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D vitamini ile Vitamin B12, Metilmalonik Asit, Homosistein ve Ferritin Düzeyleri Arasındaki İlişki

Yıl 2025, Cilt: 58 Sayı: 1, 7 - 10, 04.05.2025
https://doi.org/10.20492/aeahtd.1483471

Öz

Amaç: D vitamini ile diğer vitamin düzeyleri arasında bir ilişki olup olmadığı tam olarak bilinmemektedir. Bu çalışmada D vitamini ile folat, ferritin, B12 vitamini, homosistein ve metilmalonik asit (MMA) düzeyleri arasındaki potansiyel ilişki incelenmiştir.
Gereç ve Yöntemler: Kasım 2022 ile Nisan 2023 tarihleri arasında Dahiliye polikliniğimize başvuran 189 yetişkin hastanın (18-65 yaş) laboratuvar sonuçları hastane kayıtlarından retrospektif olarak elde edildi. 18 yaş altı ve 65 yaş üstü, son 3 ay içinde D vitamini replasman öyküsü olan, kanser, akut enfeksiyon, gebelik, böbrek veya karaciğer hastalığı, Çölyak hastalığı gibi malabsorbsiyon veya inflamatuar barsak hastalığı tanısı alan katılımcılar çalışma dışı bırakıldı.
Bulgular: D vitamini ile hemoglobin ve ferritin arasında pozitif korelasyon vardı (sırasıyla r=0,219 p=0,003 ve r=0,262 p<0,001). Daha yüksek D vitamini çeyrekliklerinde yer alan hastaların hemoglobin ve ferritin düzeyleri, daha düşük çeyreklik dilimlere kıyasla daha yüksekti. D vitamini ile MMA’nın ilişkili olduğu belirlendi (OR= 4,576 %95 GA=1,506-13,903 p=0,007). D vitamini ile sırasıyla homosistein, folat ve B12 vitamini düzeyleri arasında ilişki yoktu.
Sonuç: Serum MMA’nın doku düzeyinde B12 eksikliğini göstermede serum B12 ölçümünden daha duyarlı bir yöntem olduğunu ve bu nedenle B12 vitamini ile D vitamininin birbiriyle ilişkili bulunmadığını düşünüyoruz.

Destekleyen Kurum

yok

Teşekkür

yok

Kaynakça

  • 1. Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician. 2017;96(6):384-89.
  • 2. Carlberg C. Vitamin D: A Micronutrient Regulating Genes. Curr Pharm Des. 2019;25(15):1740-46. doi: 10.2174/138161282566619 0705193227.
  • 3. Konuksever D, Yücel Karakaya SP. Evaluation of correlation between vitamin D with vitamin B12 and folate in children. Nutrition. 2022;99-100:111683. doi: 10.1016/j.nut.2022.111683
  • 4. Rahman A, Al-Taiar A, Shaban L, Al-Sabah R, Mojiminiyi O. Plasma 25-hydroxyvitamin D is positively associated with folate and vitamin B12 levels in adolescents. Nutr Res. 2020;79:87-99. doi: 10.1016/j. nutres.2020.06.003.
  • 5. Brandsch C, Zibolka J, Frommhagen M, Lehmann U, Dierkes J, Kühne H, et al. Vitamin D is not linked to folate status and mRNA expression of intestinal proton-coupled folate transporter. Eur J Nutr. 2014;53(4):1115-22. doi: 10.1007/s00394-013-0614-7.
  • 6. Kullak-Ublick GA, Gubler C, Spanaus K, Ismair MG, Claro da Silva T, Jetter A. No major effects of vitamin D3 (1,25 dihydroxyvitamin D3) on absorption and pharmacokinetics of folic acid and fexofenadine in healthy volunteers. Eur J Clin Pharmacol. 2016;72(7):797-805. doi: 10.1007/s00228-016-2050-0.
  • 7. Nur-Eke R, Özen M. The Relationship between Vitamin D Levels and Iron Deficiency and Anemia in Adults Applied for Periodic Medical Examination. Clin Lab. 2020;66(6). doi: 10.7754/Clin. Lab.2019.190918.
  • 8. Monlezun DJ, Camargo CA Jr, Mullen JT, Quraishi SA. Vitamin D Status and the Risk of Anemia in Community-Dwelling Adults: Results from the National Health and Nutrition Examination Survey 2001-2006. Medicine (Baltimore). 2015;94(50):e1799. doi: 10.1097/ MD.0000000000001799.
  • 9. Klee GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B(12) and folate. Clin Chem. 2000;46(8 Pt 2):1277-83.
  • 10. Lee YA, Kang SG, Song SW, Kim SH. Association between Homocysteine and Vitamin D Levels in Asymptomatic Korean Adults. Nutrients. 2024;16(8):1155. doi: 10.3390/nu16081155.
  • 11. Amer M, Qayyum R. The relationship between 25-hydroxyvitamin D and homocysteine in asymptomatic adults. J Clin Endocrinol Metab. 2014;99(2):633-8. doi: 10.1210/jc.2013-3262
  • 12. Solomon LR. Functional cobalamin (vitamin B12) deficiency: role of advanced age and disorders associated with increased oxidative stress. Eur J Clin Nutr. 2015;69(6):687-92. doi: 10.1038/ ejcn.2014.272.
  • 13. Lac PT, Choi K, Liu IA, Meguerditchian S, Rasgon SA, Sim JJ. The effects of changing vitamin D levels on anemia in chronic kidney disease patients: a retrospective cohort review. Clin Nephrol. 2010;74(1):25-32. doi: 10.5414/cnp74025.
  • 14. Norman AW. Minireview: vitamin D receptor: new assignments for an already busy receptor. Endocrinology. 2006;147(12):5542-8. doi: 10.1210/en.2006-0946.
  • 15. Bacchetta J, Zaritsky JJ, Sea JL, Chun RF, Lisse TS, Zavala K, et al. Suppression of iron-regulatory hepcidin by vitamin D. J Am Soc Nephrol. 2014;25(3):564-72. doi: 10.1681/ASN.2013040355.
  • 16. Zughaier SM, Alvarez JA, Sloan JH, Konrad RJ, Tangpricha V. The role of vitamin D in regulating the iron-hepcidin-ferroportin axis in monocytes. J Clin Transl Endocrinol. 2014;1(1):19-25. doi: 10.1016/j. jcte.2014.01.003.
  • 17. Shimmi SC, Eldosouky HF, Hossain Parash MT, Wan Saudi WS. Probability of Concurrent Deficiency of Vitamin D and Iron in Hypothyroidism: A Cross-Sectional Study. Cureus. 2023;15(4):e37152. doi: 10.7759/cureus.37152.
  • 18. Hitesh T, Khatuja R, Agrawal P, Dhamnetiya D, Jha RP, Renjhen P. Unlocking the mystery of the role of Vitamin D in iron deficiency anemia in antenatal women: a case control study in a tertiary care hospital in New Delhi. BMC Pregnancy Childbirth. 2023;23(1):749. doi: 10.1186/s12884-023-06047-w.
  • 19. Liu T, Zhong S, Liu L, Liu S, Li X, Zhou T,et al. Vitamin D deficiency and the risk of anemia: a meta-analysis of observational studies. Ren Fail. 2015;37(6):929-34. doi: 10.3109/0886022X.2015.1052979.
  • 20. Karabayir N, Teber BG, Dursun HK, Pehlivan LS. Is There An Association Between Vitamin B12 Level and Vitamin D Status in Children? J Pediatr Hematol Oncol. 2022;44(3):e677-e681. doi: 10.1097/ MPH.0000000000002329.
  • 21. Plant AS, Tisman G. Frequency of combined deficiencies of vitamin D and holotranscobalamin in cancer patients. Nutr Cancer. 2006;56(2):143-8. doi: 10.1207/s15327914nc5602_4.
  • 22. Singh K, Gandhi S, Batool R. A Case-Control Study of the Association between Vitamin D Levels and Gastric Incomplete Intestinal Metaplasia. Nutrients. 2018;10(5):629. doi: 10.3390/nu10050629.
  • 23. Delgado JA, Pastor García MI, Márquez Jiménez N, Costa Petit G, Regís Perelló A, Robles J,et al. Functional vitamin B12 deficiency: Improving methylmalonic acid reference intervals in urine. Clin Chim Acta. 2023;544:117334. doi: 10.1016/j.cca.2023.117334.
  • 24. Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496- 513. doi: 10.1111/bjh.12959.
  • 25. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol. 1990;34(2):99-107. doi: 10.1002/ajh.2830340205
  • 26. Guo J, Liu X, Wang Z, Lu R, Liu Y, Zhang Y,et al. Methylmalonic acid, vitamin B12, and mortality risk in patients with preexisting coronary heart disease: a prospective cohort study. Nutr J. 2023;22(1):63. doi: 10.1186/s12937-023-00900-6.
  • 27. Hooshmand B, Appold F, Fissler P, Perneczky R, Otto M, Tumani H, et al. Markers of Vitamin B12 Status in Relation to Cerebrospinal Fluid Biomarkers of Alzheimer's Disease and Cognitive Performance. Ann Neurol. 2023;94(2):223-231. doi: 10.1002/ana.26673.

Correlation Between Vitamin D and Ferritin, Vitamin B12, Homocysteine, and Methylmalonic acid

Yıl 2025, Cilt: 58 Sayı: 1, 7 - 10, 04.05.2025
https://doi.org/10.20492/aeahtd.1483471

Öz

Aim: It is not well-known whether there is an association between vitamin D and other vitamin levels. In this study, potential interrelation between vitamin D and folate, ferritin, vitamin B12, homocysteine, and methylmalonic acid levels was examined.
Material and Methods: Laboratory results of 189 adult patients (18-65 years old) who admitted to our Internal Medicine outpatient clinic between November 2022 to April 2023 were retrospectively retrieved from hospital registry. Participants younger than 18 and older than 65 years old, with a history of vitamin D replacement within 3 months, diagnosed with cancer, acute infection, pregnancy, renal or hepatic disease, malabsorption like Celiac or inflammatory bowel disease were excluded.
Results: There was a positive correlation between vitamin D and both hemoglobin and ferritin (r=0.219 p=0.003 and r=0.262 p<0.001 respectively). Patients in the higher vitamin D quartiles had higher hemoglobin and ferritin levels compared to lesser quartiles. Vitamin D and MMA were found to be associated (OR= 4.576 %95 CI=1.506-13.903 p=0.007). There were no association between vitamin D and homocysteine, folate, and vitamin B12 levels respectively.
Conclusion: We assume serum MMA is a more sensitive method than serum B12 measurement to show tissue level B12 deficiency and that is why vitamin B12, and vitamin D were not found to be associated with each other.

Kaynakça

  • 1. Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician. 2017;96(6):384-89.
  • 2. Carlberg C. Vitamin D: A Micronutrient Regulating Genes. Curr Pharm Des. 2019;25(15):1740-46. doi: 10.2174/138161282566619 0705193227.
  • 3. Konuksever D, Yücel Karakaya SP. Evaluation of correlation between vitamin D with vitamin B12 and folate in children. Nutrition. 2022;99-100:111683. doi: 10.1016/j.nut.2022.111683
  • 4. Rahman A, Al-Taiar A, Shaban L, Al-Sabah R, Mojiminiyi O. Plasma 25-hydroxyvitamin D is positively associated with folate and vitamin B12 levels in adolescents. Nutr Res. 2020;79:87-99. doi: 10.1016/j. nutres.2020.06.003.
  • 5. Brandsch C, Zibolka J, Frommhagen M, Lehmann U, Dierkes J, Kühne H, et al. Vitamin D is not linked to folate status and mRNA expression of intestinal proton-coupled folate transporter. Eur J Nutr. 2014;53(4):1115-22. doi: 10.1007/s00394-013-0614-7.
  • 6. Kullak-Ublick GA, Gubler C, Spanaus K, Ismair MG, Claro da Silva T, Jetter A. No major effects of vitamin D3 (1,25 dihydroxyvitamin D3) on absorption and pharmacokinetics of folic acid and fexofenadine in healthy volunteers. Eur J Clin Pharmacol. 2016;72(7):797-805. doi: 10.1007/s00228-016-2050-0.
  • 7. Nur-Eke R, Özen M. The Relationship between Vitamin D Levels and Iron Deficiency and Anemia in Adults Applied for Periodic Medical Examination. Clin Lab. 2020;66(6). doi: 10.7754/Clin. Lab.2019.190918.
  • 8. Monlezun DJ, Camargo CA Jr, Mullen JT, Quraishi SA. Vitamin D Status and the Risk of Anemia in Community-Dwelling Adults: Results from the National Health and Nutrition Examination Survey 2001-2006. Medicine (Baltimore). 2015;94(50):e1799. doi: 10.1097/ MD.0000000000001799.
  • 9. Klee GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B(12) and folate. Clin Chem. 2000;46(8 Pt 2):1277-83.
  • 10. Lee YA, Kang SG, Song SW, Kim SH. Association between Homocysteine and Vitamin D Levels in Asymptomatic Korean Adults. Nutrients. 2024;16(8):1155. doi: 10.3390/nu16081155.
  • 11. Amer M, Qayyum R. The relationship between 25-hydroxyvitamin D and homocysteine in asymptomatic adults. J Clin Endocrinol Metab. 2014;99(2):633-8. doi: 10.1210/jc.2013-3262
  • 12. Solomon LR. Functional cobalamin (vitamin B12) deficiency: role of advanced age and disorders associated with increased oxidative stress. Eur J Clin Nutr. 2015;69(6):687-92. doi: 10.1038/ ejcn.2014.272.
  • 13. Lac PT, Choi K, Liu IA, Meguerditchian S, Rasgon SA, Sim JJ. The effects of changing vitamin D levels on anemia in chronic kidney disease patients: a retrospective cohort review. Clin Nephrol. 2010;74(1):25-32. doi: 10.5414/cnp74025.
  • 14. Norman AW. Minireview: vitamin D receptor: new assignments for an already busy receptor. Endocrinology. 2006;147(12):5542-8. doi: 10.1210/en.2006-0946.
  • 15. Bacchetta J, Zaritsky JJ, Sea JL, Chun RF, Lisse TS, Zavala K, et al. Suppression of iron-regulatory hepcidin by vitamin D. J Am Soc Nephrol. 2014;25(3):564-72. doi: 10.1681/ASN.2013040355.
  • 16. Zughaier SM, Alvarez JA, Sloan JH, Konrad RJ, Tangpricha V. The role of vitamin D in regulating the iron-hepcidin-ferroportin axis in monocytes. J Clin Transl Endocrinol. 2014;1(1):19-25. doi: 10.1016/j. jcte.2014.01.003.
  • 17. Shimmi SC, Eldosouky HF, Hossain Parash MT, Wan Saudi WS. Probability of Concurrent Deficiency of Vitamin D and Iron in Hypothyroidism: A Cross-Sectional Study. Cureus. 2023;15(4):e37152. doi: 10.7759/cureus.37152.
  • 18. Hitesh T, Khatuja R, Agrawal P, Dhamnetiya D, Jha RP, Renjhen P. Unlocking the mystery of the role of Vitamin D in iron deficiency anemia in antenatal women: a case control study in a tertiary care hospital in New Delhi. BMC Pregnancy Childbirth. 2023;23(1):749. doi: 10.1186/s12884-023-06047-w.
  • 19. Liu T, Zhong S, Liu L, Liu S, Li X, Zhou T,et al. Vitamin D deficiency and the risk of anemia: a meta-analysis of observational studies. Ren Fail. 2015;37(6):929-34. doi: 10.3109/0886022X.2015.1052979.
  • 20. Karabayir N, Teber BG, Dursun HK, Pehlivan LS. Is There An Association Between Vitamin B12 Level and Vitamin D Status in Children? J Pediatr Hematol Oncol. 2022;44(3):e677-e681. doi: 10.1097/ MPH.0000000000002329.
  • 21. Plant AS, Tisman G. Frequency of combined deficiencies of vitamin D and holotranscobalamin in cancer patients. Nutr Cancer. 2006;56(2):143-8. doi: 10.1207/s15327914nc5602_4.
  • 22. Singh K, Gandhi S, Batool R. A Case-Control Study of the Association between Vitamin D Levels and Gastric Incomplete Intestinal Metaplasia. Nutrients. 2018;10(5):629. doi: 10.3390/nu10050629.
  • 23. Delgado JA, Pastor García MI, Márquez Jiménez N, Costa Petit G, Regís Perelló A, Robles J,et al. Functional vitamin B12 deficiency: Improving methylmalonic acid reference intervals in urine. Clin Chim Acta. 2023;544:117334. doi: 10.1016/j.cca.2023.117334.
  • 24. Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496- 513. doi: 10.1111/bjh.12959.
  • 25. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol. 1990;34(2):99-107. doi: 10.1002/ajh.2830340205
  • 26. Guo J, Liu X, Wang Z, Lu R, Liu Y, Zhang Y,et al. Methylmalonic acid, vitamin B12, and mortality risk in patients with preexisting coronary heart disease: a prospective cohort study. Nutr J. 2023;22(1):63. doi: 10.1186/s12937-023-00900-6.
  • 27. Hooshmand B, Appold F, Fissler P, Perneczky R, Otto M, Tumani H, et al. Markers of Vitamin B12 Status in Relation to Cerebrospinal Fluid Biomarkers of Alzheimer's Disease and Cognitive Performance. Ann Neurol. 2023;94(2):223-231. doi: 10.1002/ana.26673.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hematoloji, İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Recep Alanlı 0000-0003-4663-1898

Mustafa Kemal Kılıç 0000-0001-7101-0503

Mehmet Şeneş 0000-0002-7924-5478

Yayımlanma Tarihi 4 Mayıs 2025
Gönderilme Tarihi 14 Mayıs 2024
Kabul Tarihi 3 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 58 Sayı: 1

Kaynak Göster

AMA Alanlı R, Kılıç MK, Şeneş M. D vitamini ile Vitamin B12, Metilmalonik Asit, Homosistein ve Ferritin Düzeyleri Arasındaki İlişki. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Mayıs 2025;58(1):7-10. doi:10.20492/aeahtd.1483471