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Studies on Vitamin B12 and Folate Deficiency Markers in the Elderly: A Population-based Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of this study were to document the levels of cobalamin, folate, methylmalonic acid (MMA) and total homocysteine (tHcy) in serum and their relations to symptoms, clinical findings, and other factors in order to improve the possibilities of detecting early deficiency of vitamin B12 or folate, and to study the effects of cobalamin and folic acid treatment over a three-year period.

The study population consisted of a 20% random sample of persons 70 years or older living in Älvkarleby in mid-Sweden. They were invited to a survey and 224 (88.4%) persons responded. Data were obtained by questionnaire, laboratory investigations and physical examination for the period 1993 – 1999.

In a multivariate analysis performed at baseline, serum MMA and tHcy were significantly and independently correlated to age, serum cobalamin, and creatinine levels, and tHcy also to sex and serum folate. Neither serum cobalamin, folate, MMA nor tHcy had any significant correlation to haemoglobin or mean red cell volume. Almost half of the study population had signs of low tissue levels of vitamin B12 or folate. Among those who took multivitamin preparations, the proportion was much lower, 25%.

Among traditional symptoms and clinical findings that have been linked to vitamin B12 or folate tissue deficiency, only changes in the tongue mucosa and mouth angle stomatitis were significantly associated with abnormal serum folate and tHcy levels. Traditional symptoms of vitamin deficiency may appear later in the course.

69 persons who had laboratory indications of early or overt tissue deficiency of vitamin B12 or folate and who had no ongoing vitamin treatment were given cobalamin for six months. Those whose MMA or tHcy levels did not normalise were given folic acid in addition to cobalamin. After further treatment for three months, all persons but one had normal levels. The laboratory effect still remained after three years of treatment. There was a tendency towards improvement of vibration sense, especially in the long nerve paths, and improvement of neurological symptoms and oral mucosa findings.

Conclusion: A substantial proportion of elderly persons have laboratory signs of incipient tissue deficiency of vitamin B12 and folate. Treatment normalises lab parameters and some symptoms.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2003. , p. 45
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1242
Keywords [en]
Medicine, Cobalamin, folate, MMA, tHcy, multivitamin, symptoms, survey, treatment trial
Keywords [sv]
Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Family Medicine
Identifiers
URN: urn:nbn:se:uu:diva-3364ISBN: 91-554-5581-6 (print)OAI: oai:DiVA.org:uu-3364DiVA, id: diva2:162503
Public defence
2003-05-09, Rudbeckssalen, Rudbeckslaboraroriet, Uppsala, 13:15
Opponent
Supervisors
Available from: 2003-04-11 Created: 2003-04-11 Last updated: 2011-05-13Bibliographically approved
List of papers
1. Serum cobalamin, folate, methylmalonic acid and total homocysteine as vitamin B12 and folate tissue deficiency markers amongst elderly Swedes - a population-based study
Open this publication in new window or tab >>Serum cobalamin, folate, methylmalonic acid and total homocysteine as vitamin B12 and folate tissue deficiency markers amongst elderly Swedes - a population-based study
2001 In: J Int Med, Vol. 249, p. 423-432Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-90216 (URN)
Available from: 2003-04-11 Created: 2003-04-11Bibliographically approved
2. Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: A population-based study
Open this publication in new window or tab >>Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: A population-based study
In: J Int MedArticle in journal (Refereed) Submitted
Identifiers
urn:nbn:se:uu:diva-90217 (URN)
Available from: 2003-04-11 Created: 2003-04-11Bibliographically approved
3. Elevated serum levels of methylmalonic acid and homocysteine in elderly people: A population-based intervention study
Open this publication in new window or tab >>Elevated serum levels of methylmalonic acid and homocysteine in elderly people: A population-based intervention study
1999 In: J Int Med, Vol. 246, p. 603-611Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-90218 (URN)
Available from: 2003-04-11 Created: 2003-04-11Bibliographically approved
4. A population-based intervention study on elevated serum levels of methylmalonic acid and homocysteine in elderly people: Results after 36 months of follow-up
Open this publication in new window or tab >>A population-based intervention study on elevated serum levels of methylmalonic acid and homocysteine in elderly people: Results after 36 months of follow-up
In: J Int MedArticle in journal (Refereed) Submitted
Identifiers
urn:nbn:se:uu:diva-90219 (URN)
Available from: 2003-04-11 Created: 2003-04-11Bibliographically approved

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