{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:40:57Z","timestamp":1792176057441,"version":"4.4.0"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T00:00:00Z","timestamp":1518652800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Nutr"],"published-print":{"date-parts":[[2018,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The prevalence of a sub-clinical vitamin B<jats:sub>12<\/jats:sub> deficiency in the vegetarians is high. Total serum vitamin B<jats:sub>12<\/jats:sub> concentration alone does not reliably reflect vitamin B<jats:sub>12<\/jats:sub> status. Holotranscobalamin (holo-TC) II is a bioactive B<jats:sub>12<\/jats:sub> fraction promoting specific uptake of B<jats:sub>12<\/jats:sub> by cells and the circulating concentration reflects the intake of B<jats:sub>12<\/jats:sub>, whereas total homocysteine (tHcy) indicates the metabolic ability. In this study, we investigated the diagnostic value of circulating holo-TC, B<jats:sub>12<\/jats:sub>, folate and homocysteine in vegetarians who were at risk of B<jats:sub>12<\/jats:sub> deficiency. B<jats:sub>12<\/jats:sub>-related biomarkers were measured in 119 young, healthy graduate vegetarians. None was folate deficient. As per reported definition, half were B<jats:sub>12<\/jats:sub> deficient; 70 % of males and 50 % of females had low plasma holo-TC concentrations; and 92 % of males and half of females had hyperhomocysteinaemia. None had any clinical signs of B<jats:sub>12<\/jats:sub> deficiency. Receiver operating characteristic curve analysis demonstrated similar AUC at the B<jats:sub>12<\/jats:sub> concentration of 100 and 150 pmol\/l when holo-TC (0\u00b7777 and 0\u00b7784) and homocysteine (0\u00b7924 and 0\u00b7928) were used as variables. Cut-off value of 100 pmol\/l resulted in the highest sensitivity of 77\u00b778 % and specificity of 71\u00b705 % with a predictive value of 19\u00b76 pmol\/l for holo-TC and a sensitivity of 82\u00b772 % and specificity of 89\u00b77 % with a predictive value of 21\u00b77 \u00b5mol\/l for homocysteine. The combination of B<jats:sub>12<\/jats:sub>, holo-TC and tHcy improves the diagnostic accuracy at these cut-offs, and we suggest that for the young Indian vegetarians the cut-off for plasma B<jats:sub>12<\/jats:sub> and holotrancobalamin is 100 pmol\/l and 19\u00b76 pmol\/l, respectively, and for homocysteine it is 17\u00b76 (females) and 27 \u00b5mol\/l (males) for identifying B<jats:sub>12<\/jats:sub> deficiency.<\/jats:p>","DOI":"10.1017\/s0007114518000090","type":"journal-article","created":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T05:29:43Z","timestamp":1518672583000},"page":"629-635","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":50,"title":["Identification of vitamin B<sub>12<\/sub> deficiency in vegetarian Indians"],"prefix":"10.1017","volume":"119","author":[{"given":"Sadanand","family":"Naik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namita","family":"Mahalle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayshri","family":"Bhide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,2,15]]},"reference":[{"key":"S0007114518000090_ref35","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2010.158154"},{"key":"S0007114518000090_ref32","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.013441"},{"key":"S0007114518000090_ref31","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.28082"},{"key":"S0007114518000090_ref30","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/3.5.375"},{"key":"S0007114518000090_ref25","doi-asserted-by":"publisher","DOI":"10.1024\/0300-9831\/a000078"},{"key":"S0007114518000090_ref23","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2014-0818"},{"key":"S0007114518000090_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2013.04.002"},{"key":"S0007114518000090_ref21","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2014.272"},{"key":"S0007114518000090_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1996.tb03538.x"},{"key":"S0007114518000090_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/74.2.233"},{"key":"S0007114518000090_ref17","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2891-12-136"},{"key":"S0007114518000090_ref10","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.013458"},{"key":"S0007114518000090_ref8","doi-asserted-by":"publisher","DOI":"10.1258\/0007142991902547"},{"key":"S0007114518000090_ref5","first-page":"5109","article-title":"Facts and recommendations about total homocysteine determinations: an expert opinion","volume":"85","author":"Refsum","year":"2001","journal-title":"Br J Nutr"},{"key":"S0007114518000090_ref2","doi-asserted-by":"publisher","DOI":"10.1079\/BJN19560018"},{"key":"S0007114518000090_ref24","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.115.116509"},{"key":"S0007114518000090_ref33","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.061382"},{"key":"S0007114518000090_ref9","first-page":"775","article-title":"Vitamin B12 deficiency and hyperhomocysteinemia in rural and urban Indians","volume":"54","author":"Yajnik","year":"2006","journal-title":"J Assoc Physicians India"},{"key":"S0007114518000090_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.1.3"},{"key":"S0007114518000090_ref16","unstructured":"Gopalan C , Rama Sastri BV & Balsubramanian SC (2007) Dietsoft software version 1.1.7. 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