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Cobalamin absorption and serum homocysteine and methylmalonic acid in elderly subjects with low serum cobalamin.
Eur J Haematol. 1993 Jul; 51(1):25-30.EJ

Abstract

We prospectively studied 41 consecutive elderly patients with serum cobalamin (vitamin B12) levels lower than 125 pmol/l. The protein-bound cobalamin absorption test (PBAT) was performed in 34 of them and in 27 selected elderly control patients. The lower decision limit was 0.18% and an abnormal test was detected in only 9 (26%) of the 34 patients with low serum cobalamin level. When the PBAT was compared to the Schilling (Dicopac method) test, a concordant result was found in 80%. Serum methylmalonic acid and/or total homocysteine concentrations were elevated in 75% (26/35) of the patients with low serum cobalamin levels but also in 30% (5/17) of the control patients. Of the 12 and 9 cobalamin-deficient patients with elevated serum levels of methylmalonic acid and homocysteine, normalization after cobalamin therapy was obtained in 11 and 5 respectively. In conclusion, determination of serum metabolites and their response to cobalamin therapy are a sensitive index of significant cobalamin deficiency and a useful means of distinguishing between cobalamin and folate deficiency. The PBAT offers little advantage over the Schilling test in diagnosing cobalamin malabsorption in elderly patients.

Authors+Show Affiliations

Department of Internal Medicine, University Hospitals K.U. Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

8348941

Citation

Joosten, E, et al. "Cobalamin Absorption and Serum Homocysteine and Methylmalonic Acid in Elderly Subjects With Low Serum Cobalamin." European Journal of Haematology, vol. 51, no. 1, 1993, pp. 25-30.
Joosten E, Pelemans W, Devos P, et al. Cobalamin absorption and serum homocysteine and methylmalonic acid in elderly subjects with low serum cobalamin. Eur J Haematol. 1993;51(1):25-30.
Joosten, E., Pelemans, W., Devos, P., Lesaffre, E., Goossens, W., Criel, A., & Verhaeghe, R. (1993). Cobalamin absorption and serum homocysteine and methylmalonic acid in elderly subjects with low serum cobalamin. European Journal of Haematology, 51(1), 25-30.
Joosten E, et al. Cobalamin Absorption and Serum Homocysteine and Methylmalonic Acid in Elderly Subjects With Low Serum Cobalamin. Eur J Haematol. 1993;51(1):25-30. PubMed PMID: 8348941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cobalamin absorption and serum homocysteine and methylmalonic acid in elderly subjects with low serum cobalamin. AU - Joosten,E, AU - Pelemans,W, AU - Devos,P, AU - Lesaffre,E, AU - Goossens,W, AU - Criel,A, AU - Verhaeghe,R, PY - 1993/7/1/pubmed PY - 1993/7/1/medline PY - 1993/7/1/entrez SP - 25 EP - 30 JF - European journal of haematology JO - Eur J Haematol VL - 51 IS - 1 N2 - We prospectively studied 41 consecutive elderly patients with serum cobalamin (vitamin B12) levels lower than 125 pmol/l. The protein-bound cobalamin absorption test (PBAT) was performed in 34 of them and in 27 selected elderly control patients. The lower decision limit was 0.18% and an abnormal test was detected in only 9 (26%) of the 34 patients with low serum cobalamin level. When the PBAT was compared to the Schilling (Dicopac method) test, a concordant result was found in 80%. Serum methylmalonic acid and/or total homocysteine concentrations were elevated in 75% (26/35) of the patients with low serum cobalamin levels but also in 30% (5/17) of the control patients. Of the 12 and 9 cobalamin-deficient patients with elevated serum levels of methylmalonic acid and homocysteine, normalization after cobalamin therapy was obtained in 11 and 5 respectively. In conclusion, determination of serum metabolites and their response to cobalamin therapy are a sensitive index of significant cobalamin deficiency and a useful means of distinguishing between cobalamin and folate deficiency. The PBAT offers little advantage over the Schilling test in diagnosing cobalamin malabsorption in elderly patients. SN - 0902-4441 UR - https://www.unboundmedicine.com/medline/citation/8348941/Cobalamin_absorption_and_serum_homocysteine_and_methylmalonic_acid_in_elderly_subjects_with_low_serum_cobalamin_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0902-4441&date=1993&volume=51&issue=1&spage=25 DB - PRIME DP - Unbound Medicine ER -