ArticleNutrition journal2023
Methylmalonic acid, vitamin B12, and mortality risk in patients with preexisting coronary heart disease: a prospective cohort study.
Article in Nutrition journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 30 citations in OpenAlex.
- B vitamins and cardiovascular health: mechanisms, clinical evidence, and precision prevention strategies.Nutrition & metabolism · 2026Review
- Tricarboxylic acid cycle metabolite index predicts adverse outcomes in acute myocardial infarction patients.BMC medicine · 2026Article
- Article
- Effect of Mitochondria-Derived Methylmalonic Acid on Progress and Mortality Risk in US Adults With Cardiovascular-Kidney-Metabolic Syndrome.Journal of the American Heart Association · 2026Article
- Elevated methylmalonic acid, but not vitamin B12, predicts all-cause mortality in hyperlipidemic adults: a prospective cohort study.Frontiers in nutrition · 2026Article
- Interactive effects of folate and methylmalonic acid on cardiovascular disease mortality: Epidemiological and experimental evidence.iScience · 2025Article
- Relationship and predictive value of controlling nutritional status score and serum vitamin level with coronary heart disease in young and middle-aged adults.BMC nutrition · 2025Article
- Association between methylmalonic acid and prevalence of depression in US adults: evidence from NHANES 2011-2014.European journal of psychotraumatology · 2025Article
- Recent research advances in the biological function and molecular mechanism of methylmalonic acid.Journal of Zhejiang University. Science. B · 2025Review
- The Role of Methylmalonic Acid in the Risk of Sarcopenia and All-Cause Mortality Among Individuals With Sarcopenia: Evidence From NHANES.Food science & nutrition · 2025Article
- Interpretable prediction of coronary heart disease risk in adults over 50 with accelerated aging using 45 dietary nutrients.Frontiers in nutrition · 2025Article
- Mitochondrial dysfunction-related metabolite methylmalonic acid is associated with decreased cognitive performance.PloS one · 2025Article
- Homocysteine Metabolism, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population.JACC. Asia · 2024Article
- Decreased cobalamin sensitivity and biological aging acceleration in the general population.The journal of nutrition, health & aging · 2024Article
- Article
- Mitochondria-derived methylmalonic acid aggravates ischemia-reperfusion injury by activating reactive oxygen species-dependent ferroptosis.Cell communication and signaling : CCS · 2024Article
- Linking Cortical Structure and Cerebrospinal Fluid Metabolites with Venous Thromboembolism Risk: A Two-Step Mendelian Randomization and Co-Localization Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe inconsistent relationship between Vitamin B12 (B12), methylmalonic acid (MMA, marker of B12 deficiency) and mortality was poorly understood, especially in patients with coronary heart disease (CHD). This study aims to investigate the association of serum MMA, and B12-related biomarkers (serum level, dietary intake, supplement use, and sensibility to B12) with all-cause and cardiovascular mortality in adults with CHD.
methodsThe data of this study were from a subcohort within the US National Health and Nutrition Examination Survey (NHANES). We included adults with preexisting CHD with serum MMA and B12, and dietary B12 intake measurements at recruitment. All participants were followed up until 31 December 2019. Weighted Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% CI of mortality risk.
resultsOverall, 1755 individuals (weighted mean [SE] age, 65.2 [0.5] years; 1047 men [weighted 58.5%]) with CHD were included, with geometric mean levels of serum MMA 182.4 nmol/L, serum B12 494.5 pg/ml, and dietary B12 intake 4.42 mg/day, and percentage of B12 supplements use 39.1%. During a median follow-up of 7.92 years, 980 patients died. Serum B12 concentration, dietary B12 intake and supplements use were not significantly associated with mortality risk (each p ≥ 0.388). In contrast, individuals in the top tertile of MMA had multivariable-adjusted HRs (95% CIs) of 1.70 (1.31-2.20) for all-cause mortality, and 2.00 (1.39-2.89) for cardiovascular mortality (both p trend < 0.001) compared to those in the bottom tertile of MMA. MMA-related mortality risk was particularly higher among participants with sufficient serum B12 (p < 0.001). CHD patients with increased levels of both MMA and B12 had a doubled mortality risk compared to those with lower MMA and B12 (p < 0.001).
conclusionMMA accumulation but not serum or dietary vitamin B12 was associated with increased cardiovascular mortality risk among patients with CHD. This paradox may be related to decreased response to vitamin B12.
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