Wang Xiaoya, Li Wudi, Xiang Meixiang
Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Cardiovasc Med. 2022 Oct 10;9:966543. doi: 10.3389/fcvm.2022.966543. eCollection 2022.
Functional vitamin B12 deficiency is common in cardiovascular diseases (CVDs), such as heart failure and myocardial infarction. Methylmalonic acid (MMA) is a specific and sensitive marker of vitamin B12 deficiency. However, there are scarce data in regard to the relationship between MMA and CVDs.
In this cross-sectional study, we analyzed data of 5,313 adult participants of the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Associations between MMA and other variables were assessed with linear regression models. Univariable and multivariable logistic regression models were employed to explore the association between MMA and CVDs.
The weighted prevalence of CVDs was 8.8% in the general population of the USA. Higher MMA levels were found in participants with CVDs ( < 0.001). Linear regression models revealed positive associations between serum MMA level and age ( < 0.001), glycohemoglobin ( = 0.023), fasting glucose ( = 0.044), mean cell volume ( = 0.038), and hypertension ( = 0.003). In the multivariable logistic model adjusting for age, gender, ethnicity, smoking, hypertension, glycohemoglobin, body mass index (BMI), low-density lipoprotein-cholesterol (LDL-C), renal dysfunction and vitamin B12, serum MMA (adjusted odds ratio, 3.08; 95% confidence interval: 1.63-5.81, = 0.002, per ln nmol/L increment) was associated with CVDs.
Our study demonstrated that elevated serum MMA levels were independently associated with the presence of CVDs and may be used to predict the occurrence of CVDs.
功能性维生素B12缺乏在心血管疾病（如心力衰竭和心肌梗死）中很常见。甲基丙二酸（MMA）是维生素B12缺乏的一种特异性和敏感性标志物。然而，关于MMA与心血管疾病之间的关系，数据稀少。
在这项横断面研究中，我们分析了2013 - 2014年美国国家健康与营养检查调查（NHANES）中5313名成年参与者的数据。使用线性回归模型评估MMA与其他变量之间的关联。采用单变量和多变量逻辑回归模型探讨MMA与心血管疾病之间的关联。
在美国总体人群中，心血管疾病的加权患病率为8.8%。心血管疾病患者的MMA水平较高（<0.001）。线性回归模型显示血清MMA水平与年龄（<0.001）、糖化血红蛋白（=0.023）、空腹血糖（=0.044）、平均红细胞体积（=0.038）和高血压（=0.003）之间存在正相关。在调整了年龄、性别、种族、吸烟、高血压、糖化血红蛋白、体重指数（BMI）、低密度脂蛋白胆固醇（LDL-C）、肾功能不全和维生素B12的多变量逻辑模型中，血清MMA（调整后的比值比，3.08；95%置信区间：1.63 - 5.81，=0.002，每ln nmol/L增量）与心血管疾病相关。
我们的研究表明，血清MMA水平升高与心血管疾病的存在独立相关，可用于预测心血管疾病的发生。
