Evidence map›Paper›PMID 41626614›Full record

ArticleFrontiers in nutrition2026

Elevated methylmalonic acid, but not vitamin B12, predicts all-cause mortality in hyperlipidemic adults: a prospective cohort study.

Qingtao Gong, Baiqiang Wang, Leiyang Li, Gongshuang Zhao, Chengzhi Li, Lianyue Ma, Hong Yang, Xiaojuan Zhang, Guipeng An, Chenghu Guo

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

10 authors.

Qingtao Gong *Public Health Clinical Center Affiliated to Shandong University, Shandong University, Jinan, China.
Baiqiang Wang *Public Health Clinical Center Affiliated to Shandong University, Shandong University, Jinan, China.
Leiyang LiPublic Health Clinical Center Affiliated to Shandong University, Shandong University, Jinan, China.
Gongshuang ZhaoPublic Health Clinical Center Affiliated to Shandong University, Shandong University, Jinan, China.
Chengzhi LiPublic Health Clinical Center Affiliated to Shandong University, Shandong University, Jinan, China.
Lianyue MaState Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.
Hong YangJinan Vocational College of Nursing, Jinan, China.
Xiaojuan ZhangPublic Health Clinical Center Affiliated to Shandong University, Shandong University, Jinan, China.
Guipeng AnState Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.
Chenghu GuoState Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Despite lipid-lowering therapy, patients with hyperlipidemia retain significant residual risk. This study investigated the independent and combined associations of serum methylmalonic acid (MMA), vitamin B12, and functional vitamin B12 status with all-cause mortality in this population. Methods: We analyzed data from hyperlipidemic participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. Weighted Cox proportional hazards models were employed to evaluate the relationships between serum MMA, vitamin B12, functional vitamin B12 deficiency (defined as elevated MMA despite normal/high B12 levels), and all-cause mortality. Nonlinear associations were examined using restricted cubic splines. Results: During a median follow-up of 6.8 years, 626 deaths occurred. After full adjustment, each unit increase in ln-transformed MMA was associated with a 55% higher mortality risk (adjusted HR = 1.55, 95% CI: 1.30-1.84, Conclusion: Elevated serum MMA and functional vitamin B12 deficiency are significantly associated with increased all-cause mortality in hyperlipidemia, whereas serum vitamin B12 level alone lacks independent prognostic value. MMA may serve as a novel biomarker for mortality risk in hyperlipidemia population, highlighting the clinical importance of assessing functional vitamin B12 status.

Indexed as

all-cause mortalityhyperlipidemiamethylmalonic acidprognosisvitamin B12

Identifiers

PMID41626614
PMCPMC12852000

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