Applicability of the Combined Indicator of Vitamin B12 Status in ambulatory care of vegetarians

Abstract

Introduction: Vitamin B₁₂ deficiency has a high prevalence in the vegetarian population. The cB₁₂ indicator represents a method with high predictive capacity, even in the absence of one or two missing biomarkers. Objective: The aim of this study was to investigate the applicability of the cB₁₂ indicator with missing biomarkers in the diagnosis of vitamin B₁₂ deficiency in vegetarian individuals at outpatient level, as well as to analyze the diagnostic capacity of the cut-off point proposed for the tool. Material and Methods: This is a cross-sectional study with a sample of vegetarian individuals. The concordance of serum B₁₂ deficiency/low B₁₂ between the cB₁₂ indicator cut-off point and other cut-off points proposed for serum vitamin B₁₂ was evaluated. The sensitivity and specificity of the tool's cut-off point were also assessed. Results: Significant but weak agreement was observed between the cB₁₂ indicator cut-off point and one of the serum vitamin B₁₂ cut-off points considered, as well as low sensitivity and high specificity in relation to them. Similar results were found for the sub-sample of vegetarian individuals not supplemented with vitamin B₁₂, however, significant and moderate agreement was observed in relation to one of the serum vitamin B₁₂ cut-off points considered. Conclusions: The main results suggest that this analysis be carried out in future studies with different samples and a greater number of observations in order to better investigate the accuracy of the cB₁₂ indicator with missing biomarkers, as well as reviewing its cut-off point.