{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:39:50Z","timestamp":1792175990657,"version":"4.4.0"},"reference-count":54,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2001,8,1]],"date-time":"2001-08-01T00:00:00Z","timestamp":996624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":7880,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Clinical Nutrition"],"published-print":{"date-parts":[[2001,8]]},"DOI":"10.1093\/ajcn\/74.2.233","type":"journal-article","created":{"date-parts":[[2018,2,20]],"date-time":"2018-02-20T15:40:30Z","timestamp":1519141230000},"page":"233-241","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":280,"title":["Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians"],"prefix":"10.1016","volume":"74","author":[{"given":"Helga","family":"Refsum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chittaranjan S","family":"Yajnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind","family":"Gadkari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rn","family":"Schneede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stein E","family":"Vollset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"\u00d6rning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B","family":"Guttormsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Joglekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmood G","family":"Sayyad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arve","family":"Ulvik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per M","family":"Ueland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1093\/ajcn\/74.2.233_bib1","first-page":"383","article-title":"Observations on dietary practices in India","volume":"38","author":"Price","year":"1984","journal-title":"Hum Nutr Appl Nutr"},{"issue":"suppl","key":"10.1093\/ajcn\/74.2.233_bib2","doi-asserted-by":"crossref","first-page":"525S","DOI":"10.1093\/ajcn\/70.3.525s","article-title":"The Oxford Vegetarian Study: an overview","volume":"70","author":"Appleby","year":"1999","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib3","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1093\/ajcn\/47.4.660","article-title":"Plasma and urine taurine levels in vegans","volume":"47","author":"Laidlaw","year":"1988","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1017\/S0029665199000361","article-title":"The nutritional adequacy of plant-based diets","volume":"58","author":"Sanders","year":"1999","journal-title":"Proc Nutr Soc"},{"issue":"suppl","key":"10.1093\/ajcn\/74.2.233_bib5","doi-asserted-by":"crossref","first-page":"1213S","DOI":"10.1093\/ajcn\/59.5.1213S","article-title":"Staging vitamin B-12 (cobalamin) status in vegetarians","volume":"59","author":"Herbert","year":"1994","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib6","first-page":"536","article-title":"Nutrition scenario in India\u2014implications for clinical practice","volume":"98","author":"Balaji","year":"2000","journal-title":"J India Med Assoc"},{"key":"10.1093\/ajcn\/74.2.233_bib7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/0035-9203(88)90247-7","article-title":"Tropical sprue in Southern India","volume":"82","author":"Mathan","year":"1988","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"10.1093\/ajcn\/74.2.233_bib8","first-page":"3","article-title":"Biology of disease. Megaloblastic anemias","volume":"52","author":"Herbert","year":"1985","journal-title":"Lab Invest"},{"key":"10.1093\/ajcn\/74.2.233_bib9","first-page":"120","article-title":"Serum vitamin B12 levels in an Indian population: an evaluation of three assay methods","volume":"46","author":"Kumar","year":"1989","journal-title":"Med Lab Sci"},{"key":"10.1093\/ajcn\/74.2.233_bib10","first-page":"269","article-title":"Prevalence and etiology of nutritional anaemias in early childhood in an urban slum","volume":"107","author":"Gomber","year":"1998","journal-title":"Indian J Med Res"},{"key":"10.1093\/ajcn\/74.2.233_bib11","first-page":"261","article-title":"Megaloblastic anaemia\u2014a review from University Hospital, Kuala Lumpur","volume":"17","author":"Ng","year":"1988","journal-title":"Ann Acad Med Singapore"},{"key":"10.1093\/ajcn\/74.2.233_bib12","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1016\/S0140-6736(85)92690-X","article-title":"Megaloblastic anaemia in a vegetarian Hindu community","volume":"2","author":"Chanarin","year":"1985","journal-title":"Lancet"},{"key":"10.1093\/ajcn\/74.2.233_bib13","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1017\/S0029665199000580","article-title":"Folate and vitamin B12","volume":"58","author":"Scott","year":"1999","journal-title":"Proc Nutr Soc"},{"key":"10.1093\/ajcn\/74.2.233_bib14","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1056\/NEJM198806303182604","article-title":"Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis","volume":"318","author":"Lindenbaum","year":"1988","journal-title":"N Engl J Med"},{"key":"10.1093\/ajcn\/74.2.233_bib15","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/ajh.2830340205","article-title":"Diagnosis of cobalamin deficiency. II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations","volume":"34","author":"Lindenbaum","year":"1990","journal-title":"Am J Hematol"},{"key":"10.1093\/ajcn\/74.2.233_bib16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1046\/j.1365-2362.1999.00446.x","article-title":"Holotranscobalamin\u2014a sensitive marker of cobalamin malabsorption","volume":"29","author":"Lindgren","year":"1999","journal-title":"Eur J Clin Invest"},{"key":"10.1093\/ajcn\/74.2.233_bib17","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1038\/sj.ejcn.1600874","article-title":"The effect of diet on plasma homocysteine concentrations in healthy male subjects","volume":"53","author":"Mann","year":"1999","journal-title":"Eur J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib18","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1203\/00006450-199408000-00010","article-title":"Methylmalonic acid and homocysteine in plasma as indicators of functional cobalamin deficiency in infants on macrobiotic diets","volume":"36","author":"Schneede","year":"1994","journal-title":"Pediatr Res"},{"key":"10.1093\/ajcn\/74.2.233_bib19","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1093\/clinchem\/39.2.263","article-title":"Homocysteine and other thiols in plasma and urine: automated determination and sample stability","volume":"39","author":"Fiskerstrand","year":"1993","journal-title":"Clin Chem"},{"key":"10.1093\/ajcn\/74.2.233_bib20","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1021\/ac00101a005","article-title":"Application of capillary electrophoresis with laser-induced fluorescence detection for routine determination of methylmalonic acid in human serum","volume":"34","author":"Schneede","year":"1995","journal-title":"Anal Chem"},{"key":"10.1093\/ajcn\/74.2.233_bib21","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/0378-4347(95)00115-Y","article-title":"Simultaneous profile analysis of plasma amino and organic acids by capillary gas chromatography","volume":"669","author":"Husek","year":"1995","journal-title":"J Chromatogr B Biomed Appl"},{"key":"10.1093\/ajcn\/74.2.233_bib22","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0076-6879(97)81007-5","article-title":"Microbiological assay for serum, plasma, and red cell folate using cryopreserved, microtiter plate method","volume":"281","author":"Molloy","year":"1997","journal-title":"Methods Enzymol"},{"key":"10.1093\/ajcn\/74.2.233_bib23","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1093\/clinchem\/33.1.52","article-title":"Microbiological assay for vitamin B12 with use of a colistin-sulfate-resistant organism","volume":"33","author":"Kelleher","year":"1987","journal-title":"Clin Chem"},{"key":"10.1093\/ajcn\/74.2.233_bib24","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/clinchem\/43.2.267","article-title":"C677T mutation of methylenetetrahydrofolate reductase gene determined in blood or plasma by multiple injection capillary electrophoresis and laser-induced fluorescence detection","volume":"43","author":"Ulvik","year":"1997","journal-title":"Clin Chem"},{"key":"10.1093\/ajcn\/74.2.233_bib25","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1006\/mgme.1999.2879","article-title":"A common variant in methionine synthase reductase combined with low cobalamin (vitamin B12) increases risk for spina bifida","volume":"67","author":"Wilson","year":"1999","journal-title":"Mol Genet Metab"},{"key":"10.1093\/ajcn\/74.2.233_bib26","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1055\/s-0037-1614563","article-title":"Prevalence of prothrombin G20210A, factor V G1691A (Leiden), and methylenetetrahydrofolate reductase (MTHFR) C677T in seven different populations determined by multiplex allele-specific PCR","volume":"81","author":"Hessner","year":"1999","journal-title":"Thromb Haemost"},{"key":"10.1093\/ajcn\/74.2.233_bib27","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1055\/s-0037-1614230","article-title":"Analysis of the 677 C\u2192T mutation of the methylenetetrahydrofolate reductase gene in different ethnic groups","volume":"79","author":"Franco","year":"1998","journal-title":"Thromb Haemost"},{"key":"10.1093\/ajcn\/74.2.233_bib28","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1093\/ajcn\/70.6.1016","article-title":"Lifestyle and cardiovascular disease risk factors as determinants of total cysteine in plasma: the Hordaland Homocysteine Study","volume":"70","author":"El-Khairy","year":"1999","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib29","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/ajcn\/60.1.2","article-title":"Prevalence of cobalamin deficiency in the Framingham elderly population","volume":"60","author":"Lindenbaum","year":"1994","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib30","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1093\/ajcn\/70.5.904","article-title":"Serum cobalamin, homocysteine, and methylmalonic acid concentrations in a multiethnic elderly population: ethnic and sex differences in cobalamin and metabolite abnormalities","volume":"70","author":"Carmel","year":"1999","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib31","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1192\/bjp.117.541.699","article-title":"Serum vitamin B12 levels in Indian psychiatric patients","volume":"117","author":"Jathar","year":"1970","journal-title":"Br J Psychiatry"},{"key":"10.1093\/ajcn\/74.2.233_bib32","first-page":"331","article-title":"Pancytopenia in nutritional megaloblastic anaemia. A study from north-west India","volume":"41","author":"Sarode","year":"1989","journal-title":"Trop Geogr Med"},{"key":"10.1093\/ajcn\/74.2.233_bib33","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/S0140-6736(99)93019-2","article-title":"Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men","volume":"355","author":"Chambers","year":"2000","journal-title":"Lancet"},{"key":"10.1093\/ajcn\/74.2.233_bib34","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1136\/jech.54.1.31","article-title":"Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore","volume":"54","author":"Hughes","year":"2000","journal-title":"J Epidemiol Community Health"},{"key":"10.1093\/ajcn\/74.2.233_bib35","first-page":"295","article-title":"Plasma homocysteine levels in patients with coronary heart disease","volume":"50","author":"Chacko","year":"1998","journal-title":"Indian Heart J"},{"key":"10.1093\/ajcn\/74.2.233_bib36","first-page":"499","article-title":"Fibrinogen and homocysteine levels in coronary artery disease","volume":"51","author":"Gheye","year":"1999","journal-title":"Indian Heart J"},{"key":"10.1093\/ajcn\/74.2.233_bib37","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/j.1365-2141.1976.tb00943.x","article-title":"Erythrocyte vitamin B12 activity in healthy Indian lactovegetarians","volume":"32","author":"Inamdar-Deshmurkh","year":"1976","journal-title":"Br J Haematol"},{"key":"10.1093\/ajcn\/74.2.233_bib38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/sj.ejcn.1600883","article-title":"Anaemia in pregnancy: possible causes and risk factors in Nepali women","volume":"54","author":"Bondevik","year":"2000","journal-title":"Eur J Clin Nutr"},{"issue":"suppl","key":"10.1093\/ajcn\/74.2.233_bib39","doi-asserted-by":"crossref","first-page":"586S","DOI":"10.1093\/ajcn\/70.3.586s","article-title":"Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians","volume":"70","author":"Haddad","year":"1999","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib40","first-page":"88","article-title":"Ethnic and racial factors in cobalamin metabolism and its disorders","volume":"36","author":"Carmel","year":"1999","journal-title":"Semin Hematol"},{"key":"10.1093\/ajcn\/74.2.233_bib41","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s004310050744","article-title":"Methionine synthase deficiency without megaloblastic anaemia","volume":"156","author":"Kvittingen","year":"1997","journal-title":"Eur J Pediatr"},{"key":"10.1093\/ajcn\/74.2.233_bib42","doi-asserted-by":"crossref","first-page":"546","DOI":"10.7326\/0003-4819-87-5-546","article-title":"Production of vitamin B 12 analogues in patients with small-bowel bacterial overgrowth","volume":"87","author":"Brandt","year":"1977","journal-title":"Ann Intern Med"},{"key":"10.1093\/ajcn\/74.2.233_bib43","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/j.1365-2141.1986.tb02894.x","article-title":"Megaloblastic anaemia due to vitamin B12 deficiency caused by small intestinal bacterial overgrowth: possible role of vitamin B12 analogues","volume":"62","author":"Murphy","year":"1986","journal-title":"Br J Haematol"},{"key":"10.1093\/ajcn\/74.2.233_bib44","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1146\/annurev.med.49.1.31","article-title":"Homocysteine and cardiovascular disease","volume":"49","author":"Refsum","year":"1998","journal-title":"Annu Rev Med"},{"key":"10.1093\/ajcn\/74.2.233_bib45","first-page":"209","article-title":"A prospective study on folate, B12, and pyridoxal 5\u2032-phosphate (B6) and breast cancer","volume":"8","author":"Wu","year":"1999","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10.1093\/ajcn\/74.2.233_bib46","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1001\/archneur.55.11.1449","article-title":"Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease","volume":"55","author":"Clarke","year":"1998","journal-title":"Arch Neurol"},{"key":"10.1093\/ajcn\/74.2.233_bib47","series-title":"Advances in Thomas Addison\u2019s diseases.","first-page":"259","article-title":"Nutritional cobalamin deficiency in infants","author":"Schneede","year":"1994"},{"key":"10.1093\/ajcn\/74.2.233_bib48","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/ajcn\/72.3.762","article-title":"Signs of impaired cognitive function in adolescents with marginal cobalamin status","volume":"72","author":"Louwman","year":"2000","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib49","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1093\/ajcn\/71.4.962","article-title":"Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine Study","volume":"71","author":"Vollset","year":"2000","journal-title":"Am J Clin Nutr"},{"key":"10.1093\/ajcn\/74.2.233_bib50","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1136\/jcp.41.7.759","article-title":"Vegetarian diet and cobalamin deficiency: their association with tuberculosis","volume":"41","author":"Chanarin","year":"1988","journal-title":"J Clin Pathol"},{"key":"10.1093\/ajcn\/74.2.233_bib51","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1046\/j.1365-2257.1998.00143.x","article-title":"Clinicopathological features of megaloblastic anaemia in Hong Kong: a study of 84 Chinese patients","volume":"20","author":"Au","year":"1998","journal-title":"Clin Lab Haematol"},{"key":"10.1093\/ajcn\/74.2.233_bib52","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1046\/j.1365-2249.1999.00870.x","article-title":"Immunomodulation by vitamin B12: augmentation of CD8+ T lymphocytes and natural killer (NK) cell activity in vitamin B12-deficient patients by methyl-B12 treatment","volume":"116","author":"Tamura","year":"1999","journal-title":"Clin Exp Immunol"},{"key":"10.1093\/ajcn\/74.2.233_bib53","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0899-9007(95)00061-5","article-title":"Vitamins and immunomodulation in AIDS","volume":"12","author":"Liang","year":"1996","journal-title":"Nutrition"},{"key":"10.1093\/ajcn\/74.2.233_bib54","first-page":"216","article-title":"Strategies for control of micronutrient malnutrition","volume":"102","author":"Vijayaraghavan","year":"1995","journal-title":"Indian J Med Res"}],"container-title":["The American Journal of Clinical Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002916523063013?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002916523063013?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/ajcn\/article-pdf\/74\/2\/233\/23964553\/233.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T22:28:37Z","timestamp":1686263317000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002916523063013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,8]]},"references-count":54,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2001,8]]}},"alternative-id":["S0002916523063013"],"URL":"https:\/\/doi.org\/10.1093\/ajcn\/74.2.233","relation":{},"ISSN":["0002-9165"],"issn-type":[{"value":"0002-9165","type":"print"}],"subject":[],"published":{"date-parts":[[2001,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Clinical Nutrition","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1093\/ajcn\/74.2.233","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2001 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}