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Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: a population-based study.
J Intern Med. 2003 Oct; 254(4):343-52.JI

Abstract

OBJECTIVES

The early stages of tissue B12 or folate deficiency often cause diagnostic problems. In this report, the levels of serum cobalamin, folate, methylmalonic acid (MMA) and total homocysteine (tHcy), and their relationships with clinical findings and reported symptoms in a representative random population sample are presented.

DESIGN

Cohort study.

SETTING

A general central Swedish population 70 years or older.

SUBJECTS AND METHODS

A 20% random sample of persons 70 years or older in a defined geographical area were invited to a survey. A total of 235 (85%) persons responded, of whom 161 had no interfering diseases or medication. Blood specimens for serum cobalamin, folate, MMA and tHcy analyses were drawn.

MAIN OUTCOME MEASURES

Presence of anaemic, gastrointestinal, neurological and psychiatric symptoms, obtained by questionnaire, and vibration sense measurement and findings at a physical and Mini Mental State Examination.

RESULTS

Among a large number of symptoms and clinical findings that traditionally have been linked to vitamin B12 or folate tissue deficiency, only changes in the tongue mucosa and mouth angle stomatitis turned out to be significantly associated with abnormal serum tHcy and serum folate levels. There were no relationships to serum cobalamin and serum MMA.

CONCLUSIONS

Changes in the oral mucosa were the only signs and symptoms found in this study, indicating that these may be the very early markers of metabolic defects. The traditional symptoms of vitamin deficiency may appear later in the course.

Authors+Show Affiliations

Department of Public Health and Caring Sciences, Uppsala University, Family Medicine and Clinical Epidemiology Section, University Hospital, Uppsala, Sweden. karin.bjorkegren@pubcare.uu.seNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

12974873

Citation

Björkegren, K, and K Svärdsudd. "Reported Symptoms and Clinical Findings in Relation to Serum Cobalamin, Folate, Methylmalonic Acid and Total Homocysteine Among Elderly Swedes: a Population-based Study." Journal of Internal Medicine, vol. 254, no. 4, 2003, pp. 343-52.
Björkegren K, Svärdsudd K. Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: a population-based study. J Intern Med. 2003;254(4):343-52.
Björkegren, K., & Svärdsudd, K. (2003). Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: a population-based study. Journal of Internal Medicine, 254(4), 343-52.
Björkegren K, Svärdsudd K. Reported Symptoms and Clinical Findings in Relation to Serum Cobalamin, Folate, Methylmalonic Acid and Total Homocysteine Among Elderly Swedes: a Population-based Study. J Intern Med. 2003;254(4):343-52. PubMed PMID: 12974873.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: a population-based study. AU - Björkegren,K, AU - Svärdsudd,K, PY - 2003/9/17/pubmed PY - 2003/10/21/medline PY - 2003/9/17/entrez SP - 343 EP - 52 JF - Journal of internal medicine JO - J Intern Med VL - 254 IS - 4 N2 - OBJECTIVES: The early stages of tissue B12 or folate deficiency often cause diagnostic problems. In this report, the levels of serum cobalamin, folate, methylmalonic acid (MMA) and total homocysteine (tHcy), and their relationships with clinical findings and reported symptoms in a representative random population sample are presented. DESIGN: Cohort study. SETTING: A general central Swedish population 70 years or older. SUBJECTS AND METHODS: A 20% random sample of persons 70 years or older in a defined geographical area were invited to a survey. A total of 235 (85%) persons responded, of whom 161 had no interfering diseases or medication. Blood specimens for serum cobalamin, folate, MMA and tHcy analyses were drawn. MAIN OUTCOME MEASURES: Presence of anaemic, gastrointestinal, neurological and psychiatric symptoms, obtained by questionnaire, and vibration sense measurement and findings at a physical and Mini Mental State Examination. RESULTS: Among a large number of symptoms and clinical findings that traditionally have been linked to vitamin B12 or folate tissue deficiency, only changes in the tongue mucosa and mouth angle stomatitis turned out to be significantly associated with abnormal serum tHcy and serum folate levels. There were no relationships to serum cobalamin and serum MMA. CONCLUSIONS: Changes in the oral mucosa were the only signs and symptoms found in this study, indicating that these may be the very early markers of metabolic defects. The traditional symptoms of vitamin deficiency may appear later in the course. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/12974873/Reported_symptoms_and_clinical_findings_in_relation_to_serum_cobalamin_folate_methylmalonic_acid_and_total_homocysteine_among_elderly_Swedes:_a_population_based_study_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0954-6820&date=2003&volume=254&issue=4&spage=343 DB - PRIME DP - Unbound Medicine ER -