increase in cardiovascular mortality in the groups with low or high serum B12. High intake of vitamin B12 in the form of supplements was not associated with any adverse effect on mortality and therefore can be regarded as safe.

Wolffia globosa-Mankai Plant-Based Protein Contains Bioactive Vitamin B12 and Is Well Absorbed in Humans.

Background: Rare plants that contain corrinoid compounds mostly comprise cobalamin analogues, which may compete with cobalamin (vitamin B12 (B12)) metabolism. We examined the presence of B12 in a cultivated strain of an aquatic plant: Wolffia globosa (Mankai), and predicted functional pathways using gut-bioreactor, and the effects of long-term Mankai consumption as a partial meat substitute, on serum B12 concentrations. Methods: We used microbiological assay, liquid-chromatography/electrospray-ionization-tandem-mass-spectrometry (LC-MS/MS), and anoxic bioreactors for the B12 experiments. We explored the effect of a green Mediterranean/low-meat diet, containing 100 g of frozen Mankai shake/day, on serum B12 levels during the 18-month DIRECT-PLUS (ID:NCT03020186) weight-loss trial, compared with control and Mediterranean diet groups. Results: The B12 content of Mankai was consistent at different seasons (p = 0.76). Several cobalamin congeners (Hydroxocobalamin(OH-B12); 5-deoxyadenosylcobalamin(Ado-B12); methylcobalamin(Me-B12); cyanocobalamin(CN-B12)) were identified in Mankai extracts, whereas no pseudo B12 was detected. A higher abundance of 16S-rRNA gene amplicon sequences associated with a genome containing a KEGG ortholog involved in microbial B12 metabolism were observed, compared with control bioreactors that lacked Mankai. Following the DIRECT-PLUS intervention (n = 294 participants; retention-rate = 89%; baseline B12 = 420.5 ± 187.8 pg/mL), serum B12 increased by 5.2% in control, 9.9% in Mediterranean, and 15.4% in Mankai-containing green Mediterranean/low-meat diets (p = 0.025 between extreme groups). Conclusions: Mankai plant contains bioactive B12 compounds and could serve as a B12 plant-based food source.

Elevated Homocysteine after Elevated Propionylcarnitine or Low Methionine in Newborn Screening Is Highly Predictive for Low Vitamin B12 and Holo-Transcobalamin Levels in Newborns.

Early diagnostics and treatment of vitamin B12 deficiency (B12D) in infants, mainly maternally conditioned, is crucial in preventing possible developmental delay and neurological deficits. Currently, B12D is rarely listed in regular newborn screening panels and mostly regarded as an incidental finding. The aim of this study was to evaluate a targeted newborn screening strategy for detection of suspected B12D. A decision strategy based on the primary parameters propionylcarnitine and methionine for selection of samples to be analyzed for total homocysteine by mass spectrometry was established. Therefore, 93,116 newborns were initially screened. Concentrations of vitamin B12 and holotranscobalamin in serum were obtained from clinical follow-up analyses of recalled newborns. Moreover, an extremely sensitive mass spectrometric method to quantify methylmalonic acid from the dried blood spots was developed. Overall, 0.15% of newborns were screened positive for suspected B12D, of which 64% had vitamin B12 concentrations below 148 pM. We also determined a cutoff value for methylmalonic acid in dried blood spots indicative for B12D in infants. Overall, we calculated a prevalence of 92/100,000 for suspected B12D in the Austrian newborns. In conclusion, we present a screening algorithm including second-tier measurement of total homocysteine that allows detection of low B12 serum concentrations with a high detection rate and low false-positive rate.

Phama Sci Preparation, In Vitro and In Vivo Studies of Vitamin B12 Loaded Implants Al-Rasheed University College, Iraq

Vitamin B12 is an important water-soluble vitamin which is found in a variety of food such as fish, shellfish, meat, and dairy products. It helps maintain healthy nerve cells and red blood cells, as well as aid in rapid DNA production during cell division. The daily requirement of vitamin B12 for the human body is approximately 1-25 µg . In 1960 introduced long-acting depot antipsychotic drug as the first long acting medications. Depot formulations providing further reductions in morbidity and mortality. Because they bypass the gastrointestinal tract, Depot treatments decrease the amount of medication needed and reduce certain peripheral side effects. Understanding the clinical and compliance of patients from the use of single dose with multiple and consecutive treatment of B12, we have developed long-term implantable medication delivery loaded with vitamin B12. The proposed method of controlled drug delivery uses sterile implants processed with a Poly (lactic-co-glycolic acid) (PLGA) polymer with a delivery interval of up to one month depending on polymer composition, and drug loading. In this study, 3 goals were addressed: 1: To formulate six different batches of biodegradable polymer implants loaded with vitamin 12 and target profile shown in Tables 1. 2: To characterize the formulated implants and establish an in vitro release for the B12 as a function of time. 3: Perform in vivo study and measure the serum concentration of B12 released from implants subcutaneously inserted into rats. Accomplishment of these three goals could provide the feasibility of controlled release vitamin B12 implants for human treatment for vitamin deficiency.

Low Serum B12 Concentrations Are Associated with Low B12 Dietary Intake But Not with Helicobacter pylori Infection or Abnormal Gastric Function in Rural Mexican Women.

Background: Gastric function, Helicobacter pylori infection, and vitamin B12 (B12) dietary intake were assessed as predictors of serum B12. Methods: H. pylori antibodies, gastric function, B12 dietary intake, and biochemical/hematological parameters were measured in 191 adult women from two rural communities in Querétaro, Mexico. Results: The overall mean serum B12 concentration was 211 ± 117 pmol/L. The prevalences of low (≤ 148 pmol/L), marginal (148 to 221 pmol/L), and adequate (> 221 pmol/L) serum B12 were 28.4%, 31.1%, and 40.5%, respectively. Seventy-one percent of women tested positive for H. pylori antibodies. The prevalence of gastric function categories did not differ by serum B12 categories. The odds ratio for having low serum B12 was 2.7 (p = 0.01) for women with an intake below the estimated average requirement, 3.6 (p = 0.01) for those in the lowest tertile of total B12 intake, and 3.0 (p = 0.02) for those in the lowest tertile of B12 intake from animal source foods. Age and B12 intake were predictors of serum B12 concentrations [serum B12 (pmol/L) = 90.060 + 5.208 (B12 intake, µg/day) + 2.989 (age, years). Conclusions: Low serum B12 concentrations were associated with low B12 dietary intake but not with H. pylori infection or abnormal gastric function in rural Mexican women.

Response to exercise in older adults who take supplements of antioxidants and/or omega-3 polyunsaturated fatty acids: A systematic review

BackgroundNutrition is a key factor in determining exercise response. The aim of this review is to assess the response to exercise in older adults who take supplements of antioxidants and/or omega-3 polyunsaturated fatty acids. MethodsA systematic literature search was performed (June 2009- September 2019) in MEDLINE via Pubmed. The following search strategy was used with Boolean markers: (“omega-3 fatty acids” [Major] OR “antioxidants” [Major]) AND “exercise” AND “aged” [MesH]. Fourteen articles were finally included. ResultsExercise-induced free radical and inflammatory marker blood levels, but not changed the plasma total antioxidant capacity (TAC), after administration of antioxidant supplement. The oral administration of antioxidants produced null or negative effect on endothelial function, but the infusion into the brachial artery during rhythmic handgrip exercise produced a significant improvement in muscle blood flow, due to an on increase in the availability of nitric acid derived from the nitric oxide synthase. Aerobic exercise and antioxidant supplementation improved submaximal and maximal aerobic parameters, as well as mitochondrial density and mitochondria-regulated apoptotic signaling. Antioxidant supplementation, but not omega-3 PUFA, decreased pro-inflammatory marker levels and fat oxidation induced by exercise. Strength training decreased serum B12 concentration but combined with omega-3 PUFA or antioxidant supplementation, B12 levels were maintained. Antioxidant supplementation has protective effect after fatigue in isometric exercise but improved appendicular fat-free mass just combined with resistance exercise. Omega-3 fatty acid supplement combined with exercise increased lean mass in women, but not in men. Muscle damage induced by exercise is protected by antioxidant supplementation. ConclusionsOlder people who take antioxidant and/or omega-3 PUFA supplements showed improved exercise response, as well as lower muscle damage.

&lt;p&gt;Comparison of serum B12, folate and homocysteine concentrations in children with autism spectrum disorder or attention deficit hyperactivity disorder and healthy controls&lt;/p&gt;

ObjectiveWe aimed to investigate the serum concentrations of vitamin B12, folate and homocysteine in children diagnosed with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) and healthy controls.Materials and methodsSerum vitamin B12, folate and homocysteine concentrations were measured in 118 children (48 children diagnosed with ADHD, 35 children diagnosed with ASD and 35 healthy controls). Symptom severity in the ADHD and ASD groups was evaluated by the Childhood Autism Rating Scale and Turgay-DSM-IV-Based Screening and Assessment Scale for Disruptive Behavior Disorders. Multivariate analysis of covariance was used to evaluate the effects of diagnosis and gender on biochemical parameters.ResultsThe ADHD and ASD groups and the healthy controls differed significantly regarding vitamin B12 and homocysteine concentrations, but not folate levels. Patients with ASD had the lowest vitamin B12 and the highest homocysteine levels. Vitamin B12 levels correlated negatively with hyperactivity and/orimpulsivity and oppositionality symptoms in children with ADHD. There were no relationships between psychometric evaluations and laboratory measurements in children with ASD. Gender did not affect vitamin concentrations.ConclusionPrevious studies found that vitamin B12 was reduced while homocysteine was elevated among patients with ADHD and ASDs. Our results also support those reported previously. Oppositionality and hyperactivity and/orimpulsivity may be related to vitamin B12 and homocysteine levels in children with ADHD. Further studies are required to define the role of these parameters and effects on the etiology and clinical manifestations of ASD and ADHD.

Breast milk provides inadequate amounts of vitamin B12 for predominantly breastfed Guatemalan infants.

Vitamin B12 (B12) plays in an important role in the development and function of the brain and nervous system, and adequate B12 status is especially important for the normal development of infants. In previous research conducted in Guatemala City we reported a high prevalence of B12 deficiency in lactating women and their infants 3 and 12 months of age, and low B12 concentrations in breast milk. The objective of this study was to assess predictors of serum B12 concentration in predominantly breastfed Guatemalan infants including intake of B12 from breast milk and other foods. Serum B12, breast milk and other food intakes, anthropometry, morbidity and socioeconomic status were assessed in infants 6.7±0.6 months of age (n=127, 52% female) in peri-urban Guatemala City. Twenty-four percent of infants had deficient B12 status (serum B12 concentration<148 pmol/L) and 37% had marginal B12 status (148-220 pmol/L). Serum B12 concentrations were negatively correlated with infants' consumption of energy from breast milk (r=-0.37, p=0.001), and positively correlated with their total consumption of animal source foods, especially cow's milk (r=0.40, p=0.001). Based on previously analyzed breast milk B12 concentrations in a nearby community, breast milk provided<10% of the recommended daily B12 intake for this age. We conclude that there was a high prevalence of B12 deficiency in these Guatemalan infants by 6 months of age. Serum B12 was higher in infants consuming more cow's milk and lower in those consuming more breast milk.

Prevalence of low serum vitamin B12 in Mexican children and women: results from the first National Nutrition Survey (1999) as a basis for interventions and progress.

Serum samples from the 1999 Mexico National Nutrition Survey (NNS) were analyzed to determine the prevalence of low serum B12 concentrations, identify factors related with low values including B12 intake, and importantly, to provide a baseline for monitoring progress in reducing deficiency. Samples for B12 were available from 488 children and 464 women, a sub-sample of the nationally representative 1999 NNS. The national overall prevalence of low (<200pg/mL) and marginal (200 to 300pg/mL) serum B12 was 25.6% and 21.0%, respectively. Adolescent girls had the lowest serum B12 concentrations (325±308pg/mL) and the prevalence of deficiency was 40% in pregnant women even using a lower cut-point (<135pg/mL). Residents of rural areas and the South, population groups with poorest socioeconomic status, and illiterate and indigenous women had the lowest serum B12 Children and women who met dietary recommendations for B12 intake had higher serum B12 than those who did not. Overall 45.9% of intakes fell below the Estimated Adequate Requirement. Dietary B12 intake of children and women was directly correlated with serum B12 (r=0.18, p<0.001 and r=0.11, p=0.0304). The prevalence of marginal and deficient B12 status in 1999 was much higher than the most recently published national data suggesting the success of national policies to improve micronutrient status.

Evaluation of nutritional status in children with amblyopia.

We aimed to compare the body mass index and vitamin and mineral status of children with and without amblyopia. Amblyopic children aged between 5 and 18 years (n=46) and age-matched control children (n=32) were evaluated in terms of anthropometric parameters, including height, weight, body mass index and demographic features. Serum vitamin B12 and folate were measured using an Advia Centaur XP (Siemens, Ireland) biochemistry analyzer. We evaluated the inorganic mineral elements from hair samples with inductively coupled plasma-mass spectrometry using a Thermo XSeries 2 analyzer (Thermo Fisher Scientific, Bremen, Germany). No significant difference was found between the two groups in terms of height, weight, and body mass index or serum B12 and folate concentrations (p>0.05). Children with severe amblyopia had lower vitamin B12 and folate and higher body mass index. The levels of phosphorus (p=0.012), selenium (p=0.002), molybdenum (p<0.001), iodine (p=0.002), chromium (p=0.022), boron (p<0.001), and beryllium (p=0.005) were all significantly lower in the amblyopia group compared to the control group. All of these minerals, except phosphorus, were also significantly lower in those with severe amblyopia compared to those with milder amblyopia and controls (p<0.05). Amblyopic children are significantly deficient in some inorganic elements. Inorganic elements, vitamin B12, and folate may play an important role in the visual development of amblyopic children.