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Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly: Implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy.
Scand J Gastroenterol 2008; 43(9):1050-6SJ

Abstract

OBJECTIVES

To investigate the prevalence of serological markers for chronic atrophic gastritis (AG) and Helicobacter pylori antibodies (HPAb) in an elderly population, and to examine the interrelationship and significance for cobalamin, folic acid and iron status and response to oral vitamin therapy.

MATERIAL AND METHODS

The study included community-dwelling subjects (n=209), mean age 76 years, randomized to 4 month of oral daily treatment with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B(6) or placebo (double-blind). Biochemical tests were carried out before and after treatment.

RESULTS

AG, as indicated by a pepsinogen I/II ratio <2.9, occurred in 14% (26/190) and HPAb in 54% (102/190) of the subjects. AG subjects had higher levels of serum methylmalonic acid (MMA) (p<0.001), plasma homocysteine (tHcy) (p<0.05), lower haemoglobin (Hb) (p<0.01) and a higher prevalence of vitamin B(12) deficiency (p<0.01). HPAb was associated with AG, whereas AG subjects without HPAb had higher tHcy and MMA levels. There was no correlation between AG and iron status. Oral vitamin treatment led to greater (albeit non-significant) improvements in MMA, tHcy and total cobalamins in AG subjects compared to non-AG subjects.

CONCLUSIONS

AG is a common condition and is a significant determinant of vitamin B(12) status. AG is correlated to HPAB and lower Hb. Elderly AG subjects respond at least as well as non-AG subjects to oral treatment with B-vitamins in the doses employed.

Authors+Show Affiliations

Departments of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18609169

Citation

Lewerin, Catharina, et al. "Serum Biomarkers for Atrophic Gastritis and Antibodies Against Helicobacter Pylori in the Elderly: Implications for Vitamin B12, Folic Acid and Iron Status and Response to Oral Vitamin Therapy." Scandinavian Journal of Gastroenterology, vol. 43, no. 9, 2008, pp. 1050-6.
Lewerin C, Jacobsson S, Lindstedt G, et al. Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly: Implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy. Scand J Gastroenterol. 2008;43(9):1050-6.
Lewerin, C., Jacobsson, S., Lindstedt, G., & Nilsson-Ehle, H. (2008). Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly: Implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy. Scandinavian Journal of Gastroenterology, 43(9), pp. 1050-6. doi:10.1080/00365520802078341.
Lewerin C, et al. Serum Biomarkers for Atrophic Gastritis and Antibodies Against Helicobacter Pylori in the Elderly: Implications for Vitamin B12, Folic Acid and Iron Status and Response to Oral Vitamin Therapy. Scand J Gastroenterol. 2008;43(9):1050-6. PubMed PMID: 18609169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly: Implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy. AU - Lewerin,Catharina, AU - Jacobsson,Stefan, AU - Lindstedt,Goran, AU - Nilsson-Ehle,Herman, PY - 2008/7/9/pubmed PY - 2008/10/22/medline PY - 2008/7/9/entrez SP - 1050 EP - 6 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 43 IS - 9 N2 - OBJECTIVES: To investigate the prevalence of serological markers for chronic atrophic gastritis (AG) and Helicobacter pylori antibodies (HPAb) in an elderly population, and to examine the interrelationship and significance for cobalamin, folic acid and iron status and response to oral vitamin therapy. MATERIAL AND METHODS: The study included community-dwelling subjects (n=209), mean age 76 years, randomized to 4 month of oral daily treatment with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B(6) or placebo (double-blind). Biochemical tests were carried out before and after treatment. RESULTS: AG, as indicated by a pepsinogen I/II ratio <2.9, occurred in 14% (26/190) and HPAb in 54% (102/190) of the subjects. AG subjects had higher levels of serum methylmalonic acid (MMA) (p<0.001), plasma homocysteine (tHcy) (p<0.05), lower haemoglobin (Hb) (p<0.01) and a higher prevalence of vitamin B(12) deficiency (p<0.01). HPAb was associated with AG, whereas AG subjects without HPAb had higher tHcy and MMA levels. There was no correlation between AG and iron status. Oral vitamin treatment led to greater (albeit non-significant) improvements in MMA, tHcy and total cobalamins in AG subjects compared to non-AG subjects. CONCLUSIONS: AG is a common condition and is a significant determinant of vitamin B(12) status. AG is correlated to HPAB and lower Hb. Elderly AG subjects respond at least as well as non-AG subjects to oral treatment with B-vitamins in the doses employed. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/18609169/Serum_biomarkers_for_atrophic_gastritis_and_antibodies_against_Helicobacter_pylori_in_the_elderly:_Implications_for_vitamin_B12_folic_acid_and_iron_status_and_response_to_oral_vitamin_therapy_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520802078341 DB - PRIME DP - Unbound Medicine ER -