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Perspectives
The Flip Side of Vitamin B12 Deficiency in Organic Acid Profiling |
| Oct 16 2009 |
Bacterial Overgrowth may Affect Methylmalonate Levels via Synthesis of Propionate - the Precursor to Methylmalonate
The application of organic acid profiling in clinical practice for assessment of b-vitamin sufficiency has traditionally centered on the effect of cofactor availability (namely b-vitamins) on enzyme function. While this theory still explains the majority of abnormalities for markers associated with b-vitamin deficiency, there are instances in which elevations of markers may be due to causes other than lack of cofactor or genetic enzymatic defects.
Marker in Focus: Methylmalonic Acid
One such marker that has received a lot of attention in this regard is methylmalonate (MMA). MMA is the excretion product of the adenosylcobalamin-dependent methylmalonyl-coA mutase (MMCoA) enzyme. MMA is a metabolic intermediate in the breakdown of valine, isoleucine, pyrimidines and odd-chain fatty acids. Hence factors, which affect the levels of each of these substances, can also possibly alter the level of MMA. Another independent factor which can affect levels of MMA is endogenous synthesis of propionate by the microbiota of the human GI tract. Propionic acid is the principle precursor of MMA, and is one of the major metabolic by-products of anaerobic bacterial metabolism in the human colon.
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