(PTFS03-04-26) Factors Associated With Vitamin B12 Status and Its Associations With Glucose Metabolism and Hematological Indices Among Non-Pregnant Adult Females in Oromia, Ethiopia

Saturday, July 25, 2026

1:12 PM - 1:16 PM ET

Location: Prince George's Hall B-E (The Hub) - Poster Theater 2 / Poster Board Number: PT2-4

Emerging Leaders in Nutrition Science Poster Competition

Presenting Author(s)

Debritu Nane Satato, PhD (she/her/hers)

Postdoctoral research scholar
William & Mary
Williamsburg, Virginia, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

Isaac Agbemafle, PhD (he/him/his)

Assistant Professor
University of Rhode Island
Kingston, Rhode Island, United States
CA

Charles D. Arnold, MS

Statistician
University of California, Davis
Davis, California, United States
CM

Christine M. McDonald

University of California, San Francisco, United States
MW

Meseret Woldeyohannes

Ethiopian Public Health Institute, Ethiopia
MT

Masresha Tessema

Ethiopian Public Health Institute, Ethiopia
MF

Mengistu Fereja

Ethiopian Public Health Institute
Addis Ababa, Adis Abeba, Ethiopia
Homero Martinez, MD, PhD

Senior Technical Advisor
Nutrition International
Ottawa, Ontario, Canada
MA

Mandana Arabi

Nutrition International, Canada
PS

Patrick Stover, PhD

Director
Florida State University
KB

Kenneth H. Brown, MD

University of California, Davis
Davis, California, United States

Disclosure(s):

Debritu Nane Satato, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To identify factors associated with vitamin B₁₂ status and explore relationships between vitamin B₁₂ biomarkers and insulin resistance (HOMA-IR), mean corpuscular volume (MCV) and red blood cell distribution width (RDW) among non-pregnant adult females (NPAF) in Ethiopia.

Methods: This cross-sectional analysis included 444 NPAF (18-49 years) who participated in the Double-Fortified Salt with Iodine and Folic Acid project. Fasting blood samples were analyzed for vitamin B₁₂ biomarkers (serum vitamin B₁₂, holotranscobalamin, methyl malonic acid (MMA), and homocysteine), hemoglobin (Hb), red blood cell (RBC) indices, glucose, and insulin. HOMA-IR was estimated from fasting glucose and insulin. Observed weighed food records, repeated in a subset, assessed vitamin B₁₂ intake and usual intake distribution was estimated using the National Cancer Institute method. Multinomial and linear regression identified factors associated with serum vitamin B₁₂ and MMA. Partial Spearman correlations assessed associations of vitamin B₁₂ biomarkers and HOMA-IR, MCV, and RDW after covariate adjustment.

Results: Overall, 12.6% of NPAF were deficient in serum vitamin B₁₂ ( < 148 pmol/L) and 41.4% were marginally deficient (148 to 221 pmol/L); 99.7% had inadequate dietary B₁₂ intake and 58.1% had elevated MMA (>376 nmol/L). Semi-urban residence was associated with lower odds of marginal deficiency (Adjusted Odds Ratio 0.23; 95% CI: 0.11-0.73) and lower MMA (Geometric Mean Ratio (GMR) 0.82; 95% CI: 0.67-0.93); higher wealth was associated with lower MMA (GMR 0.61; 95% CI: 0.51-0.82). Median (IQR) HOMA-IR was 1.62 (1.13–2.24), with no significant associations between vitamin B₁₂biomarkers and HOMA-IR. Anemia (Hb < 12.2 g/dL, adjusted for altitude), macrocytosis, and anisocytosis were present in 0.5%, 0.9%, and 2.3% of NPAF, respectively. Elevated serum MMA was positively correlated with MCV and RDW (rho=0.17), while vitamin B₁₂ was weakly inversely correlated with MCV (rho=-0.09).

Conclusions: Vitamin B₁₂ deficiency and dietary inadequacy were common among NPAF. Greater wealth and semi-urban residence were associated with better vitamin B₁₂ status. Vitamin B₁₂biomarkers were related to RBC indices, but not to HOMA-IR in this population.

Funding Sources: This study was supported by Nutrition International with funds from the Gates Foundation.