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Screening for vitamin B-12 and folate deficiency in older persons.
Am J Clin Nutr 2003; 77(5):1241-7AJ

Abstract

BACKGROUND

Vitamin B-12 deficiency is usually accompanied by elevated concentrations of serum total homocysteine (tHcy) and methylmalonic acid (MMA). Folate deficiency also results in elevated tHcy. Measurement of these metabolites can be used to screen for functional vitamin B-12 or folate deficiency.

OBJECTIVE

We assessed the prevalence of vitamin B-12 and folate deficiency in a population-based study (n = 1562) of older persons living in Oxford City, United Kingdom.

DESIGN

We postulated that, as vitamin B-12 or folate concentrations declined from adequate to impaired levels, tHcy (or MMA) concentrations would increase. Individuals were classified as being at high risk of vitamin B-12 deficiency if they had low vitamin B-12 (< 150 pmol/L) or borderline vitamin B-12 (150-200 pmol/L) accompanied by elevated MMA (> 0.35 micromol/L) or tHcy (> 15.0 micromol/L). Individuals were classified as being at high risk of folate deficiency if they had low folate (< 5 nmol/L) or borderline folate (5-7 nmol/L) accompanied by elevated tHcy (> 15 micromol/L).

RESULTS

Cutoffs of 15.0 micro mol/L for tHcy and 0.35 micro mol/L for MMA identified persons with normal or elevated concentrations. Among persons aged 65-74 and >or= 75 y, respectively, approximately 10% and 20% were at high risk of vitamin B-12 deficiency. About 10% and 20%, respectively, were also at high risk of folate deficiency. About 10% of persons with vitamin B-12 deficiency also had folate deficiency.

CONCLUSION

Use of tHcy or MMA among older persons with borderline vitamin concentrations may identify those at high risk of vitamin B-12 deficiency who should be considered for treatment.

Authors+Show Affiliations

Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom. robert.clarke@ctsu.ox.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12716678

Citation

Clarke, Robert, et al. "Screening for Vitamin B-12 and Folate Deficiency in Older Persons." The American Journal of Clinical Nutrition, vol. 77, no. 5, 2003, pp. 1241-7.
Clarke R, Refsum H, Birks J, et al. Screening for vitamin B-12 and folate deficiency in older persons. Am J Clin Nutr. 2003;77(5):1241-7.
Clarke, R., Refsum, H., Birks, J., Evans, J. G., Johnston, C., Sherliker, P., ... Scott, J. M. (2003). Screening for vitamin B-12 and folate deficiency in older persons. The American Journal of Clinical Nutrition, 77(5), pp. 1241-7.
Clarke R, et al. Screening for Vitamin B-12 and Folate Deficiency in Older Persons. Am J Clin Nutr. 2003;77(5):1241-7. PubMed PMID: 12716678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for vitamin B-12 and folate deficiency in older persons. AU - Clarke,Robert, AU - Refsum,Helga, AU - Birks,Jacqueline, AU - Evans,John Grimley, AU - Johnston,Carole, AU - Sherliker,Paul, AU - Ueland,Per M, AU - Schneede,Joern, AU - McPartlin,Joseph, AU - Nexo,Ebba, AU - Scott,John M, PY - 2003/4/30/pubmed PY - 2003/5/21/medline PY - 2003/4/30/entrez SP - 1241 EP - 7 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 77 IS - 5 N2 - BACKGROUND: Vitamin B-12 deficiency is usually accompanied by elevated concentrations of serum total homocysteine (tHcy) and methylmalonic acid (MMA). Folate deficiency also results in elevated tHcy. Measurement of these metabolites can be used to screen for functional vitamin B-12 or folate deficiency. OBJECTIVE: We assessed the prevalence of vitamin B-12 and folate deficiency in a population-based study (n = 1562) of older persons living in Oxford City, United Kingdom. DESIGN: We postulated that, as vitamin B-12 or folate concentrations declined from adequate to impaired levels, tHcy (or MMA) concentrations would increase. Individuals were classified as being at high risk of vitamin B-12 deficiency if they had low vitamin B-12 (< 150 pmol/L) or borderline vitamin B-12 (150-200 pmol/L) accompanied by elevated MMA (> 0.35 micromol/L) or tHcy (> 15.0 micromol/L). Individuals were classified as being at high risk of folate deficiency if they had low folate (< 5 nmol/L) or borderline folate (5-7 nmol/L) accompanied by elevated tHcy (> 15 micromol/L). RESULTS: Cutoffs of 15.0 micro mol/L for tHcy and 0.35 micro mol/L for MMA identified persons with normal or elevated concentrations. Among persons aged 65-74 and >or= 75 y, respectively, approximately 10% and 20% were at high risk of vitamin B-12 deficiency. About 10% and 20%, respectively, were also at high risk of folate deficiency. About 10% of persons with vitamin B-12 deficiency also had folate deficiency. CONCLUSION: Use of tHcy or MMA among older persons with borderline vitamin concentrations may identify those at high risk of vitamin B-12 deficiency who should be considered for treatment. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/12716678/Screening_for_vitamin_B_12_and_folate_deficiency_in_older_persons_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/77.5.1241 DB - PRIME DP - Unbound Medicine ER -