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Total Homocysteine, Vitamin B₁₂, and Total Antioxidant Status in Vegetarians

¹ Department of Clinical Chemistry/Central Laboratory, University Hospital of the Saarland, D-66421 Homburg/Saar, Germany.

² Department of Clinical Chemistry and Pathobiochemistry, University Leipzig, D-4103 Leipzig, Germany.

^aAddress correspondence to this author at: Department of Clinical Chemistry/Central Laboratory, University Hospital of the Saarland, Bldg. 40, D-66421 Homburg/Saar, Germany. E-mail kchwher{at}med-rz.uni-sb.de.

Background: Decreasing or eliminating animal products from the diet decreases the intake of some essential nutrients, such as vitamin B₁₂, which may lead to hyperhomocysteinemia. We investigated vitamin B₁₂-dependent metabolism and oxidative stress in groups with various or no intake of meat or animal products.

Methods: We investigated 44 high meat eaters, 19 low meat eaters, 34 lacto-ovo/lacto vegetarians, and 7 vegan vegetarians. Homocysteine (HCY) was assayed by HPLC, methylmalonic acid (MMA) by capillary gas chromatography–mass spectrometry, serum folate and vitamin B₁₂ with a chemiluminescence immunoassay, and total antioxidant status (TAS) by a Randox method.

Results: The mean serum HCY concentration of vegetarians was significantly increased, and in vegans the median concentration exceeded 15 µmol/L. Vegetarians had a higher serum concentration of MMA but a lower TAS. Vitamin B₁₂ and folate did not differ significantly between vegetarian and omnivorous subjects. Overall, HCY and MMA were significantly correlated. Vitamin B₁₂ correlated negatively with MMA, HCY, and folate, whereas the correlation with TAS was positive. Backward regression analysis revealed an independent influence of MMA on HCY, of HCY and vitamin B₁₂ on MMA, and of vitamin B₁₂ on TAS. The increased MMA concentration suggested a 25% frequency of functional vitamin B₁₂ deficiency in all vegetarians. Serum vitamin B₁₂ was below the lower reference limit in only five subjects.

Conclusions: Functional vitamin B₁₂ deficiency in vegetarians may contribute to hyperhomocysteinemia and decreased TAS, which may partly counteract the beneficial lifestyle of vegetarians. However, increased serum HCY is most likely not responsible for the lower TAS values in vegetarians. We recommend assaying of MMA and HCY to investigate functional vitamin B₁₂ status.

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