The Masking Effect: A comparison of pre and post folic acid fortification periods for vitamin B-12 deficiency without macrocytosis in the United States
نویسندگان
چکیده
Background: There has been a concern regarding the masking of vitamin B-‐12 deficiency in the post-‐fortification period (after January 1, 1998). Objective: The objective of this study was to investigate the potential masking of vitamin B-‐12 deficiency by comparing the proportion of individuals with low serum B-‐12 without macrocytosis between pre-‐ and post-‐fortification periods using data from the National Health and Nutrition Examination Survey (NHANES). Methods: The study included 7242 individuals from NHANES III (pre-‐fortification group) and combined NHANES 1999-‐2000, 2001-‐2002, 2003-‐2004, 2005-‐2006 (post-‐fortification group). Vitamin B-‐12 deficiency and macrocytosis were defined as having <148 pmol/L of serum vitamin B-‐12 and mean corpuscular volume (MCV) of>98 fL, respectively. A multivariate logistic regression was performed to estimate the likelihood of being low serum B-‐12 without macrocytosis in the post-‐ fortification period in relation to the pre-‐fortification period. Results: Between pre-‐ and post-‐fortification periods, there was no significant difference in the proportion of individuals with low serum vitamin B-‐12 without macrocytosis. However, odds of having low serum vitamin B-‐12 without macrocytosis in the post fortification era increased in men (OR=2.65, 1.24-‐5.65), non-‐Hispanic blacks (OR=3.12, 1.04-‐9.35), Non-‐smokers (OR=4.63, 1.90-11.27), and
منابع مشابه
Proportion of individuals with low serum vitamin B-12 concentrations without macrocytosis is higher in the post folic acid fortification period than in the pre folic acid fortification period.
BACKGROUND Large intakes of folic acid may delay the diagnosis of vitamin B-12 deficiency, which could lead to irreversible neuropathy. OBJECTIVE The objective of this study was to determine whether the proportion of individuals with low serum vitamin B-12 without macrocytosis (undiagnosed vitamin B-12 deficiency) has increased in the post-folic acid fortification period. DESIGN Individuals...
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