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Metabolic evidence of vitamin B-12 deficiency, including high homocysteine and methylmalonic acid and low holotranscobalamin, is more pronounced in older adults with elevated plasma folate.
Am J Clin Nutr 2009; 90(6):1586-92AJ

Abstract

BACKGROUND

An analysis of data from the National Health and Nutrition Examination Survey indicated that in older adults exposed to folic acid fortification, the combination of low serum vitamin B-12 and elevated folate is associated with higher concentrations of homocysteine and methylmalonic acid and higher odds ratios for cognitive impairment and anemia than the combination of low vitamin B-12 and nonelevated folate. These findings await confirmation in other populations.

OBJECTIVE

The purpose was to compare metabolic indicators of vitamin B-12 status, cognitive function, and depressive symptoms among elderly Latinos with elevated and nonelevated plasma folate.

DESIGN

Cross-sectional data were analyzed for 1535 subjects (age: >or=60 y) from the Sacramento Area Latino Study on Aging. Subjects were divided into 4 groups on the basis of plasma vitamin B-12 (< or >or=148 pmol/L) and folate (<or= or >45.3 nmol/L). Homocysteine, methylmalonic acid, holotranscobalamin, ratio of holotranscobalamin to vitamin B-12, Modified Mini-Mental State Examination, delayed recall, and depressive symptom scores were compared between the groups.

RESULTS

Individuals with low vitamin B-12 and elevated folate (n = 22) had the highest concentrations of homocysteine and methylmalonic acid and the lowest concentration of holotranscobalamin and ratio of holotranscobalamin to vitamin B-12 when compared with all other groups (P <or= 0.003). No differences in Modified Mini-Mental State Examination, delayed recall, and depressive symptom scores were observed between the low vitamin B-12 and elevated-folate group compared with other groups.

CONCLUSIONS

Low vitamin B-12 is associated with more pronounced metabolic evidence of vitamin B-12 deficiency when folate is elevated than when folate is not elevated. These data should be considered when assessing the potential costs, risks, and benefits of folic acid and vitamin B-12 fortification programs.

Authors+Show Affiliations

School of Medicine, Department of Medical Pathology and Laboratory Medicine, University of California, Davis, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

19726595

Citation

Miller, Joshua W., et al. "Metabolic Evidence of Vitamin B-12 Deficiency, Including High Homocysteine and Methylmalonic Acid and Low Holotranscobalamin, Is More Pronounced in Older Adults With Elevated Plasma Folate." The American Journal of Clinical Nutrition, vol. 90, no. 6, 2009, pp. 1586-92.
Miller JW, Garrod MG, Allen LH, et al. Metabolic evidence of vitamin B-12 deficiency, including high homocysteine and methylmalonic acid and low holotranscobalamin, is more pronounced in older adults with elevated plasma folate. Am J Clin Nutr. 2009;90(6):1586-92.
Miller, J. W., Garrod, M. G., Allen, L. H., Haan, M. N., & Green, R. (2009). Metabolic evidence of vitamin B-12 deficiency, including high homocysteine and methylmalonic acid and low holotranscobalamin, is more pronounced in older adults with elevated plasma folate. The American Journal of Clinical Nutrition, 90(6), pp. 1586-92. doi:10.3945/ajcn.2009.27514.
Miller JW, et al. Metabolic Evidence of Vitamin B-12 Deficiency, Including High Homocysteine and Methylmalonic Acid and Low Holotranscobalamin, Is More Pronounced in Older Adults With Elevated Plasma Folate. Am J Clin Nutr. 2009;90(6):1586-92. PubMed PMID: 19726595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic evidence of vitamin B-12 deficiency, including high homocysteine and methylmalonic acid and low holotranscobalamin, is more pronounced in older adults with elevated plasma folate. AU - Miller,Joshua W, AU - Garrod,Marjorie G, AU - Allen,Lindsay H, AU - Haan,Mary N, AU - Green,Ralph, Y1 - 2009/09/02/ PY - 2009/9/4/entrez PY - 2009/9/4/pubmed PY - 2009/12/16/medline SP - 1586 EP - 92 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 90 IS - 6 N2 - BACKGROUND: An analysis of data from the National Health and Nutrition Examination Survey indicated that in older adults exposed to folic acid fortification, the combination of low serum vitamin B-12 and elevated folate is associated with higher concentrations of homocysteine and methylmalonic acid and higher odds ratios for cognitive impairment and anemia than the combination of low vitamin B-12 and nonelevated folate. These findings await confirmation in other populations. OBJECTIVE: The purpose was to compare metabolic indicators of vitamin B-12 status, cognitive function, and depressive symptoms among elderly Latinos with elevated and nonelevated plasma folate. DESIGN: Cross-sectional data were analyzed for 1535 subjects (age: >or=60 y) from the Sacramento Area Latino Study on Aging. Subjects were divided into 4 groups on the basis of plasma vitamin B-12 (< or >or=148 pmol/L) and folate (<or= or >45.3 nmol/L). Homocysteine, methylmalonic acid, holotranscobalamin, ratio of holotranscobalamin to vitamin B-12, Modified Mini-Mental State Examination, delayed recall, and depressive symptom scores were compared between the groups. RESULTS: Individuals with low vitamin B-12 and elevated folate (n = 22) had the highest concentrations of homocysteine and methylmalonic acid and the lowest concentration of holotranscobalamin and ratio of holotranscobalamin to vitamin B-12 when compared with all other groups (P <or= 0.003). No differences in Modified Mini-Mental State Examination, delayed recall, and depressive symptom scores were observed between the low vitamin B-12 and elevated-folate group compared with other groups. CONCLUSIONS: Low vitamin B-12 is associated with more pronounced metabolic evidence of vitamin B-12 deficiency when folate is elevated than when folate is not elevated. These data should be considered when assessing the potential costs, risks, and benefits of folic acid and vitamin B-12 fortification programs. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19726595/Metabolic_evidence_of_vitamin_B_12_deficiency_including_high_homocysteine_and_methylmalonic_acid_and_low_holotranscobalamin_is_more_pronounced_in_older_adults_with_elevated_plasma_folate_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2009.27514 DB - PRIME DP - Unbound Medicine ER -