Investigation of atherogenic indices associated with cardiometabolic risk in patients with low vitamin B12 levels

INTRODUCTION: This study aimed to investigate novel composite lipid indices, including the non-High Density Cholesterol/High Density Cholesterol ratio, Lipoprotein Combined Index, and Triglyceride-Glucose Index in adults with low vitamin B12 levels, alongside established markers such as Castelli Risk Index I, Castelli Risk Index II, and the Atherogenic Index of Plasma. By examining the relationship between vitamin B12 status and these indices, it aimed to clarify the role of low vitamin B12 levels in cardiometabolic risk.
METHODS: This retrospective study included 400 participants. Glucose and lipid levels were measured using fasting serum samples. Composite lipid parameter values were calculated according to methodologies described in the litera-ture. Results were compared between low vitamin B12 levels and control groups.
RESULTS: In this study, low vitamin B12 levels were found to be associated with low high-density lipoprotein cholesterol (p=0.035), high atherogenic plasma index (p=0.048), and high triglyceride-glucose index (p=0.043). In contrast, no sig-nificant differences were observed between the groups in terms of Castelli Risk Index I, Castelli Risk Index II, non-High Density Cholesterol/High Density Cholesterol ratio, or Lipoprotein Combined Index. The area under the ROC curve was found to be ± standard error of 0.557±0.029 [95% CI: 0.501–0.613] (p=0.048) for the Atherogenic Plasma Index and ± standard error of 0.557±0.029 [95% CI: 0.500–0.613] (p=0.049) for the Triglyceride-Glucose Index.
DISCUSSION AND CONCLUSION: In this study, B12 deficiency was associated with negative lipid indices. It is hypothesized that regular assessment of B12 levels and appropriate correction of deficiencies may help reduce cardiometabolic risk. Further pro-spective studies with comprehensive biomarkers are needed to clarify causality and clinical benefit.

Keywords: Atherogenic index of plasma, cardiometabolic risk, castelli risk index I, castelli risk index II, lipoprotein com-bined index, non-high density cholesterol/high density cholesterol ratio, triglyceride-glucose index, vitamin B12