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The diagnostic utility of mean corpuscular volume (MCV), as an indicator of abnormal serum methylmalonic acid (MMA) and total plasma homocysteine (tHCY) biomarkers of vitamin B12 or folate deficiency, was assessed in 26,397 participants (12,730 males and 13,667 females) in the National Health and Nutrition Examination Survey (NHANES) dataset (76)

In fact, less than a quarter of the variation in MMA levels is explained by vitamin B12 levels, eGFR, age, and sex, indicating that a large part of the variation in MMA levels is attributable to other factors (eg, catabolism, dietary components, or gut microbial production)

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