血清活性维生素B_(12)评价维生素B_(12)营养状况  

ROLE OF SERUM ACTIVE VITAMIN B_(12) IN THE NUTRITIONAL ASSESSMENT OF VITAMIN B_(12) STATUS

作　　者：李萌[1] 徐鹏飞[1] 杨春梅[1] 周欢琴[1] LI Meng;XU Peng-fei;YANG Chun-mei;ZHOU Huan-qin(The Department of Clinical Laboratory,Zhejiang Hospital,Hangzhou 310011,China)

机构地区：[1]浙江医院医学检验科,杭州310013

出　　处：《营养学报》2018年第4期387-391,397,共6页Acta Nutrimenta Sinica

基　　金：浙江省自然科学基金(No.LY16H200002)

摘　　要：目的探讨血清活性维生素B_(12)在评价维生素B_(12)营养状况中的作用。方法收集浙江医院2013年7月~2014年12月进行维生素B_(12)、叶酸及同型半胱氨酸项目检查患者370例,同时留取清晨空腹项目检测后残余血清,活性维生素B_(12)采用化学发光微粒子法批量检测;并分析各指标间的相关性。结果研究结果显示,活性维生素B_(12)水平及维生素B_(12)水平在">60岁"组显著高于"≤60岁"组(均P<0.05),但在男性和女性间未见统计学差异(P>0.05);通过疾病分组,慢性阻塞性肺气肿及神经系统疾病的患者活性维生素B_(12)及维生素B_(12)水平较低,同型半胱氨酸水平较高,且维生素B_(12)和同型半胱氨酸水平在各组间具有统计学差异(均P<0.05),但活性维生素B_(12)各疾病组间未见统计学差异。Spearman相关性分析显示活性维生素B_(12)与维生素B_(12)间呈正相关(r=0.600,P<0.05)。同型半胱氨酸水平与活性维生素B_(12)、维生素B_(12)、叶酸呈负相关(r分别为-0.176、-0.302和-0.261,均P<0.05)。按截断值分组,活性维生素B_(12)与维生素B_(12)结果一致性一般(Kappa值为0.542,P <0.05),。结论活性维生素B_(12)与维生素B_(12)的作用不完全一致,两指标的联合应用将有利于维生素B_(12)营养状况的评估,更好的了解人群分布特征,制定卫生干预措施及临床治疗。Objective To investigate the role of serum active vitamin B12 in the assessment of vitamin B12 Status. Methods 370 patients in Zhejiang hospital from July 2013 to December 2014 were recruited into this study to detect their vitamin B12, folic acid and homocysteine level. Active vitamin B12 was tested by chemiluminescence microparticle immuno assay. The correlation of these markers were analyzed. Results The levels of active vitamin B12 and vitamin Bi2 in the ＂〉 60 years＂ group were significantly higher than that of ＂≤ 60 years ＂group （P〈0.05）, but there was no significant difference between male and female （P〉0.05）. Patients with chronic obstructive pulmonary disease and nervous system disease had lower levels of active vitamin B12 and vitamin B12, and higher level of homoeysteine, and there was significant difference for vitamin BI2 and homocysteine in different disease groups （P〈0.05）, but not of active vitamin Bl2. Spearman correlation analysis showed that active vitamin BI2 was positively correlated with vitamin B12 （r=0.600, P〈0.05）. The level of homocysteine was negatively correlated with active vitamin BI2, vitamin BI2 and folate （r=-0.176, -0.302 and -0.261 respectively, P〈0.05）. Grouped by cutoff values, consistency analysis showed that Kappa value of active vitamin B12 and vitamin B12 was 0.542 （P 〈0.05）, indicating moderate consistency. Conclusion Role of active vitamin B12 and vitamin B12 was not completely consistent. The combination of two markers to evaluate the vitamin B12 status is better to understand the population distribution, and develop health intervention measures and clinical treatment.

关 键 词：维生素B12 活性维生素B12 全反钴胺素 同型半胱氨酸 叶酸 

分 类 号：R151.2[医药卫生—营养与食品卫生学]