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April 24, 2026Current Developments in Nutrition0 citationsOpen Access

Methylmalonic Acid Shows Higher Diagnostic Accuracy for Vitamin B12 Status

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 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Diagnosis of cobalamin deficiency I: Usefulness of serum methylmalonic acid and total homocysteine concentrations1990 · 349 citations
  2. 2National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification2003 · 4,645 citations
  3. 3A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease2021 · 424 citations
  4. 4Vitamin B12Deficiency2013 · 1,209 citations