Role of Functional Biomarkers to Identify Early Vitamin B12 Deficiency in Patients with Sleeve Gastrectomy: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Biomarker Measurements
2.3. Sample Preparation for LC-MS/MS
2.3.1. tHcy Estimation
2.3.2. MMA Estimation
2.3.3. MCA Estimation
2.4. Statistical Analysis
3. Results
3.1. Demographics and Medication Profile in Patients One Year after LSG
3.2. B12, tHcy, and MMA in Patients and Controls
3.3. Folate Levels in Patients and Controls
3.4. MCA Levels in Patients and Controls
3.5. Hb Levels in Patients and Controls
3.6. Comparison of Metabolite Levels with B12 Levels in Patients and Controls using Different Approaches
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Patients (n = 71) | Controls (n = 66) | p-Value |
---|---|---|---|
Age (years) | 36 ± 9 | 35 ± 10 | NS |
Female, n (%) | 45 (63) | 40 (61) | NS |
Male, n (%) | 26 (37) | 26 (39) | NS |
Weight (kg) | 86 ± 22 | 82 ± 14 | NS |
Height (cm) | 162 ± 13 | 159 ± 7 | 0.009 * |
BMI (kg/m2) | 31 ± 6 | 32 ± 5 | NS |
Systolic BP (mmHg) | 114 ± 13 | 119 ± 13 | 0.011 * |
Diastolic BP (mmHg) | 70 ± 11 | 74 ± 8 | 0.008 * |
HbA1c | 5.4 ± 0.7 | 5.6 ± 0.5 | NS |
Cholesterol | 4.9 ± 0.9 | 4.6 ± 0.6 | NS |
LDL | 3.0 ± 0.8 | 2.7 ± 0.6 | 0.054 * |
HDL | 1.5 ± 0.3 | 1.0 ± 0.3 | <0.000 * |
Triglycerides | 0.8 ± 0.4 | 1.0 ± 0.5 | 0.001 * |
Marital status, married | 47 | 43 | NS |
Marital status, single | 24 | 20 | NS |
Level of education, educated | 70 | 58 | NS |
Level of education, illiterate | 1 | 5 | NS |
Diabetes | 0 | 8 | 0.003 * |
Family history of diabetes | 54 | 42 | NS |
Hypertension | 0 | 4 | 0.036 * |
Heart Failure | 0 | 0 | NS |
Dyslipidemia | 0 | 5 | 0.019 * |
Breathlessness | 0 | 7 | 0.005 * |
Sleep apnea | 15 | 9 | NS |
Gallbladder disease | 5 | 2 | NS |
Psychological | 2 | 13 | 0.002 * |
Musculoskeletal | 0 | 32 | <0.001 * |
Clotting abnormality | 0 | 0 | NS |
Pregnancy complication | 0 | 7 | 0.005 * |
Infertility PCOS | 6 | 9 | NS |
Fetal defects | 0 | 0 | NS |
Cancer | 0 | 0 | NS |
Reference Value | Patients Median (Min–Max) | Controls Median (Min–Max) | p-Value | |
---|---|---|---|---|
B12 (pmol/L) | 200–1000 | 177 (54–907) | 334.7 (125.4–1232.5) | <0.001 ** |
tHcy (µmol/L) | <13.2 | 13.7 (7.6–29.6) | 10.9 (2.9–19.5) | <0.001 ** |
MMA (µmol/L) | <0.376 | 0.28 (0.12–2.04) | 0.20 (0.08–0.73) | 0.011 ** |
Folate (nmol/L) | >9 | 11.15 (0.00–36.23) | 22.4 (11.3–67.8) | <0.001 ** |
MCA (µmol/L) | 0.021–0.097 | 0.033 (0.014–0.169) | 0.0386 (0.0152–0.0928) | 0.266 |
Hb male (g/L) | 130–170 | 140.5 (116–166) | 134 (102–153) | 0.005 ** |
Hb female (g/L) | 120–150 | 115 (70–141) | 118 (83–149) | 0.043 * |
Patients, No. of Cases (%) | Control, No. of Cases (%) | p-Value | |
---|---|---|---|
Using Cutoff by American Society for Metabolic and Bariatric Surgery [9] | |||
Deficient B12 (<148 pmol/L) | 20 (28%) | 3 (5%) | <0.001 ** |
Elevated tHcy (>13.2 µmol/L) | 39 (55%) | 12 (18%) | <0.001 ** |
Elevated MMA (>0.376 µmol/L) | 20 (28%) | 12 (18%) | 0.167 |
Deficient Folate (<9 nmol/L) | 21 (30%) | 0 (0%) | - |
Elevated MCA (>0.097 µmol/L) | 2 (3%) | 0 (0%) | - |
Deficient Hb male (<130 g/L) | 3 (3%) | 10 (15%) | 0.011 * |
Deficient Hb female (<120 g/L) | 30 (42%) | 21 (32%) | 0.176 |
Deficient B12 + Elevated tHcy | 10 (14%) | 3 (5%) | 0.057 * |
Deficient B12 + Elevated MMA | 9 (13%) | 1 (1.5%) | 0.012 ** |
Deficient B12 + Elevated (tHcy + MMA) | 4 (5.6%) | 1 (1.5%) | 0.199 |
CB12 Calculated using B12 and MMA as Biomarkers [31] | |||
Elevated CB12 (>1.5) | 0 (0%) | 0 (0%) | - |
CB12 adequacy (−0.5 to1.5) | 39 (55%) | 57 (86%) | <0.001 ** |
Low CB12 (−1.5 to −0.5) | 27 (38%) | 7 (11%) | <0.001 ** |
Possible CB12(−2.5 to 1.5) | 5 (7%) | 0 (0%) | - |
Probable CB12 deficiency (<−2.5) | 0 (0%) | 0 (0%) | - |
CB12 Calculated using tHcy and MMA as Biomarkers [31] | |||
Elevated CB12 (>1.5) | 0 (0%) | 1 (2.1%) | - |
CB12 adequacy (−0.5 to 1.5) | 27 (38%) | 38 (57%) | 0.013 |
Low CB12 (−1.5 to −0.5) | 36 (51%) | 9 (14%) | <0.001 ** |
Possible CB12 (−2.5 to −1.5) | 7 (9.9%) | 0 (0%) | - |
Probable CB12 deficiency (<−2.5) | 1 (1.4%) | 0 (0%) | - |
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Al-Dirbashi, O.Y.; Sharma, C.; Al Dahouri, N.; Al Aidaros, A.; Al-Muhairi, S.; Beiram, R.; Gariballa, S.; Al Kaabi, J. Role of Functional Biomarkers to Identify Early Vitamin B12 Deficiency in Patients with Sleeve Gastrectomy: A Cross-Sectional Study. Medicina 2020, 56, 142. https://doi.org/10.3390/medicina56030142
Al-Dirbashi OY, Sharma C, Al Dahouri N, Al Aidaros A, Al-Muhairi S, Beiram R, Gariballa S, Al Kaabi J. Role of Functional Biomarkers to Identify Early Vitamin B12 Deficiency in Patients with Sleeve Gastrectomy: A Cross-Sectional Study. Medicina. 2020; 56(3):142. https://doi.org/10.3390/medicina56030142
Chicago/Turabian StyleAl-Dirbashi, Osama Y., Charu Sharma, Nahid Al Dahouri, Anas Al Aidaros, Shamma Al-Muhairi, Rami Beiram, Salah Gariballa, and Juma Al Kaabi. 2020. "Role of Functional Biomarkers to Identify Early Vitamin B12 Deficiency in Patients with Sleeve Gastrectomy: A Cross-Sectional Study" Medicina 56, no. 3: 142. https://doi.org/10.3390/medicina56030142