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Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study

BACKGROUND: A substantial proportion of patients referred for plasma vitamin B12 (cobalamin [Cbl]) measurement present with high Cbl levels, which have been reported in patients with different cancer types. However, the cancer risk among patients with newly diagnosed high Cbl levels has not been ade...

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Autores principales: Arendt, Johan Frederik Berg, Pedersen, Lars, Nexo, Ebba, Sørensen, Henrik Toft
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848986/
https://www.ncbi.nlm.nih.gov/pubmed/24249744
http://dx.doi.org/10.1093/jnci/djt315
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author Arendt, Johan Frederik Berg
Pedersen, Lars
Nexo, Ebba
Sørensen, Henrik Toft
author_facet Arendt, Johan Frederik Berg
Pedersen, Lars
Nexo, Ebba
Sørensen, Henrik Toft
author_sort Arendt, Johan Frederik Berg
collection PubMed
description BACKGROUND: A substantial proportion of patients referred for plasma vitamin B12 (cobalamin [Cbl]) measurement present with high Cbl levels, which have been reported in patients with different cancer types. However, the cancer risk among patients with newly diagnosed high Cbl levels has not been adequately examined. METHODS: We conducted this cohort study using population-based Danish medical registries. Patients referred for Cbl measurement with levels greater than the lower reference limit (≥200 pmol/L) were identified from the population of Northern Denmark during the period of 1998 to 2009 using a database of laboratory test results covering the entire population. Data on cancer incidence (follow-up 1998–2010), Cbl treatment, and prior diagnoses were obtained from medical registries. Patients receiving Cbl treatment were excluded. Cancer risks were calculated as standardized incidence ratios (SIRs) with 95% confidence intervals (CIs), stratified by plasma Cbl levels. All statistical tests were two-sided. RESULTS: We identified 333 667 persons without prevalent cancer and not receiving Cbl treatment. Six percent had Cbl levels greater than the upper reference limit (≥601 pmol/L). Cancer risk increased with higher Cbl levels and was highest during the first year of follow-up (Cbl 601–800 pmol/L: SIR = 3.44, 95% CI = 3.14 to 3.76; Cbl >800 pmol/L: SIR = 6.27, 95% CI = 5.70 to 6.88; both P < .001). The risks were particularly elevated for hematological and smoking- and alcohol-related cancers for persons with high Cbl levels. CONCLUSIONS: High Cbl levels were associated with the risk of subsequently diagnosed cancer, mostly within the first year of follow-up. This may have clinical implications for the interpretation of high Cbl levels.
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spelling pubmed-38489862013-12-04 Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study Arendt, Johan Frederik Berg Pedersen, Lars Nexo, Ebba Sørensen, Henrik Toft J Natl Cancer Inst Article BACKGROUND: A substantial proportion of patients referred for plasma vitamin B12 (cobalamin [Cbl]) measurement present with high Cbl levels, which have been reported in patients with different cancer types. However, the cancer risk among patients with newly diagnosed high Cbl levels has not been adequately examined. METHODS: We conducted this cohort study using population-based Danish medical registries. Patients referred for Cbl measurement with levels greater than the lower reference limit (≥200 pmol/L) were identified from the population of Northern Denmark during the period of 1998 to 2009 using a database of laboratory test results covering the entire population. Data on cancer incidence (follow-up 1998–2010), Cbl treatment, and prior diagnoses were obtained from medical registries. Patients receiving Cbl treatment were excluded. Cancer risks were calculated as standardized incidence ratios (SIRs) with 95% confidence intervals (CIs), stratified by plasma Cbl levels. All statistical tests were two-sided. RESULTS: We identified 333 667 persons without prevalent cancer and not receiving Cbl treatment. Six percent had Cbl levels greater than the upper reference limit (≥601 pmol/L). Cancer risk increased with higher Cbl levels and was highest during the first year of follow-up (Cbl 601–800 pmol/L: SIR = 3.44, 95% CI = 3.14 to 3.76; Cbl >800 pmol/L: SIR = 6.27, 95% CI = 5.70 to 6.88; both P < .001). The risks were particularly elevated for hematological and smoking- and alcohol-related cancers for persons with high Cbl levels. CONCLUSIONS: High Cbl levels were associated with the risk of subsequently diagnosed cancer, mostly within the first year of follow-up. This may have clinical implications for the interpretation of high Cbl levels. Oxford University Press 2013-12-04 2013-11-18 /pmc/articles/PMC3848986/ /pubmed/24249744 http://dx.doi.org/10.1093/jnci/djt315 Text en © The Author 2013. Published by Oxford University Press. http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Article
Arendt, Johan Frederik Berg
Pedersen, Lars
Nexo, Ebba
Sørensen, Henrik Toft
Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study
title Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study
title_full Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study
title_fullStr Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study
title_full_unstemmed Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study
title_short Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study
title_sort elevated plasma vitamin b12 levels as a marker for cancer: a population-based cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848986/
https://www.ncbi.nlm.nih.gov/pubmed/24249744
http://dx.doi.org/10.1093/jnci/djt315
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