Vitamin B12 in tests. Analysis for folic acid and vitamin B12
Protein S, like its cofactor, protein C, is an anticoagulant clotting factor. These two proteins mutually enhance and complement each other.
The level of protein S in the blood depends on the presence of vitamin K in the body and controls blood clotting processes. This is extremely important to prevent massive blood loss in the event of injury or surgical intervention. However, if the blood clots excessively, it will lead to the formation of blood clots in the veins and arteries (thrombosis), which can also be extremely dangerous for human life. That is why the blood contains both coagulants and anticoagulants. Coagulants promote clotting, while anticoagulants ensure that the blood remains fluid and does not clot unnecessarily. Protein S is an anticoagulant. Deficiency of this protein leads to increased risk blood clot formation.
Normal level of protein S in the blood. Explanation of the result (table)
A blood test for protein S is performed if the patient has blood clots of unknown origin that occur without apparent reason or thrombosis is a hereditary pathology in this family.
Also, blood testing for the level of protein S may be needed for a screening examination of relatives of a patient who has a deficiency of this protein or to determine the cause of habitual miscarriages. Typically, a blood test for protein S is done at the same time as a blood test for levels of protein C and possibly other clotting factors.
Material for analysis is taken from a vein.
Protein S level in blood ordinary people and pregnant women.
If Protein S is elevated, what does it mean?
An increase in the level of protein S in the patient's blood is not of clinical interest and is not used in diagnosis. However, you need to understand that high performance Protein C may cause difficult to stop bleeding. Protein S levels increase with age, but this does not cause any health problems.
If protein S is low, what does this mean?
Protein S deficiency can lead to excessive blood clotting. in this case, blood clots tend to form in the veins rather than in the arteries.
Protein S deficiency can be acquired or it can be hereditary. A decrease in protein S levels is observed during pregnancy, as well as due to certain diseases, namely:
- DIC syndrome,
- liver diseases,
- AIDS.
Protein S deficiency can also be caused by the use of certain medical supplies, for example, long-acting antibiotics or Warfarin.
For diseases of the kidneys, liver, endocrine system, infectious processes blood protein determination is shown. This analysis is part biochemical research. C-reactive protein is an indicator of the activity of the inflammatory process, used in diagnosis, determining the effectiveness of therapy, and the risk of cardiovascular diseases. C and S proteins reflect the anticoagulation system of the blood.
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Explanation of terms
A blood test for protein content is part of a biochemical study. It is prescribed for many diseases. To understand the main names that appear in the results, you need to know the meaning of some terms:
- protein total, protein total– sum of albumin and globulin content, total concentration proteins;
- C-reactive protein (pronounced "c")– indicator of the intensity of the inflammatory process;
- C-protein– inhibits the formation of blood clots, has an effect opposite to coagulation factors (proteins that thicken blood);
- S protein– enhances the activity of C-protein;
- blood for eosinophilic cationic protein investigated at allergic diseases for diagnosis and determination of severity.
Blood protein analysis
Plasma protein is represented mainly by albumins and globulins. The former are formed by the liver and make up about 60% of the total blood protein. Globulins, in addition to the liver, are produced by cells immune system. A referral for analysis can be issued by a surgeon, cardiologist and nephrologist. General content blood protein is part of a standard biochemical test.
Indications and performance
Pathological conditions in which the content of proteins in the blood may have diagnostic value, are:
- frequent subcutaneous hemorrhages, tendency to bleed;
- the appearance of blood in the stool;
- decreased urine output, swelling of the legs, pain in the lower back, bones;
- starvation, emaciation;
- suspicion of oncological and autoimmune processes;
- insufficiency of liver and kidney function;
- infectious diseases;
- burns.
Blood test from a vein The analysis requires venous blood taken after a 10-hour break in food intake. On the morning of the test, you can drink exclusively clean water.
Normal when blood levels are low and high
The results of the analysis for blood protein content are compared with tables that indicate values corresponding to age. For example, for newborns the norm is considered to be from 45 to 67 g/l, and for adults – 64 to 84 g/l. Indicators are elevated when:
- dehydration (severe diarrhea or vomiting, widespread thermal burn, ketoacidosis in diabetes, hyperosmolar coma);
- acute and chronic infections;
- diseases connective tissue(lupus erythematosus, scleroderma, rheumatism);
- multiple myeloma.
A decrease in the concentration of proteins in the blood may be due to the following reasons:
- lack of intake during fasting, acute pancreatitis, intestinal diseases, parenteral nutrition;
- liver damage – cirrhosis, tumor, hepatitis, poisoning;
- loss due to bleeding, nephritis, renal amyloidosis, nephropathy, burns;
- protein breakdown during prolonged fever, injuries, thyrotoxicosis, excessive physical exertion, oncology;
- copious administration of solutions during infusion therapy;
- long-term use steroid hormones, anabolic steroids;
- transfer of blood plasma into the pleural, abdominal or pericardial cavity with significant effusion (exudation).
Blood consists not only of well-known cells - erythrocytes, leukocytes, but also of various organic compounds, related in their structure to protein substances When is a protein C and protein S test needed?
One of the main factors of the body's anticoagulant system is protein C. It prevents the formation blood clot. Its cofactor, protein S, is also of diagnostic importance. This protein enhances the effect of protein C and ensures the maintenance of blood fluidity. They are formed in the liver, their synthesis depends on the content of vitamin K in the body and the use of drugs that act on blood clots.
Indications for the diagnosis of these indicators are:
- frequent venous or arterial thrombosis in young patients;
- miscarriage;
- carrying out treatment with anticoagulants (before starting use);
- postoperative period;
- suspicion of hereditary thrombophilia;
- liver diseases.
Normal levels of protein C for children under 1 year of age and adults are from 70 to 140 percent, and protein S levels are 20 to 25 mg/l. The study of these indicators is usually carried out during a coagulogram.
A decrease in these values occurs when:
- congenital deficiency ();
- liver dysfunction;
- high consumption in case of intravascular coagulation;
- infections, including HIV;
- kidney diseases;
- malignant neoplasms.
C-protein is always reduced during use. Increasing the level of this protein diagnostic value does not have.
C-reactive protein is a marker of inflammation
After the penetration of a foreign protein (virus, bacteria), the formation of C-reactive protein increases in the liver. In the first days it can exceed the norm by tens and even hundreds of times. This protein can be “good” (increases immune protection) and “bad” (disturbs the condition of the inner lining of blood vessels, stimulates spasm, ).
Indications for analysis:
For all age categories the concentration of this protein should not exceed 5 mg/l. During pregnancy, an increase to 20 mg/l is allowed. For pathological conditions important to consider dynamic changes indicator, since they reflect the deterioration or improvement of the patient’s condition. High values of C-reactive protein occur with:
- diseases of the digestive system;
- acute and chronic inflammation;
- rheumatism and autoimmune diseases;
- amyloidosis;
- transplant rejection;
- malignant neoplasms and metastases;
- viral and bacterial infections;
- septic process;
- deep burns;
- after operations;
- tuberculosis;
- meningitis.
Description
Determination method Automatic analyzer of coagulation system parameters ACL TOP, method - immunoturbidimetry.
Material under study Plasma (citrate)
Natural anticoagulant, protein C cofactor.
Protein S is a cofactor of protein C (see test), enhancing its anticoagulant and profibrinolytic effect. This is vitamin K - a dependent protein synthesized in the liver. In blood plasma it is present in two forms - free and bound to C4-BP (complement C4b binding protein). Biological activity only the free form exhibits, the bound form is functionally inactive, so the definition free form more informative. Protein S content depends on gender, hormonal levels, changes with age. Free protein S deficiency can be congenital or acquired. Congenital deficiency type I - classic - decreased levels of total and free protein S, decreased functional activity; type II - decreased functional activity with normal levels of total and free protein S; type III - selective reduction in the level of free form. Like other types of thrombophilias, the heterozygous variant of protein S deficiency manifests itself in adulthood in the form of thromboembolism. Homozygous variants and combinations with other thrombophilias usually appear during the newborn period in the form of fulminant purpura. Acquired deficiency can be observed during pregnancy, while taking oral anticoagulants, using oral contraceptives, in patients with liver pathology, in newborns, and other clinical settings. Decreased levels of free protein S may be associated with an acute-phase inflammatory response (increased levels of C4-BP lead to increased binding of protein S and decreased levels of its free form). It is preferable not to perform the study during acute thrombotic episodes (although normal level protein S under these conditions essentially eliminates protein S deficiency).
Literature
Preparation
It is preferable to take blood in the morning on an empty stomach, after 8-14 hours of overnight fasting (you can drink water), it is acceptable in the afternoon 4 hours after easy reception food.
On the eve of the study, it is necessary to exclude increased psycho-emotional and physical stress ( sports training), drinking alcohol.
Indications for use
Interpretation of results
Interpretation of research results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. Accurate diagnosis is determined by the doctor, using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.
Units of measurement in the Independent Laboratory INVITRO: %. Reference values:
- children 1 day - 12 weeks: 15 - 55%
- children 12 weeks - 6 months: 35 - 92%
- children 6 months - 12 months: 45 - 115%
- children 1 year - 5 years: 62 - 120%
- children 5 years - 9 years: 62 - 130%
- children 9 years - 17 years: 60 - 140%
- women: 54.7 - 123.7%
- men: 74.1 - 146.1%
- congenital deficiency or defect of Protein S;
- decreased synthetic function of the liver;
- reception medicines(anticoagulants, oral contraceptives);
- pregnancy;
- acute phase inflammatory diseases.
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Period of execution
The analysis will be ready within 1 day, excluding Saturday and Sunday (except for the day of taking the biomaterial). You will receive the results by email. mail immediately when ready.
Completion time: 1 day, excluding Saturday and Sunday (except for the day of taking biomaterial)Preparing for analysis
Limit fatty and fried foods for 24 hours, eliminate alcohol and heavy physical activity, as well as x-rays, fluorography, ultrasound and physiotherapy.
From 8 to 14 hours before donating blood, do not eat food, drink only clean water.
Discuss with your doctor the medications you are taking and the need to stop them.
Analysis information
Index:
Vitamin B12 is involved in the body in the synthesis of the amino acid methionine and the oxidation of proteins and fats. The analysis allows you to assess vitamin deficiency in the body due to dietary habits or problems with absorption
Destination:
Vitamin B12 deficiency can occur due to wrong diet(vegetarianism), as well as during pregnancy and lactation. Diseases such as gastritis A, cirrhosis of the liver, cancer or polyps in the stomach, and other pathologies can also disrupt the concentration of this substance in the body.
Specialist:
Prescribed by a therapist or gastroenterologist.
Important:
The level of vitamin B12 decreases with its lack in food (vegetarianism) and alcohol abuse.
Research method: Chemiluminescent immunoassay.
Material for research - Blood serum.
Vitamin B12 (cobalamin, cyanocobalamin, antianemic vitamin, cobalamin, cyanocobalamin)
Find out more about popular analyses:Vitamins B12 combine a group of cobalt-containing biologically active substances called cobalamins. These include hydroxycobalamin, cyanocobalamin and two coenzyme forms of vitamin B12 (methylcobalamin and 5-deoxyadenosylcobalamin). In a narrower sense, vitamin B12 is called cyanocobalamin, since it is in this form that the main amount of the vitamin enters the human body. Cobalamins consist of a corrin ring surrounding a central cobalt atom and differ in the arrangement of the side groups associated with the cobalt atom. Serum contains the coenzyme form of vitamin B12 - methylcobalamin; in cells, vitamin B12 is represented by 5-deoxyadenosylcobalamin. The control compound used in measuring serum cobalamin concentrations is cyanocobalamin, which is a more stable form.
Vitamin B12 enters the human body with animal foods, including fish, meat, dairy products, and eggs. Cyanocobalamin is absorbed from the lower part ileum, its absorption is influenced by Castle's intrinsic factor, a protein produced by stomach cells. Cobalamins accumulate in the liver and, as needed, enter the plasma, where they are bound to proteins (transcobalamins). Vitamin B12 is involved as a coenzyme in two important metabolic reactions: the conversion of L-methylmalonyl-CoA to succinyl-CoA, and the conversion of the amino acid homocysteine to methionine. These processes are necessary for normal height cells and their synthesis of deoxyribonuleic acid (DNA). A deficiency of this vitamin can lead to megaloblastic anemia, and ultimately to serious neurological disorders. Megaloblastic anemia is characterized by a slowdown in the maturation of hematopoietic cells - the S phase lengthens, which is morphologically expressed in a delay in nuclear maturation during normal hemoglobinization, as well as in large sizes blood cells and preservation of nuclear elements in mature (cytoplasmic) erythrocytes. This occurs primarily as a result of a decrease in the cells' ability to synthesize DNA.
Folic acid and vitamin B12 affect the process of methionine synthesis, therefore, if there is a deficiency of one or another of the substances, this metabolic process is disrupted and this can lead, in the future, to similar disturbances in the functioning of vital functions. important organs and systems. Usually when clinical examination(blood test for vitamin content) it is necessary to determine the concentration of both vitamins with subsequent treatment depending on the deficiency of one or the other.
Causes of vitamin B12 deficiency: Insufficient absorption of vitamin B12 due to impaired secretion of intrinsic factor Castle. This process causes pernicious anemia and is more common after 50 years. Gastrectomy, insufficient absorption vitamin as a result of surgical resection of the intestine, as well as various infectious diseases or inflammatory processes, affecting small intestine. Vitamin B12 deficiency due to insufficient dietary intake is rare and may only appear after abstaining from all animal products for several years. Vitamin B12 deficiency may also be caused by increased production of antibodies to internal factor or congenital deficiency of intrinsic factor.
When taking a blood test for vitamins, an increase in the concentration of vitamin B12 may be observed during pregnancy, the use of oral contraceptives and multivitamins, as well as in myeloproliferative diseases (chronic myelocytic leukemia and myelomonocytic leukemia). Clinical disorders caused by increased concentrations of vitamin B12 are still unknown.
Interpretation of the results of the study "Vitamin B12 (cobalamin, cyanocobalamin, antianemic vitamin, cobalamin, cyanocobalamin)"
Attention! Interpretation of test results is for informational purposes only, is not a diagnosis and does not replace medical advice. Reference values may differ from those indicated depending on the equipment used, the actual values will be indicated on the results form.
The concentration of vitamin B12 in the blood serum from 107.0 to 133.0 pmol/l is regarded as reduced level, and a concentration of less than 107.0 pmol/l is considered a vitamin B12 deficiency.
Unit of measurement: pmol/l
Reference values: 148 – 664 pmol/l
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U healthy person The blood composition is approximately the same. But when various pathologies and diseases qualitative and quantitative ratio substances in biological fluids changes. To monitor the condition of the body, it is carried out laboratory analysis venous or capillary blood samples. One type of examination is a vitamin B12 test.
Even schoolchildren know that vitamins are essential for health. kindergarten. With insufficient intake of these substances, they can develop various diseases. Cyanocobalamin performs many important functions, it is necessary to ensure hematopoietic functions and normal operation nervous system. A deficiency of this substance can have serious consequences.
What kind of substance?
Vitamin B12 is a water-soluble substance that is essential for good health. It has complex structure, scientists have not yet been able to synthesize the molecule artificially. Vitamin B12 is not produced in human organs; its source is foods, mainly meat and dairy products.
Advice! Newborn babies receive vitamin B12 with mother's milk. IN breast milk For women, the substance is contained in the most easily digestible form.
The intake of vitamin from food is carried out according to the following scheme:
- the vitamin forms a fragile complex with a special protein produced in the human stomach;
- V complex form it enters the small intestine, where it breaks down and the released vitamin is recombined with another type of protein that performs transport functions;
- the formed complex spreads throughout the body, entering organs and tissues;
- metabolism of cyanocobalamin requires a lot of time, reserves in healthy body As a rule, it lasts for at least a year.
Normally, vitamin B12 interacts with folic acid. Both of these substances are necessary to provide metabolic processes carbohydrates, fats and proteins. With a lack of cyanocobalamin in tissues Negative consequences noted in:
- bone marrow;
- mucous membranes of the mouth, tissues of the tongue.
As a result of a deficiency of the substance, the following is noted:
- impaired hematopoiesis, changes in blood composition, expressed in a decrease in the production of red blood cells;
- the appearance of malabsorption in the gastrointestinal tract;
- metabolic disorder;
- the appearance of ulcers in the mouth due to stomatitis;
- the appearance of neurological symptoms.
Deficiency is especially dangerous nutrients and vitamins during pregnancy, this condition is equally dangerous for both women and the fetus.
Advice! A lack of vitamin B12 during pregnancy can lead to fetal developmental abnormalities. In women during pregnancy, this condition disrupts the stability of the nervous system.
The daily norm of cyanocobalamin is about 3 mcg, but women during pregnancy require more of the vitamin, for them the norm is 1 mcg more.
Indications
In what cases can a blood test for vitamin B12 levels be prescribed? Main assistance to the analysis:
- diagnosis of some types of anemia;
- developmental defects or inflammatory diseases, affecting the tissues of the small intestine;
- gastritis occurring in atrophic form(this disease is more common in older patients);
- detection of congenital syndromes in which the absorption of cyanocobalamin is impaired;
- diagnostic examinations of people adhering to strict diet excluding the consumption of animal food;
- examinations for frequently recurrent stomatitis, glossitis;
- monitoring women's health and fetal development during pregnancy.
Procedure
If a blood test for cyanocobalamin content is prescribed, the patient must be warned about the need to prepare for the examination.
Because the results can be affected by many medications, it is important to find out if the patient is not currently undergoing treatment. If possible, medications should be stopped for at least a week before the date for which the test is scheduled.
If drug withdrawal is not possible (the course cannot be interrupted), this should be taken into account when assessing the results. The day before taking blood samples, it is recommended to refrain from:
- reinforced physical activity(workouts in the gym, etc.);
- drinking alcohol.
You must stop smoking at least an hour before taking blood samples. The test is taken on an empty stomach; at least 12 hours must have passed since the last meal. Before taking blood samples, you can only drink water, tea, coffee and other drinks - not. Approximately 5 ml is required to perform the analysis venous blood, venipuncture is performed to obtain material.
Normal indicators and deviations
When evaluating the results, you need to pay attention to reference values indicated on the laboratory form, since due to different analysis methods, normal values may differ significantly when analyzes are carried out in different laboratories.
In most cases, the vitamin B12 level is as follows (in pmol/l):
- for infants – 118 – 960;
- for adults, including women during pregnancy – 148 – 615;
- for people over 60 years old – 80 – 567,
Low content
If the analysis showed that the level of cyanocobalamin is reduced, then this condition may be due to:
- insufficient intake of vitamin into the body;
- malabsorption.
Insufficient intake of the vitamin into the body, in turn, may be due to:
- strict vegetarian diet. Vegetarianism is not recommended for women during pregnancy. If giving up the diet is not possible, it is necessary to prescribe additional vitamins (in the form of tablets or injections) during pregnancy;
- in infants breastfeeding Vitamin deficiency is caused by insufficient content of the substance in mother's milk;
- frequent drinking of alcohol;
- use of drugs that change acidity gastric juice in the direction of decrease.
Impaired absorption of the vitamin and, as a consequence, reduced levels of cyanocobalamin can be caused by the following reasons:
- malabsorption of nutrients in small intestine(malabsorption). This condition may be due to congenital syndromes(for example, celiac disease - gluten intolerance) or diseases (for example, SPRU);
- atrophic changes in the gastric mucosa (gastritis with atrophy of the mucosa, malformations of the small intestine);
- helminthic infections;
- Addison-Beamer syndrome (with this disease, the stomach does not produce enough protein necessary for the primary binding of cyanocobalamin);
- Immrslund-Gresbeck disease (reduced intensity of transport protein synthesis due to which the vitamin does not enter the sufficient quantity in fabric).
Increased level
If an increase in cyanocobalamin content is detected, the causes of this condition may be as follows:
- liver diseases, with such pathologies the increase in level is significant, it exceeds the norm by several tens of times;
- severe renal or heart failure;
- increased synthesis of transport protein in the small intestine.
So, a test for vitamin B12 may be prescribed in the process preventive examination or during diagnosis. It is especially important to monitor the level of vitamin in the blood during pregnancy. If the analysis shows that the norm is reduced, then appropriate treatment will be required. Increased level This substance indicates serious illness.
