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Neutrophil Cell Population Data along with vitamin B12 and homocysteine were assessed in regard to <jats:styled-content style=\"fixed-case\">MMA<\/jats:styled-content> tertile groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Statistically significant differences were between lower and upper <jats:styled-content style=\"fixed-case\">MMA<\/jats:styled-content> tertile in serum B12 (<jats:italic>P<\/jats:italic> \u02c2 0.001), homocysteine (<jats:italic>P<\/jats:italic> = 0.001) and neutrophil morphometric index, NeS\u2010<jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.029). Also, serum B12 concentrations were significantly different between lower and middle <jats:styled-content style=\"fixed-case\">MMA<\/jats:styled-content> tertile, <jats:italic>P<\/jats:italic> = 0.005. Receiver operating characteristic analysis of NeS\u2010<jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content> ability to detect <jats:styled-content style=\"fixed-case\">MMA<\/jats:styled-content>\u02c3367 nmol\/L revealed a significant area under the curve <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> = 0.761 <jats:italic>P<\/jats:italic> \u02c2 0.001 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.693\u20130.830. Optimal cut\u2010off value was NeS\u2010<jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content>\u02c33.51% with sensitivity of 74.19% and specificity of 68.87%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients at risk of cobalamin deficiency and normal <jats:styled-content style=\"fixed-case\">MCV<\/jats:styled-content>, classification according to <jats:styled-content style=\"fixed-case\">MMA<\/jats:styled-content> revealed cobalamin status differences. Neutrophil morphometric index may be an indicator of early changes in neutrophil nucleus morphology caused by impaired cobalamin status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.12479","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T11:02:13Z","timestamp":1458385333000},"page":"265-272","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Methylmalonic acid and neutrophil morphometric index in laboratory diagnosis of cobalamin deficiency without macrocytosis"],"prefix":"10.1111","volume":"38","author":[{"given":"D.","family":"Totoskovic","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy Department of Medical Biochemistry University of Belgrade Belgrade Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Dopsaj","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Department of Medical Biochemistry University of Belgrade Belgrade Serbia"},{"name":"Clinical Centre of Serbia Center of Medical Biochemistry Belgrade Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Martinovic","sequence":"additional","affiliation":[{"name":"Health Center Rakovica Laboratory Department Belgrade Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,19]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1425","article-title":"Update on vitamin B12 deficiency","volume":"83","author":"Langan RC","year":"2011","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365510050184994"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-553X.2007.00911.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90149-X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(01)00666-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1996.tb01407.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/106.1.57"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198806303182604"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.013441"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biochi.2013.02.008"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.013243"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1093\/clinchem\/46.12.2017","article-title":"Failure of assay to identify low cobalamin concentrations","volume":"46","author":"Carmel R","year":"2000","journal-title":"Clin Chem"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.059055"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.333.7569.654-c"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/60.1.2"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/70.5.904"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.015222"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2006.080382"},{"key":"e_1_2_8_20_1","first-page":"519","volume-title":"Hematology: Basic Principles and Practice","author":"Antony AC","year":"2005"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830340204"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830340205"},{"key":"e_1_2_8_23_1","first-page":"18","article-title":"An automated hematology instrument for comprehensive WBC, RBC, and platelet analysis","volume":"9","author":"Richardson\u2010Jones A","year":"1990","journal-title":"Am Clin Lab"},{"issue":"4","key":"e_1_2_8_24_1","first-page":"S11","article-title":"Automated differentials in the hematology laboratory","volume":"93","author":"Krause JR","year":"1990","journal-title":"Am J Clin Pathol"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-553X.2011.01382.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00216-012-6099-z"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00216-014-8148-2"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-2-200307150-00013"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0013164403251280"},{"key":"e_1_2_8_30_1","unstructured":"Clinical and Laboratory Standards Institute.Defining Establishing and Verifying Reference Intervas in the Clinical Laboratory Approved Guideline\u2010Third Edition. 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