The Relationship of Serum Cobalamin to Methylmalonic Acid Concentrations and Clinical Variables in Cats
Background Serum cobalamin concentration [CBL] suggests CBL deficiency in cats but serum methylmalonic acid concentration [MMA] more accurately indicates CBL deficiency. Objective To examine the ability of [CBL] to predict CBL deficiency defined by increased [MMA], and relationships of [CBL] and [MM...
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| Veröffentlicht in: | Journal of veterinary internal medicine 2013-09, Vol.27 (5), p.1056-1063 |
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| container_title | Journal of veterinary internal medicine |
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| creator | Worhunsky, P. Toulza, O. Rishniw, M. Berghoff, N. Ruaux, C.G. Steiner, J.M. Simpson, K.W. |
| description | Background
Serum cobalamin concentration [CBL] suggests CBL deficiency in cats but serum methylmalonic acid concentration [MMA] more accurately indicates CBL deficiency.
Objective
To examine the ability of [CBL] to predict CBL deficiency defined by increased [MMA], and relationships of [CBL] and [MMA] with select clinical and clinicopathological variables.
Animals
One hundred sixty‐three client‐owned cats with [CBL] measurements, 114 cats with simultaneous [MMA] measurements; 88 cats with medical information.
Methods
Prospectively collected [CBL] and [MMA] were compared using scatter plots, receiver operating characteristic and correlative analyses with historical [CBL] thresholds and those identified in the study. [CBL] and [MMA] were compared retrospectively to specific clinical and clinicopathological variables.
Results
[CBL] correlated negatively with [MMA] (τ = −0.334, P 900 pg/mL and 290 pg/mL (historical thresholds). [CBL] correlated with mean corpuscular volume (τ = −0.199, P = .013) and [MMA] with hematocrit (τ = −0.28, P = .006).
Conclusions and Clinical Importance
Cobalamin deficiency ([MMA] ≥ 1,343 nmol/L) occurred in 42% of cats and is predicted with high specificity by [CBL] ≤ 209 pg/mL. CBL status correlates with microcytosis and anemia. Discordance between [CBL] and [MMA] cautions against relying on any single marker for determining CBL status. |
| doi_str_mv | 10.1111/jvim.12152 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_24P</sourceid><recordid>TN_cdi_proquest_miscellaneous_1433266034</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3067665879</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4312-9b6423c6100c774eff08f732c5eb6ef06bc457f9c17cbb57bee9b6e022020b923</originalsourceid><addsrcrecordid>eNp9kM1u1DAUhS0EokNhwwMgS2wQUop_YjtZVlPoj1pQaSlLy3ZvGA9OPNgJdN6-Lmm7YMHdWLr3O0fWh9BrSvZomQ_r377fo4wK9gQtaMvbikoln6IFaVpaSVmTHfQi5zUhTAihnqMdxhslmlot0I_LFeCvEMzo45BXfoNjhy8gTT1eRmuC6f2Ax4jPYFxtQ29CHLzD-85fl_vgYBjTHMVmKKvgy9kEfGWSNzZAxiW-NGN-iZ51JmR4df_uom-fPl4uj6rTL4fHy_3TytWcsqq1smbcSUqIU6qGriNNpzhzAqyEjkjraqG61lHlrBXKApQIEMYII7ZlfBe9m3s3Kf6aII-699lBCGaAOGVNa86ZlITXBX37D7qOUxrK7zQnRaAUjWoL9X6mXIo5J-j0JvnepK2mRN_p13f69V_9BX5zXznZHq4f0QffBaAz8McH2P6nSp9cHZ89lFZzxucRbh4zJv3UUnEl9PfPh_r8gNDzA1nrC34Lki-eYw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3067665879</pqid></control><display><type>article</type><title>The Relationship of Serum Cobalamin to Methylmalonic Acid Concentrations and Clinical Variables in Cats</title><source>Wiley Online Library Open Access</source><creator>Worhunsky, P. ; Toulza, O. ; Rishniw, M. ; Berghoff, N. ; Ruaux, C.G. ; Steiner, J.M. ; Simpson, K.W.</creator><creatorcontrib>Worhunsky, P. ; Toulza, O. ; Rishniw, M. ; Berghoff, N. ; Ruaux, C.G. ; Steiner, J.M. ; Simpson, K.W.</creatorcontrib><description>Background
Serum cobalamin concentration [CBL] suggests CBL deficiency in cats but serum methylmalonic acid concentration [MMA] more accurately indicates CBL deficiency.
Objective
To examine the ability of [CBL] to predict CBL deficiency defined by increased [MMA], and relationships of [CBL] and [MMA] with select clinical and clinicopathological variables.
Animals
One hundred sixty‐three client‐owned cats with [CBL] measurements, 114 cats with simultaneous [MMA] measurements; 88 cats with medical information.
Methods
Prospectively collected [CBL] and [MMA] were compared using scatter plots, receiver operating characteristic and correlative analyses with historical [CBL] thresholds and those identified in the study. [CBL] and [MMA] were compared retrospectively to specific clinical and clinicopathological variables.
Results
[CBL] correlated negatively with [MMA] (τ = −0.334, P < .0001). [MMA] ≥ 1,343 nmol/L identified CBL deficiency. [CBL] = 209 pg/mL optimized sensitivity (0.51), specificity (0.96), PPV (0.89), and NPV (0.74) for detecting [MMA] ≥ 1,343 nmol/L. Prevalence of CBL deficiency was 42% (48/114) when defined by [MMA] ≥ 1,343 nmol/L versus 23% (27/114) by [CBL] ≤ 209 pg/mL. Unexpectedly, 23 and 45% of 48 cats with [MMA] ≥ 1,343 nmol/L had [CBL] > 900 pg/mL and 290 pg/mL (historical thresholds). [CBL] correlated with mean corpuscular volume (τ = −0.199, P = .013) and [MMA] with hematocrit (τ = −0.28, P = .006).
Conclusions and Clinical Importance
Cobalamin deficiency ([MMA] ≥ 1,343 nmol/L) occurred in 42% of cats and is predicted with high specificity by [CBL] ≤ 209 pg/mL. CBL status correlates with microcytosis and anemia. Discordance between [CBL] and [MMA] cautions against relying on any single marker for determining CBL status.</description><identifier>ISSN: 0891-6640</identifier><identifier>EISSN: 1939-1676</identifier><identifier>DOI: 10.1111/jvim.12152</identifier><identifier>PMID: 23875847</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Animals ; Cats - blood ; Cats - physiology ; Creatinine - blood ; Diabetes ; Diagnostic accuracy ; Enteropathy ; Erythrocyte Indices - veterinary ; Gastrointestinal disease ; Gastrointestinal diseases ; Hematocrit - veterinary ; Hepatopathy ; Metabolism ; Methylmalonic Acid - blood ; Phosphorus - blood ; Physiology ; Reference Values ; Sensitivity ; Sensitivity and Specificity ; Specificity ; Test performance ; Vitamin B ; Vitamin B 12 - blood ; Vitamin B12 ; Vitamin deficiency</subject><ispartof>Journal of veterinary internal medicine, 2013-09, Vol.27 (5), p.1056-1063</ispartof><rights>Copyright © 2013 by the American College of Veterinary Internal Medicine</rights><rights>Copyright © 2013 by the American College of Veterinary Internal Medicine.</rights><rights>2013. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4312-9b6423c6100c774eff08f732c5eb6ef06bc457f9c17cbb57bee9b6e022020b923</citedby><cites>FETCH-LOGICAL-c4312-9b6423c6100c774eff08f732c5eb6ef06bc457f9c17cbb57bee9b6e022020b923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvim.12152$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvim.12152$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,11543,27905,27906,45555,45556,46033,46457</link.rule.ids><linktorsrc>$$Uhttps://onlinelibrary.wiley.com/doi/abs/10.1111%2Fjvim.12152$$EView_record_in_Wiley-Blackwell$$FView_record_in_$$GWiley-Blackwell</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23875847$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Worhunsky, P.</creatorcontrib><creatorcontrib>Toulza, O.</creatorcontrib><creatorcontrib>Rishniw, M.</creatorcontrib><creatorcontrib>Berghoff, N.</creatorcontrib><creatorcontrib>Ruaux, C.G.</creatorcontrib><creatorcontrib>Steiner, J.M.</creatorcontrib><creatorcontrib>Simpson, K.W.</creatorcontrib><title>The Relationship of Serum Cobalamin to Methylmalonic Acid Concentrations and Clinical Variables in Cats</title><title>Journal of veterinary internal medicine</title><addtitle>J Vet Intern Med</addtitle><description>Background
Serum cobalamin concentration [CBL] suggests CBL deficiency in cats but serum methylmalonic acid concentration [MMA] more accurately indicates CBL deficiency.
Objective
To examine the ability of [CBL] to predict CBL deficiency defined by increased [MMA], and relationships of [CBL] and [MMA] with select clinical and clinicopathological variables.
Animals
One hundred sixty‐three client‐owned cats with [CBL] measurements, 114 cats with simultaneous [MMA] measurements; 88 cats with medical information.
Methods
Prospectively collected [CBL] and [MMA] were compared using scatter plots, receiver operating characteristic and correlative analyses with historical [CBL] thresholds and those identified in the study. [CBL] and [MMA] were compared retrospectively to specific clinical and clinicopathological variables.
Results
[CBL] correlated negatively with [MMA] (τ = −0.334, P < .0001). [MMA] ≥ 1,343 nmol/L identified CBL deficiency. [CBL] = 209 pg/mL optimized sensitivity (0.51), specificity (0.96), PPV (0.89), and NPV (0.74) for detecting [MMA] ≥ 1,343 nmol/L. Prevalence of CBL deficiency was 42% (48/114) when defined by [MMA] ≥ 1,343 nmol/L versus 23% (27/114) by [CBL] ≤ 209 pg/mL. Unexpectedly, 23 and 45% of 48 cats with [MMA] ≥ 1,343 nmol/L had [CBL] > 900 pg/mL and 290 pg/mL (historical thresholds). [CBL] correlated with mean corpuscular volume (τ = −0.199, P = .013) and [MMA] with hematocrit (τ = −0.28, P = .006).
Conclusions and Clinical Importance
Cobalamin deficiency ([MMA] ≥ 1,343 nmol/L) occurred in 42% of cats and is predicted with high specificity by [CBL] ≤ 209 pg/mL. CBL status correlates with microcytosis and anemia. Discordance between [CBL] and [MMA] cautions against relying on any single marker for determining CBL status.</description><subject>Animals</subject><subject>Cats - blood</subject><subject>Cats - physiology</subject><subject>Creatinine - blood</subject><subject>Diabetes</subject><subject>Diagnostic accuracy</subject><subject>Enteropathy</subject><subject>Erythrocyte Indices - veterinary</subject><subject>Gastrointestinal disease</subject><subject>Gastrointestinal diseases</subject><subject>Hematocrit - veterinary</subject><subject>Hepatopathy</subject><subject>Metabolism</subject><subject>Methylmalonic Acid - blood</subject><subject>Phosphorus - blood</subject><subject>Physiology</subject><subject>Reference Values</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Specificity</subject><subject>Test performance</subject><subject>Vitamin B</subject><subject>Vitamin B 12 - blood</subject><subject>Vitamin B12</subject><subject>Vitamin deficiency</subject><issn>0891-6640</issn><issn>1939-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1u1DAUhS0EokNhwwMgS2wQUop_YjtZVlPoj1pQaSlLy3ZvGA9OPNgJdN6-Lmm7YMHdWLr3O0fWh9BrSvZomQ_r377fo4wK9gQtaMvbikoln6IFaVpaSVmTHfQi5zUhTAihnqMdxhslmlot0I_LFeCvEMzo45BXfoNjhy8gTT1eRmuC6f2Ax4jPYFxtQ29CHLzD-85fl_vgYBjTHMVmKKvgy9kEfGWSNzZAxiW-NGN-iZ51JmR4df_uom-fPl4uj6rTL4fHy_3TytWcsqq1smbcSUqIU6qGriNNpzhzAqyEjkjraqG61lHlrBXKApQIEMYII7ZlfBe9m3s3Kf6aII-699lBCGaAOGVNa86ZlITXBX37D7qOUxrK7zQnRaAUjWoL9X6mXIo5J-j0JvnepK2mRN_p13f69V_9BX5zXznZHq4f0QffBaAz8McH2P6nSp9cHZ89lFZzxucRbh4zJv3UUnEl9PfPh_r8gNDzA1nrC34Lki-eYw</recordid><startdate>201309</startdate><enddate>201309</enddate><creator>Worhunsky, P.</creator><creator>Toulza, O.</creator><creator>Rishniw, M.</creator><creator>Berghoff, N.</creator><creator>Ruaux, C.G.</creator><creator>Steiner, J.M.</creator><creator>Simpson, K.W.</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201309</creationdate><title>The Relationship of Serum Cobalamin to Methylmalonic Acid Concentrations and Clinical Variables in Cats</title><author>Worhunsky, P. ; Toulza, O. ; Rishniw, M. ; Berghoff, N. ; Ruaux, C.G. ; Steiner, J.M. ; Simpson, K.W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4312-9b6423c6100c774eff08f732c5eb6ef06bc457f9c17cbb57bee9b6e022020b923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Animals</topic><topic>Cats - blood</topic><topic>Cats - physiology</topic><topic>Creatinine - blood</topic><topic>Diabetes</topic><topic>Diagnostic accuracy</topic><topic>Enteropathy</topic><topic>Erythrocyte Indices - veterinary</topic><topic>Gastrointestinal disease</topic><topic>Gastrointestinal diseases</topic><topic>Hematocrit - veterinary</topic><topic>Hepatopathy</topic><topic>Metabolism</topic><topic>Methylmalonic Acid - blood</topic><topic>Phosphorus - blood</topic><topic>Physiology</topic><topic>Reference Values</topic><topic>Sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Specificity</topic><topic>Test performance</topic><topic>Vitamin B</topic><topic>Vitamin B 12 - blood</topic><topic>Vitamin B12</topic><topic>Vitamin deficiency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Worhunsky, P.</creatorcontrib><creatorcontrib>Toulza, O.</creatorcontrib><creatorcontrib>Rishniw, M.</creatorcontrib><creatorcontrib>Berghoff, N.</creatorcontrib><creatorcontrib>Ruaux, C.G.</creatorcontrib><creatorcontrib>Steiner, J.M.</creatorcontrib><creatorcontrib>Simpson, K.W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of veterinary internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Worhunsky, P.</au><au>Toulza, O.</au><au>Rishniw, M.</au><au>Berghoff, N.</au><au>Ruaux, C.G.</au><au>Steiner, J.M.</au><au>Simpson, K.W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Relationship of Serum Cobalamin to Methylmalonic Acid Concentrations and Clinical Variables in Cats</atitle><jtitle>Journal of veterinary internal medicine</jtitle><addtitle>J Vet Intern Med</addtitle><date>2013-09</date><risdate>2013</risdate><volume>27</volume><issue>5</issue><spage>1056</spage><epage>1063</epage><pages>1056-1063</pages><issn>0891-6640</issn><eissn>1939-1676</eissn><abstract>Background
Serum cobalamin concentration [CBL] suggests CBL deficiency in cats but serum methylmalonic acid concentration [MMA] more accurately indicates CBL deficiency.
Objective
To examine the ability of [CBL] to predict CBL deficiency defined by increased [MMA], and relationships of [CBL] and [MMA] with select clinical and clinicopathological variables.
Animals
One hundred sixty‐three client‐owned cats with [CBL] measurements, 114 cats with simultaneous [MMA] measurements; 88 cats with medical information.
Methods
Prospectively collected [CBL] and [MMA] were compared using scatter plots, receiver operating characteristic and correlative analyses with historical [CBL] thresholds and those identified in the study. [CBL] and [MMA] were compared retrospectively to specific clinical and clinicopathological variables.
Results
[CBL] correlated negatively with [MMA] (τ = −0.334, P < .0001). [MMA] ≥ 1,343 nmol/L identified CBL deficiency. [CBL] = 209 pg/mL optimized sensitivity (0.51), specificity (0.96), PPV (0.89), and NPV (0.74) for detecting [MMA] ≥ 1,343 nmol/L. Prevalence of CBL deficiency was 42% (48/114) when defined by [MMA] ≥ 1,343 nmol/L versus 23% (27/114) by [CBL] ≤ 209 pg/mL. Unexpectedly, 23 and 45% of 48 cats with [MMA] ≥ 1,343 nmol/L had [CBL] > 900 pg/mL and 290 pg/mL (historical thresholds). [CBL] correlated with mean corpuscular volume (τ = −0.199, P = .013) and [MMA] with hematocrit (τ = −0.28, P = .006).
Conclusions and Clinical Importance
Cobalamin deficiency ([MMA] ≥ 1,343 nmol/L) occurred in 42% of cats and is predicted with high specificity by [CBL] ≤ 209 pg/mL. CBL status correlates with microcytosis and anemia. Discordance between [CBL] and [MMA] cautions against relying on any single marker for determining CBL status.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23875847</pmid><doi>10.1111/jvim.12152</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Cats - blood Cats - physiology Creatinine - blood Diabetes Diagnostic accuracy Enteropathy Erythrocyte Indices - veterinary Gastrointestinal disease Gastrointestinal diseases Hematocrit - veterinary Hepatopathy Metabolism Methylmalonic Acid - blood Phosphorus - blood Physiology Reference Values Sensitivity Sensitivity and Specificity Specificity Test performance Vitamin B Vitamin B 12 - blood Vitamin B12 Vitamin deficiency |
| title | The Relationship of Serum Cobalamin to Methylmalonic Acid Concentrations and Clinical Variables in Cats |
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