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      Prevalence and Indicators of Vitamin B12 Insufficiency among Young Women of Childbearing Age

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          Abstract

          Vitamin B12 insufficiency is a global health issue among women of childbearing age, yet few studies have investigated its prevalence and risk factors among healthy Middle Eastern populations. This cross-sectional study included 346 Saudi women aged 19–30 years and enrolled at King Saud University, Riyadh, Saudi Arabia. A series of questionnaires were administered to record the study participants’ sociodemographic status, medical history, dietary intake, and physical activity. Participants’ anthropometric data were also recorded and their fasting blood samples were analyzed. The rate of vitamin B12 insufficiency (≤220 pmol/L) was approximately 6% among the study participants. After adjusting for confounding factors, it was observed that the risk factors for vitamin B12 insufficiency included daily sitting time ≥ 7 h, low income (<10,000 Saudi riyal) and increasing age. The recommended dietary allowance of vitamin B12 (>2.4 mcg/day) has been shown to confer reasonable protection against vitamin B12 insufficiency. These study findings highlight that a combination of increased physical activity and dietary vitamin B12 intake above the current recommended dietary allowance may help improve the serum vitamin B12 levels of young women of childbearing age, especially those with a low socioeconomic status. Timely detection and protection against vitamin B12 insufficiency in this subpopulation are important to prevent maternal and fetal health risks.

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          Most cited references61

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          Vitamin B12 deficiency

          Vitamin B12 (B12; also known as cobalamin) is a B vitamin that has an important role in cellular metabolism, especially in DNA synthesis, methylation and mitochondrial metabolism. Clinical B12 deficiency with classic haematological and neurological manifestations is relatively uncommon. However, subclinical deficiency affects between 2.5% and 26% of the general population depending on the definition used, although the clinical relevance is unclear. B12 deficiency can affect individuals at all ages, but most particularly elderly individuals. Infants, children, adolescents and women of reproductive age are also at high risk of deficiency in populations where dietary intake of B12-containing animal-derived foods is restricted. Deficiency is caused by either inadequate intake, inadequate bioavailability or malabsorption. Disruption of B12 transport in the blood, or impaired cellular uptake or metabolism causes an intracellular deficiency. Diagnostic biomarkers for B12 status include decreased levels of circulating total B12 and transcobalamin-bound B12, and abnormally increased levels of homocysteine and methylmalonic acid. However, the exact cut-offs to classify clinical and subclinical deficiency remain debated. Management depends on B12 supplementation, either via high-dose oral routes or via parenteral administration. This Primer describes the current knowledge surrounding B12 deficiency, and highlights improvements in diagnostic methods as well as shifting concepts about the prevalence, causes and manifestations of B12 deficiency.
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            Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study.

            Participants from DPP/DPPOS were assigned to placebo (n=1082) or metformin (n=1073) for 3.2 years, followed by metformin in the metformin group for 9 years. Metformin use was associated with increased risk of vitamin B12 deficiency.
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              Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies.

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                22 December 2020
                January 2021
                : 18
                : 1
                : 1
                Affiliations
                [1 ]Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
                [2 ]Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; danishhussain121@ 123456gmail.com (S.D.H.); aalnaami@ 123456yahoo.com (A.M.A.); kwani@ 123456ksu.edu.sa (K.W.); ndaghri@ 123456ksu.edu.sa (N.A.-D.)
                [3 ]Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham NG1 8NS, UK
                [4 ]College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; Aleisa.Khaled@ 123456gmail.com
                [5 ]Population, Evidence & Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK; p.saravanan@ 123456warwick.ac.uk
                [6 ]Academic Department of Diabetes, Endocrinology & Metabolism, George Eliot Hospital, Nuneaton CV10 7DJ, UK
                Author notes
                [* ]Correspondence: salmosharruf@ 123456ksu.edu.sa (S.A.-M.); philip.mcternan@ 123456ntu.ac.uk (P.G.M.); Tel.: +44-(0)115-848-3477 (S.A.-M.); +966-55-424-3033 (P.G.M.)
                Author information
                https://orcid.org/0000-0002-7830-1415
                https://orcid.org/0000-0002-4266-0205
                https://orcid.org/0000-0001-9568-6516
                https://orcid.org/0000-0002-9566-2626
                Article
                ijerph-18-00001
                10.3390/ijerph18010001
                7792587
                33374905
                d5f5505c-f60e-4167-80f9-6c161bd5eef5
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 23 November 2020
                : 16 December 2020
                Categories
                Article

                Public health
                women,sedentary,physical activity,vitamin b12 insufficiency,vitamin b12
                Public health
                women, sedentary, physical activity, vitamin b12 insufficiency, vitamin b12

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