혈청 비타민 B12 및 엽산 측정의 임상적 의의

Serum vitamin B12 or folate levels are frequently measured in patients with anemia to rule out megaloblastic anemia. This study was designed to evaluate the value of serum vitamin B12 and folate level determination by radioimmunoassay which has been widly used in practice. We derived normai reference ranges of serum vitamin B12 and folate from 270 healthy Korean adults by non-parametric statistical method. We evaluated serum Band folate levels, MCV, and hemglobin levels in 64 patients of vitamin B12 or folate deficiency. The results were summzarized as follows: 1) The normal reference ranges of serum vitamin B12 and folate in Korean adults are 220-820 pg/ml and 1.2-8.7 ng/ml respectively. 2) The average folate level of female adults is significantly higher than that of male, but average B levels are not different in both sexes. 3) Neither serum vitamin B12 nor folate correlated significantly with age in healthy population. 4) Thirty six percent of low serum vitamin B12 levels are patients after gastric surgery (total or subtotal gastrectomy) and various malignancies are most common conbined diseases in patients with low vitamin B12 or folate levels. 5) MCV values were less than 95 fl in 45 percent of patients with low serum vitamin B12 and in 50 percent of patients with low foate levels. 6) Fourteen percent of patients with low serum vitamin B12 and 29 percent of low folate levels respectively were not anemic (hemoglobin is 13 g/dl or higher in men and 12 g/dl or higher in women). 7) There was significant negative correlation between serum vitamin B12 levels and MCV values in patients with low B12 levels (n=42; r=0.54; p<0,01), but no correlation between B12, and hemoglobin levels. Serum folate levels did not correlate with MCV or hemoglobin values in patients with low folate levels.