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首页> 外文期刊>Journal of neurology >Utility of measuring vitamin B12 and its active fraction, holotranscobalamin, in neurological vitamin B12 deficiency syndromes.
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Utility of measuring vitamin B12 and its active fraction, holotranscobalamin, in neurological vitamin B12 deficiency syndromes.

机译：在神经性维生素B12缺乏综合症中测量维生素B12及其活性成分全反钴胺素的实用性。

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Vitamin B(12) (VitB(12), cobalamin) deficiency has been associated with various neuropsychiatric conditions, such as peripheral neuropathy, subacute combined degeneration, affective disorders, and cognitive impairment. Current assays analyze vitamin B(12), of which only a small percentage is metabolically active. Measurement of its active fraction, holotranscobalamin, might be of greater relevance, but data in populations with neuropsychiatric populations are lacking. In this study, in order to validate VitB(12) and holotranscobalamin (holoTC) serum levels for the detection of VitB(12) deficiency in neuropsychiatric conditions, we compared the validity of VitB(12) and holoTC in a patient cohort with neuropsychiatric conditions suspicious for VitB(12) deficiency. The cohort included all patients admitted to the Department of Neurology at our university between 2005 and 2009 with at least two parameters of the VitB(12) metabolism available (n = 1,279). We used elevated methylmalonic acid as the external validation criterion for VitB(12) deficiency and restricted our analyses to subjects with normal renal function. Among all normal renal function patients, 13.2% had VitB(12) deficiency. In receiver operating characteristic curve (ROC) analysis, correlation of VitB(12) and holoTC with vitamin B(12) deficiency was generally weak, and the areas under the curve (AUC) were not significantly different for holoTC compared to vitamin B(12) in all subjects (AUC: 0.66 [95%CI: 0.51-0.82]; p = 0.04 vs. 0.72 [0.65-0.78], p < 0.0001) and in subcohorts of patients with classical VitB(12) deficiency syndromes. The positive predictive values for holoTC and vitamin B(12) were low (14.7 vs. 21.0%) and both were associated with more false-positive than true-positive test results. holoTC does not show superior diagnostic accuracy compared to VitB(12) for the detection of VitB(12) deficiency in subjects with neuropsychiatric conditions. Neither test can be recommended to diagnose VitB(12) deficiency in subjects with neuropsychiatric disorders.
机译：维生素B（12）（VitB（12），钴胺素）缺乏症与各种神经精神疾病有关，例如周围神经病变，亚急性合并变性，情感障碍和认知障碍。当前的测定法分析维生素B（12），其中只有一小部分具有代谢活性。其活性成分全反钴胺素的测定可能具有更大的相关性，但缺乏神经精神病人群的数据。在这项研究中，为了验证VitB（12）和holotranscobalamin（holoTC）血清水平在神经精神疾病中检测VitB（12）缺乏症，我们比较了VitB（12）和holoTC在神经精神疾病患者队列中的有效性对VitB（12）缺乏可疑。该队列包括2005年至2009年间在我们大学神经科收治的所有患者，其中至少有两个VitB（12）代谢参数可用（n = 1,279）。我们使用升高的甲基丙二酸作为VitB（12）缺乏症的外部验证标准，并将我们的分析限于肾功能正常的受试者。在所有正常肾功能患者中，有13.2％患有VitB（12）缺乏症。在接受者工作特征曲线（ROC）分析中，VitB（12）和holoTC与维生素B（12）缺乏的相关性通常较弱，并且与维生素B（12）相比，holoTC的曲线下面积（AUC）没有显着差异）（AUC：0.66 [95％CI：0.51-0.82]; p = 0.04 vs. 0.72 [0.65-0.78]，p <0.0001）和经典VitB（12）缺乏症候群患者的亚队列。 holoTC和维生素B（12）的阳性预测值较低（分别为14.7和21.0％），并且两者的假阳性率均高于真阳性测试结果。与检测VitB（12）缺乏症的神经精神疾病患者相比，holoTC并未显示出与VitB（12）相比更高的诊断准确性。两种测试都不能建议诊断患有神经精神疾病的受试者的VitB（12）缺乏症。

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