The aim of this study was to evaluate the vitamin B12 status in a non-vegetarian sample of the adult urban population from Romania. The studied sample included 80 non vegetarian subjects aged between 19 and 74.6 years who did not use vitamin B12 supplements or vitamin B12 fortified food. The serum vitamin B12 assay was performed using electrochemiluminescence immunoassay on a Roche Elecsys 2010 analyzer. Among all subjects, 93.75% (95% CI 86.2-97.3%) had serum vitamin B12 concentrations in the reference range of the employed method (191-663 pg/ml). In these subjects, we found no statistically significant correlations between serum vitamin B12 concentration and age or between serum vitamin B12 concentration and hemoglobin level. The serum vitamin B12 levels did not differ significantly (p>0.05-Student’s t-test) between women and men. Subnormal serum levels of vitamin B12 were observed in 5% (95%CI 1.96-12.16%) of the investigated subjects, associated with irritable bowel syndrome and with long-term therapy with proton pomp inhibitors or birth control pills. In the present study, we have identified a large number of subjects with marginal depletion of vitamin B12 in the population aged below 50 years. These results suggest the need of a screening for vitamin B12 status in people from all age groups, the importance of the identification of responsible causes for the high prevalence of vitamin B12 marginal status, as well as the fact that monitoring the vitamin B12 status is especially important in subjects undergoing long-term treatment with certain drugs
5. Jabbar A, Yawar A, Waseem S, Islam N, Ul Haque N, Zuberi L, et al. Vitamin B12 deficiency common in primary hypothyroidism. J Pak Med Assoc. 2008May;58(5):258-61.
6. Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA. 2013 Dec;310(22):2435-42. DOI: 10.1001/jama.2013.280490
7. Reinstatler L, Ping Qt Y, Williamson RS, Garn JV, Oakley Jr GP. Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: The national health and nutrition examination Survey, 1999-2006. Diabetes Care. 2012 Feb;35:327-33. DOI: 10.2337/dc11-1582
8. Iqtidar N, Chaudary MN. Misdiagnosed vitamin B12 deficiency a challenge to be confronted by use of modern screening markers. J Pak Med Assoc. 2012 Nov;62(11):1223-9.
9. Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009 Feb;89(2):693S-6S. DOI: 10.3945/ajcn.2008.26947A
10. Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency - an update. Haematol. 2006 Nov;91(11):1506-12.
11. McLean E, de Benoist B, Allen LH. Review of the magnitude of folate and vitamin B12 deficiencies worldwide. Food Nutr Bull. 2008 Jul;29(2):S38-S51.
13. Heil W, Ehrhardt V. Reference Ranges for Adults and Children Pre-Analytical Considerations. Roche Diagnostics Ltd.: Switzerland, 2008, pp 72.
14. Arora S, Singh B, Gupta VK, Venkatesan M. Burden of vitamin B12 deficiency in urban population in Delhi, India: a hospital based study. Int J Pharm Bio Sci. 2011 Jan-Mar;2(1):B521-28.
15. Drabkin DL, Austin JH. Spectrophotometric studies: Spectrophotometric constants for common hemoglobin derivatives in human, dog and rabbit blood. J Biol Chem. 1932 Nov;98(2):719-33.
16. Oshiro I, Takenaka T, Maeda J. New method for hemoglobin determination by using sodium lauryl sulfate (SLS). Clin Biochem. 1982 April;15(2):83-88. DOI: 10.1016/S0009-9120(82)91069-4
17. Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health. 2008 Apr;31(2):180-91. DOI: 10.1002/nur.20247
18. Sütterlin MW, Bussen SS, Rieger L, Dietl J, Steck T. Serum folate and Vitamin B12 levels in women using modern oral contraceptives (OC) containing 20 microgethinyl estradiol. Eur J Obstet Gynecol Reprod Biol. 2003 Mar;107(1):57-61. DOI: 10.1016/S0301-2115(02)00371-8
19. McArthur JO, Tang H, Petocz P, Samman S. Biological variability and impact of oral contraceptives on vitamins B6, B12 and folate status in women of reproductive age. Nutrients. 2013 Sep;5(9):3634-45. DOI: 10.3390/nu5093634 20. Da Silva L, McCray S. Vitamin B12: no one should be without it. Practical Gastroenterology. 2009 Jan;XXXIII(1):34-46.
21. Qatatsheh A. Vitamin B12 status in males and females of different age groups. Am J Agri and Biol Sci. 2011 June;6(2):221-26. DOI: 10.3844/ajabssp.2011.221.226
22. Dharmarajan TS, Norkus EP. An algorithmic approach to the screening of vitamin B12 status and the treatment of identified deficiency. In: Herbert V. Vitamin B12 deficiency. London: Royal Society of Medicine Press Ltd, 1999:49-52.
23. Stabler SP. Screening the older population for cobalamin deficiency. J Am Geriatr Soc. 1995 Nov;43(11):1290-7.
24. Mar N, Askin D, Klafter RJ. Pitfalls in the diagnosis of vitamin B12 deficiency. Open J Hematol. 2012 Sept;3(1):2.