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April 24, 2026Current Developments in NutritionOpen Access

The diagnostic accuracy of methylmalonic acid to detect inadequate vitamin B12 status relative to 3cB12 was higher compared to that of total cobalamin and total homocysteine in a cross-sectional survey of apparently healthy U.S. adults1

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Authors

EMEkaterina MinevaMSMaya R. SternbergCPChristine M. Pfeiffer

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Overview

Cross-sectional survey evaluates methylmalonic acid, cobalamin, and homocysteine for vitamin B12 status, indicating methylmalonic acid may be the best marker.

Key Points

  • This research aims to evaluate the effectiveness of conventional markers for detecting inadequate vitamin B12 status.
  • Utilized NHANES 1999–2004 data for participants with normal renal function.
  • Constructed training and validation sets to derive and test new cutoffs for vitamin B12 markers.
  • Performed analysis accounting for complex survey design.
  • Methylmalonic acid demonstrated the highest area under the curve (0.963) in the training set.
  • New optimum cutoffs indicated MMA >229 nmol/L and B12 <220 pmol/L for effective screening.
  • MMA >376 nmol/L showed high specificity but lower sensitivity for screening general populations.

Cite This Study

Mineva et al. (2026) studied this question.

synapsesocial.com/papers/69eb0ac4553a5433e34b4b82https://doi.org/10.1016/j.cdnut.2026.107704
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Clinical audit of plasma Methylmalonic acid (MMA) requests following publication of NICE Guidelines on Vitamin B12 deficiency in over 16s2026
  2. 2Optimizing diagnostic thresholds of total vitamin B12 (B12) for identifying cobalamin deficiency in adults with macrocytic anemia2026
  3. 3Vitamin B12-Related Biomarkers2024 · 4 citations
  4. 4The utility of methylmalonic acid, methylcitrate acid, and homocysteine in dried blood spots for therapeutic monitoring of three inherited metabolic diseases2024
  5. 5Diagnostic reliability of serum active vitamin B12 (holo-transcobalamin) in true evaluation of vitamin B12 deficiency:Relevance in current perspective2022