Vitamin B-12 Treatment Normalizes Metabolic Markers But Has Limited Clinical Effect: A Randomized Placebo-Controlled Study
CLINICAL CHEMISTRY(2001)
摘要
Background: The clinical significance of increased plasma methylmalonic acid (P-MMA) is unclear. We assessed the efficacy of vitamin B-12 treatment in reducing P-MMA and plasma total homocysteine compared with the clinical benefits of treatment.Methods: We studied 140 individuals with mildly to modestly increased P-MMA (0.40-2.00 mu mol/L), not previously treated with vitamin B-12 in a randomized, placebo-controlled study. A detailed medical history was obtained, and laboratory tests as well as an objective neurologic disability score were performed at baseline and 3 months after the start of intervention.Results: P-MMA (P <0.001) or plasma total homocysteine (P <0.001) decreased in the treatment group vs the placebo group, but no significant difference was found in the change of blood hemoglobin (P = 0.18) and mean cell volume (P = 0.71). Changes in symptom scores did not differ between the groups for symptoms of anemia (P = 0.63), neurologic symptoms (P = 0.21), gastroenterologic symptoms (P = 0.32), or the Neurological Disability Score (P = 0.85).Conclusions: Treatment with vitamin B-12 reduces PMMA and plasma total homocysteine, but individuals with a mild to modest increase in P-MMA may have only limited clinical benefit from vitamin B-12 treatment, at least in the short term. (C) 2001 American Association for Clinical Chemistry.
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