Elevated serum cobalamin levels and disease patterns in patients followed at a tertiary university hospital

• Grant number: 24/12433-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2024
• End date: September 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Selma Freire de Carvalho
• Grantee: Gustavo Rossete Zotelli
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Introduction. Although vitamin B12 deficiency is valued in clinical practice due to its numerous clinical manifestations, the increase in serum levels is undervalued. The relationship between diseases and/or morbid conditions and high serum cobalamin levels has been studied in recent decades. The etiology of the increase in serum vitamin B12 levels must be investigated thoroughly, as it may indicate serious illnesses. Objective. The objective of the present study is to relate serum levels of vitamin B12 to different diagnostic categories in order to identify an association between high serum levels of cobalamin and certain diseases and/or associated comorbidities. Methodology. The retrospective and descriptive study will be conducted based on information obtained from the HCFMRP-USP Electronic Medical Record System in 2019. The spreadsheets containing patient data will be provided by the Information and Analysis Center, upon request from the Data Section Doctors. During this period, 6000 subjects who had vitamin B12 dosage, gender, age and clinical diagnoses will be selected, after excluding patients under 18 years of age and pregnant women. Research subjects will be grouped according to the cut-off points for vitamin B12 dosages: a) below the reference value (< 211pg/mL); b) with normal values (211 to 911 pg/mL) and c) those with dosages above reference values (> 911 pg/mL). The descriptive and comparative statistical analysis (difference between men and women, elderly and non-elderly, with or without neoplasia and according to the type of neoplasia) will be carried out with the help of the Statistica software, version 8.0. Logistic regression analysis will be performed to determine the association between high vitamin B12 levels and selected diagnoses using the low level group as a reference. The results will be presented as a crude odds ratio adjusted for age and gender, with a 95% confidence interval (95% CI).