Common metabolic profile in infants indicating impaired cobalamin status responds to cobalamin supplementation
Abstract
OBJECTIVE: A metabolic profile consistent with impaired cobalamin status is prevalent in breastfed infants. We investigated whether this profile reflects immature organ systems or impaired cobalamin status. METHODS: In a single-center, randomized, placebo-controlled trial, we studied 107 six-week-old infants. The infants were randomly assigned to receive either an intramuscular injection of 400 mug of cobalamin or no intervention. Concentrations of cobalamin and folate in serum and total homocysteine, methylmalonic acid, and cystathionine in plasma were determined at enrollment and at the age of 4 months. RESULTS: There were no significant differences between the intervention group (n = 54) and the control group (n = 53) in the concentrations of any vitamin marker at baseline (6 weeks). At 4 months, the supplement-treated infants had a 75% higher median serum cobalamin level and remarkable reductions in median plasma total homocysteine (from 7.46 to 4.57 micromol/L) and methylmalonic acid (from 0.58 to 0.20 micromol/L) levels, whereas levels of both metabolites were essentially unchanged during the follow-up period in the control group. CONCLUSIONS: Cobalamin supplementation changed all markers of impaired cobalamin status (low cobalamin, high total homocysteine, and high methylmalonic acid levels) toward a profile observed in cobalamin-replete older children and adults. Therefore, the high total homocysteine and methylmalonic acid levels reported for a large fraction of infants reflect not immature metabolism but rather insufficient cobalamin levels to fully sustain cobalamin-dependent reactions fully.
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tHcy is a better marker in infancy for vitamin B-12 deficiency than MMA.
“Furthermore, tHcy is a better marker in infancy for vitamin B-12 deficiency than MMA (38), which was also reflected in our results.”
From Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children (2017) · cites this paper as [38]
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Self-citation
- Authors
- Bjørke-Monsen, A.-L., Torsvik, I., Sætran, H., Markestad, T., & Ueland, P. M.
- Affiliations
- Departments of Clinical Biochemistry
- Haukeland University Hospital (NO)
- University of Bergen (NO)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2008-07-01
- Volume
- 122
- Issue
- 1
- Pages
- 83-91
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2095341191
- Cited by
- 66
- References
- 69
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 6 · 2012: 1
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- cobalamin status, vitamin B12 supplementation, infants, breast-fed infants, homocysteine, methylmalonic acid, cystathionine, folic acid, vitamin B12 deficiency, metabolic profile
- MeSH terms
- Breast Feeding, Folic Acid, Homocysteine, Humans, Infant, Methylmalonic Acid, Vitamin B 12, Linear Models, Dietary Supplements
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