MMA- Methylmalonic Acid
MMA (Methylmalonic acid)
Specimen requirements- 0.5 ml non-hemolyzed serum, fasting
Serum should remain frozen during shipment to lab
Dogs: 415−1,193 nmol/L
Cats: 139−897 nmol/L
Serum Methylmalonic acid (MMA) can be used as a marker for
cobalamin deficiency on a cellular level and is often measured in
combination with cobalamin (vitamin B12). Cobalamin is
an essential cofactor for the enzyme methylmalonyl CoA mutase,
which converts L-methylmalonyl CoA to succinyl CoA. When dogs or
cats are cobalamin deficient the physiologic metabolic pathway is
reversed and the production of MMA is favored. MMA can diagnose
cobalamin deficiency in patients that have a low normal serum
cobalamin concentration. Cellular cobalamin concentrations are more
important than serum cobalamin concentrations because
cobalamin-dependent biochemical reactions occur intracellularly.
Since MMA is renally excreted, increased concentrations should be
interpreted cautiously in patients with renal failure.
1.Ruaux CG, Steiner JM, Williams DA. Metabolism of amino acids
in cats with severe cobalamin deficiency. Am J Vet Res
2. Stabler SP, Marcell PD, Podell ER, Allen RH, Lindenbaum J.
Assay of methylmalonic acid in the serum of patients with cobalamin
deficiency using capillary gas chromatography-mass spectrometry.
J Clin Invest 1986;77:1606-1612.
3. Ruaux CG, Steiner JM, Williams DA. Relationships between low
serum cobalaminconcentrations and methylmalonic acidemia in cats.
J Vet Intern Med 2009;23:472-475.
4.Berghoff N, Suchodolski JS, Steiner JM. Association between
serum cobalamin and methylmalonic acid concentrations in dogs.
Vet J 2012;191:306–311.
5. Berghoff N, Parnell NK, Hill S, Suchodolski JS, Steiner JM.
Serum cobalamin and methylmalonic acid concentrations in dogs with
chronic gastrointestinal disease. Am J Vet Res