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Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial.
Eur J Clin Nutr. 2003 Nov; 57(11):1426-36.EJ

Abstract

OBJECTIVES

To investigate, in an elderly population: (1) the effects of oral B-vitamin therapy on P-tHcys, S-MMA and Hb/MCV, (2) the appropriate decision limit for 'high' metabolite concentrations and (3) the estimated prevalence of vitamin B(12)/folate deficiency on the basis of different decision limits.

DESIGN

Double-blind placebo-controlled intervention study.

SETTING

Outpatient clinic.

SUBJECTS

A total of 209 community-dwelling subjects, median age 76 y (range 70-93) y.

INTERVENTION

Four months of oral daily supplementation with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B(6).

RESULTS

High P- tHcys was found in 64% of men and 45% of women, high S-MMA in 11% of both. Vitamin B(12) deficiency was observed in 7.2% and folate deficiency in 11% of all subjects. Health-related upper reference limits for the metabolites at the start were higher than the laboratory's upper reference limits. The latter were, however, similar to those of the vitamin replete group. There was a significant decrease in P-tHcys (P<0.001) and S-MMA (P=0.009) after 4 months of vitamin treatment. In a multivariate analysis, the P-Hcys change correlated positively with baseline P-tHcys and inversely with baseline P-folate and transferrin saturation (Fe/TIBC ratio). The S-MMA change correlated with baseline S-MMA and inversely with baseline vitamin B(12) and age.

CONCLUSIONS

Suboptimal vitamin status is an important cause of elevated P-tHcys and S-MMA in apparently healthy elderly subjects. Oral B-vitamin therapy is an effective and convenient way to normalise P-tHcys and S-MMA.

Authors+Show Affiliations

Lewerin C
Department of Haematology and Coagulation, Göteborg University, Göteborg, Sweden.
Nilsson-Ehle H
No affiliation info available
Matousek M
No affiliation info available
Lindstedt G
No affiliation info available
Steen B
No affiliation info available

MeSH

AgedAged, 80 and overDouble-Blind MethodFemaleFolic AcidFolic Acid DeficiencyHomocysteineHumansMaleMethylmalonic AcidReference ValuesVitamin B 12Vitamin B 12 DeficiencyVitamin B 6

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14576756

Citation

Lewerin, C, et al. "Reduction of Plasma Homocysteine and Serum Methylmalonate Concentrations in Apparently Healthy Elderly Subjects After Treatment With Folic Acid, Vitamin B12 and Vitamin B6: a Randomised Trial." European Journal of Clinical Nutrition, vol. 57, no. 11, 2003, pp. 1426-36.
Lewerin C, Nilsson-Ehle H, Matousek M, et al. Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial. Eur J Clin Nutr. 2003;57(11):1426-36.
Lewerin, C., Nilsson-Ehle, H., Matousek, M., Lindstedt, G., & Steen, B. (2003). Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial. European Journal of Clinical Nutrition, 57(11), 1426-36.
Lewerin C, et al. Reduction of Plasma Homocysteine and Serum Methylmalonate Concentrations in Apparently Healthy Elderly Subjects After Treatment With Folic Acid, Vitamin B12 and Vitamin B6: a Randomised Trial. Eur J Clin Nutr. 2003;57(11):1426-36. PubMed PMID: 14576756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial. AU - Lewerin,C, AU - Nilsson-Ehle,H, AU - Matousek,M, AU - Lindstedt,G, AU - Steen,B, PY - 2003/10/25/pubmed PY - 2004/3/12/medline PY - 2003/10/25/entrez SP - 1426 EP - 36 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 57 IS - 11 N2 - OBJECTIVES: To investigate, in an elderly population: (1) the effects of oral B-vitamin therapy on P-tHcys, S-MMA and Hb/MCV, (2) the appropriate decision limit for 'high' metabolite concentrations and (3) the estimated prevalence of vitamin B(12)/folate deficiency on the basis of different decision limits. DESIGN: Double-blind placebo-controlled intervention study. SETTING: Outpatient clinic. SUBJECTS: A total of 209 community-dwelling subjects, median age 76 y (range 70-93) y. INTERVENTION: Four months of oral daily supplementation with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B(6). RESULTS: High P- tHcys was found in 64% of men and 45% of women, high S-MMA in 11% of both. Vitamin B(12) deficiency was observed in 7.2% and folate deficiency in 11% of all subjects. Health-related upper reference limits for the metabolites at the start were higher than the laboratory's upper reference limits. The latter were, however, similar to those of the vitamin replete group. There was a significant decrease in P-tHcys (P<0.001) and S-MMA (P=0.009) after 4 months of vitamin treatment. In a multivariate analysis, the P-Hcys change correlated positively with baseline P-tHcys and inversely with baseline P-folate and transferrin saturation (Fe/TIBC ratio). The S-MMA change correlated with baseline S-MMA and inversely with baseline vitamin B(12) and age. CONCLUSIONS: Suboptimal vitamin status is an important cause of elevated P-tHcys and S-MMA in apparently healthy elderly subjects. Oral B-vitamin therapy is an effective and convenient way to normalise P-tHcys and S-MMA. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/14576756/Reduction_of_plasma_homocysteine_and_serum_methylmalonate_concentrations_in_apparently_healthy_elderly_subjects_after_treatment_with_folic_acid_vitamin_B12_and_vitamin_B6:_a_randomised_trial_ DB - PRIME DP - Unbound Medicine ER -