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Define Excretion of Methyl malonic acid in urine (Methyl malonil aciduria)?
Methyl malonic acid is found only in traces in normal urine (1-2 mg/day). In vitamin B12 deficiency (pernicious anaemia), the excretion of methyl malonic acid in urine increases to about 100 to 200 mg/day due to the absence of vitamin B12 co-enzyme (methyl malonyl CoA isomerase) involved in the conversion methyl malonyl CoA to succinyl CoA. This is a sensitive method for assessing vitamin B l2 deficiency.
Before we end our discussion on vitamin B12 we would like to highlight that vitamin B12interaction with folate or folic acid is very important from the human nutrition point of view. We have already emphasized earlier under the folate action that the vitamin B12- dependent enzymes, methionine synthase, functions in one of the two folate cycles, namely, the methylation cycle. Interruption of the cycle reduces the level of S-adenosylmethionine. This occurs in pernicious anaemia and other causes of vitamin B12 deficiency, producing as a result demyelination of the peripheral nerves and the spinal column, giving rise to the clinical condition called sub acute combined degeneration. This neuropathy is one of the main presenting conditions in peinicious anaemia. The other principal presenting condition in PA is a megaloblastic anaemia mor- hologically identical to that seen in folate deficiency. Disruption of the methylation cycle also causes a lack of DNA biosynthesis and anaemia.
With this, we end our study of vitamin B12 and also our study of the B- complex vitamins. Finally let us review the other water soluble vitamin i.e. ascorbic acid.
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