Reduced Plasma Vitamin B12 Levels in Older Patients: A State of B12 Deficiency

Asselt, Dieneke van; Blom, Henk J.; Zuiderent, R.; Wevers, Ron A.; Jakobs, C.; Broek, W. van den; Corstens, F.; Hoefnagels, W.H.L.

doi:10.1093/ageing/26.suppl_1.p24-c

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because of the metabolic evidence of cobalamin deficiency in older subjects with low-normal plasma cobalamin concentrations (3,5) and the fact that intramuscular cobalamin supplementation normalizes elevated plasma metabolite concentrations, which is considered to support the presence of tissue cobalamin deficiency (1,5), it has been proposed that the plasma cobalamin cutoff for diagnosing deficiency be raised from 160 to 260 pmol/L (6,7). Although there is evidence that elevated plasma MMA concentrations are clinically relevant in subjects with apparently asymptomatic, low plasma cobalamin concentrations (8,9) and even in some patients with normal cobalamin concentrations and anemia (10), the clinical significance of elevated metabolites in subjects with low-normal plasma cobalamin concentrations in the absence of overt anemia or neurologic disease is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects

Asselt

Groot

Staveren

et al. 1998

The American Journal of Clinical Nutrition

170

108

View full text Add to dashboard Cite

Background:The reason for the high prevalence of mild cobalamin (vitamin B-12) deficiency in the elderly is poorly understood. Objective: We aimed to determine the reason for this high prevalence. Design: We examined cobalamin intake, the presence and severity of atrophic gastritis, the presence of Helicobacter pylori infection, and plasma cobalamin and methylmalonic acid (MMA) concentrations in 105 healthy, free-living, older subjects aged 74-80 y. Results: Mild cobalamin deficiency, ie, low to low-normal plasma cobalamin concentrations (< 260 pmol/L) and elevated plasma MMA concentrations (> 0.32 mol/L), were found in 23.8% of subjects; 25.7% of subjects were not cobalamin deficient (plasma cobalamin ≥ 260 pmol/L and plasma MMA ≤ 0.32 mol/L). Six subjects (5.8%), including 1 with mild cobalamin deficiency, had dietary cobalamin intakes below the Dutch recommended dietary intake of 2.5 g/d. Mildly cobalamin-deficient subjects had lower total (diet plus supplements) cobalamin intakes (median: 4.9 g/d; 25th and 75th percentiles: 3.9, 6.4) than did non-cobalamin-deficient subjects (median: 6.3 g/d; 25th and 75th percentiles: 5.4, 7.9) (P = 0.0336), mainly because of less frequent use of cobalamin supplements (8% compared with 29.6%; 2 = 3.9, P = 0.048). Atrophic gastritis was found in 32.4% of the total study group: mild to moderate in 19.6% and severe in 12.7%. The prevalence of severe atrophic gastritis, but not mild-to-moderate atrophic gastritis, was higher in mildly cobalamin-deficient subjects (25%) than in non-cobalamin-deficient subjects (3.7%) ( 2 = 4.6, P = 0.032). The prevalence of immunoglobulin G antibodies to H. pylori was similar in mildly cobalamin-deficient subjects (54.2%) and in non-cobalamin-deficient subjects (44.4%) ( 2 = 0.5, P = 0.5). Conclusions:The high prevalence of mild cobalamin deficiency in healthy, free-living, older Dutch subjects could be explained by inadequate cobalamin intake or severe atrophic gastritis in only 28% of the study population. Other mechanisms explaining mild cobalamin deficiency in older people must be sought.Am J Clin Nutr 1998;68:328-34.

show abstract