Systematic review with dose-response meta-analyses between vitamin B-12 intake and European Micronutrient Recommendations Aligned’s prioritized biomarkers of vitamin B-12 including randomized controlled trials and observational studies in adults and elderly persons

C. Dullemeijer, O.W. Souverein, E.L. Doets, H. van der Voet, J.P. van Wijngaarden, W.J. de Boer, M. Plada, R.A.M. Dhonukshe-Rutten, P.H. in 't Veld, A.J.E.M. Cavelaars, C.P.G.M. de Groot, P. van 't Veer

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20 Citations (Scopus)

Abstract

Background: Many randomized controlled trials (RCTs) and observational studies have provided information on the association between vitamin B-12 intake and biomarkers. The use of these data to estimate dose-response relations provides a useful means to summarize the body of evidence. Objective: We systematically reviewed studies that investigated vitamin B-12 intake and biomarkers of vitamin B-12 status and estimated dose-response relations with the use of a meta-analysis. Design: This systematic review included all RCTs, prospective cohort studies, nested case-control studies, and cross-sectional studies in healthy adult populations published through January 2010 that supplied or measured dietary vitamin B-12 intake and measured vitamin B-12 status as serum or plasma vitamin B-12, methylmalonic acid (MMA), or holotranscobalamin. We calculated an intake-status regression coefficient () for each individual study and calculated the overall pooled and SE () by using random-effects meta-analysis on a double-log scale. Results: The meta-analysis of observational studies showed a weaker slope of dose-response relations than the meta-analysis of RCTs. The pooled dose-response relation of all studies between vitamin B-12 intake and status indicated that a doubling of the vitamin B-12 intake increased vitamin B-12 concentrations by 11% (95% CI: 9.4%, 12.5%). This increase was larger for studies in elderly persons (13%) than in studies in adults (8%). The dose-response relation between vitamin B-12 intake and MMA concentrations indicated a decrease in MMA of 7% (95% CI: -10%, -4%) for every doubling of the vitamin B-12 intake. The assessment of risk of bias within individual studies and across studies indicated risk that was unlikely to seriously alter these results. Conclusion: The obtained dose-response estimate between vitamin B-12 intake and status provides complementary evidence to underpin recommendations for a vitamin B-12 intake of populations.
Original languageEnglish
Pages (from-to)390-402
JournalAmerican Journal of Clinical Nutrition
Volume97
Issue number2
DOIs
Publication statusPublished - 2013

Keywords

  • b-vitamins
  • folic-acid
  • homocysteine concentration
  • nutritional-status
  • multivitamin supplementation
  • methylmalonic acid
  • oral vitamin-b-12
  • older-adults
  • plasma homocysteine
  • cognitive function

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