Evidence map›Paper›PMID 39134986›Full record

Observational studyBMC medicine2024

Vitamin B12 status and the risk of developing sepsis in patients with bacterial infection: a prospective observational cohort study.

Andreas Pregernig, Ulrike Held, Martin Schläpfer, Beatrice Beck-Schimmer

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04008446 (Effect of Vitamin B12 on the Development of Sepsis, in Culture Positive Patients), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04008446 completednot on this map

Effect of Vitamin B12 on the Development of Sepsis, in Culture Positive Patients : an Observational Study.

TypeobservationalSponsorUniversity of ZurichRan2019 to 2022Enrolled100ConditionsBacteremia
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Andreas PregernigInstitute of Anesthesiology, University Hospital Zurich, Rämistrasse 100, Zurich, CH-8091, Switzerland.
Ulrike HeldEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH-8001, Switzerland.
Martin SchläpferInstitute of Anesthesiology, University Hospital Zurich, Rämistrasse 100, Zurich, CH-8091, Switzerland.
Beatrice Beck-SchimmerInstitute of Anesthesiology, University Hospital Zurich, Rämistrasse 100, Zurich, CH-8091, Switzerland. beatrice.beckschimmer@uzh.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundData have shown that vitamin B12 has immunomodulatory effects via different pathways, which could influence the pathophysiology of sepsis. The objective of this study was to investigate whether vitamin B12 levels, assessed by the measurement of holotranscobalamin (HTC), total vitamin B12 (B12), and methylmalonic acid (MMA, which accumulates in case of B12 deficiency), are associated with the development of sepsis in patients with onset of bacterial infection.

methodsThis was a single-center, prospective observational pilot study. Adult patients who presented to the emergency department with bacterial infection confirmed by a positive microbiological culture result were included in the study and followed up for 6 days to assess whether they developed sepsis or not. The primary objective was to compare HTC concentration in patients who developed sepsis to those who did not develop sepsis. Secondary objectives were the evaluation of B12 and MMA concentrations in those two groups. Multiple logistic regression models were used, with presence of sepsis as the outcome variable, and HTC, B12, and MMA concentrations as predictor variables, separately, and adjusted for potential confounders.

resultsFrom 2019 to 2022, 2131 patients were assessed for eligibility, of whom 100 met the inclusion criteria. One patient was excluded from the analysis due to missing data. Of the 99 patients, 29 developed sepsis. There was no evidence for an association between HTC or B12 concentration and the development of sepsis (OR 0.65, 95% CI 0.31-1.29, p = 0.232, OR 0.84, 95% CI 0.44-1.54, p = 0.584, respectively). There was an association between MMA concentration and the development of sepsis, with a positive effect, i.e. with increasing MMA, the odds for sepsis increased (OR 2.36, 95% CI 1.21-4.87, p = 0.014). This association remained significant when adjusted for confounders (OR 2.72, 95% CI 1.23-6.60, p = 0.018).

conclusionsOur study found an association between elevated MMA concentration and the development of sepsis. We did not find an association between HTC and B12 concentrations and the development of sepsis. Further, larger studies are warranted, as it could lead to interventional trials investigating whether B12 supplementation provides a clinical benefit to patients with infection or sepsis.

trial registrationThe study was registered on ClinicalTrials.gov under the identifier NCT04008446 on June 17, 2019.

Indexed as

Bacterial InfectionsSepsisVitamin B 12AdultAgedAged, 80 and overFemaleHumansMaleMethylmalonic AcidMiddle AgedPilot ProjectsProspective StudiesTranscobalaminsMethylmalonic AcidTranscobalaminsVitamin B 12HolotranscobalaminInfectionMethylmalonic acidObservational studyProspectiveSepsisVitamin B12

Identifiers

PMID39134986
PMCPMC11320857

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.