B12 Deficiency Increases With Age in Hospitalized Patients: A Study on 14,904 Samples

Mézière, Anthony; Audureau, Étienne; Vairelles, Stéphane; Krypciak, Sébastien; Dicko, Michèle; Monié, Marguerite; Giraudier, Stéphane

doi:10.1093/gerona/glu109

Cited by 23 publications

(13 citation statements)

References 29 publications

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“…Further, a significant positive correlation was detected between serum B 12 levels and age. This contrasts with reports of no association or inverse associations between B12 levels and age in other populations [9,11,12], or no change. On the other hand, age did not emerge as a significant predictor of serum vitamin B 12 levels after controlling for age and land of birth.…”

Section: Discussioncontrasting

confidence: 97%

Serum Vitamin B12 Levels in Two Subpopulations of Healthy Workers in Israel: Differences by Land of Birth

Boaz¹,

Raz²

2015

J Nutr Disorders Ther

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Background In humans, vitamin B 12 participates in two particularly important metabolic reactions. The methyl-cobalamin form of vitamin B 12 serves as the cofactor of cytoplasmic methionine synthase, which catalyzes ultimately yields methionine [1]. It is thus not surprising that vitamin B 12 deficiency is associated with elevated plasma homocysteine [2]. Coenzyme B 12 (adenosyl-cobalamin) also serves as the cofactor of mitochondrial methylmalonyl-CoA, which is transformed to succinyl-CoA [3]. Micronucleus formation, an indicator of genetic instability, has been shown to be reduced when plasma vitamin B12 is > 300 pmol/L [4]. Vitamin B 12 deficiency is typically defined as serum cobalamin levels < 148 pmol/L however, levels consistent with subclinical deficiency have not been defined [5]. Using this cutoff , however, variability in vitamin B 12 deficiency rates has been reported. Predictably, clinical and subclinical deficiency rates are lower in western populations and higher in developing populations. Deficiency is exacerbated by vegetarianism. In India, for example, which is both developing and includes a large vegetarian population, 70% of adults and 80% of preschool children are estimated to be deficient [6]. Use of this cutoff remains controversial, and would likely misclassify up to 50% of cases [3]. For this reason, a cutoff of 258 pmol/L has been proposed, particularly for use in older populations [7]. Variability in population levels and lack of clarity in defining deficiency are the basis for the present study, in which serum vitamin B 12 levels were studied in a convenience sample of health care workers undergoing routine blood chemistry analysis in Israel. Using the actual serum cobalamin level and a variety of cutoffs , vitamin B 12 levels were compared between health care workers born in Israel and those who immigrated to the country.

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Section: Discussioncontrasting

confidence: 97%

Serum Vitamin B12 Levels in Two Subpopulations of Healthy Workers in Israel: Differences by Land of Birth

Boaz¹,

Raz²

2015

J Nutr Disorders Ther

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“…We hypothesized the reasons for these correlations were high alcohol intake, low FA intake, and microsatellite instability. Korean men showed higher rates of alcohol consumption than women 32 , FA deficiency increased with age 33 , and FA intake showed stronger associations with decreased risk for the cancer of the rectum than of the colon 34 . HTN may be prevented by FA fortification 35 , and increased prevalence of tumors ≥5 cm were associated with MSI 36 .…”

Section: Discussionmentioning

confidence: 93%

Genetic variants in 3′-UTRs of methylenetetrahydrofolate reductase (MTHFR) predict colorectal cancer susceptibility in Koreans

Jeon

Kim

Park

et al. 2015

Sci Rep

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Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) play important roles in tumor development, progression, and metastasis. Moreover, recent studies have reported that a number of 3′-UTR polymorphisms potentially bind to specific microRNAs in a variety of cancers. The aim of this study was to investigate the association of four MTHFR polymorphisms, 2572C>A [rs4846049], 4869C>G [rs1537514], 5488C>T [rs3737967], and 6685T>C [rs4846048] with colorectal cancer (CRC) in Koreans. A total of 850 participants (450 CRC patients and 400 controls) were enrolled in the study. The genotyping of MTHFR 3′-UTR polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism analysis or TaqMan allelic discrimination assay. We found that MTHFR 2572C>A, 4869C>G, and 5488C>T genotypes were substantially associated with CRC susceptibility. Of the potentially susceptible polymorphisms, MTHFR 2572C>A was associated with increased homocysteine and decreased folate levels in the plasma based on MTHFR 677CC. Our study provides the evidences for 3′-UTR variants in MTHFR gene as potential biomarkers for use in CRC prevention.

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“…Vitamin B12 deficiency later in life is estimated to affect 10 % of people over the age of 60 [ 11 , 12 ]. Recent metaanalytic surveys [ 13 , 14 ] confirmed the finding of vitamin B12-, and folate- deficiencies in elderly patients [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Vitamin B12 and folate levels in healthy Swiss senior citizens: a prospective study evaluating reference intervals and decision limits

et al. 2015

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BackgroundThe vitamin B12 and folate status in nonanaemic healthy older persons needs attention the more so as decrease in levels may be anticipated from reduced haematinic provision and/or impaired intestinal uptake.MethodsA total of 1143 subjectively healthy Swiss midlands participants (637 females and 506 males), ≥60 years of age were included in this study. Levels of vitamin B12, holotranscobalamin (holoTC), methylmalonic acid (MMA), homocysteine (Hcy), serum folate, red blood cell (RBC) folate were measured. Further, Fedosov’s wellness score was determined. Associations of age, gender, and cystatin C/creatinine-based estimated kidney function, with the investigated parameters were assessed. Reference intervals were calculated. Further, ROC analysis was done to assess accuracy of the individual parameters in recognizing a deficient vitamin B12 status. Finally, decision limits for sensitive, specific and optimal recognition of vitamin B12 status with individual parameters were derived.ResultsThree age groups: 60–69, 70–79 and ≥ 80 had median B12 (pmol/L) levels of 237, 228 and 231 respectively (p = 0.22), holoTC (pmol/L) of 52, 546 and 52 (p = 0.60) but Hcy (μmol/L) 12, 15 and 16 (p < 0.001), MMA (nmol/L) 207, 221 and 244 (p < 0.001). Hcy and MMA (both p < 0.001), but not holoTC (p = 0.12) and vitamin B12 (p = 0.44) were found to be affected by kidney function. In a linear regression model Fedosov’s wellness score was independently associated with kidney function (p < 0.001) but not with age. Total serum folate and red blood cell (RBC) folate drift apart with increasing age: whereas the former decreases (p = 0.01) RBC folate remains in the same bandwidth across all age groups (p = 0.12) A common reference interval combining age and gender strata can be obtained for vitamin B12 and holoTC, whereas a more differentiated approach seems warranted for serum folate and RBC folate.ConclusionWhereas the vitamin B12 and holoTC levels remain steady after 60 years of age, we observed a significant increment in MMA levels accompanied by increments in Hcy; this is better explained by age-related reduced kidney function than by vitamin B12 insufficiency. Total serum folate levels but not RBC folate levels decreased with progressing age.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0060-x) contains supplementary material, which is available to authorized users.

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B12 Deficiency Increases With Age in Hospitalized Patients: A Study on 14,904 Samples

Abstract: In inpatients, functional B12 deficiency and functional folate deficiency increase with age and are not associated with anemia or macrocytosis. False vitamin B deficiencies are frequent.

Cited by 23 publications

References 29 publications

Serum Vitamin B12 Levels in Two Subpopulations of Healthy Workers in Israel: Differences by Land of Birth

Serum Vitamin B12 Levels in Two Subpopulations of Healthy Workers in Israel: Differences by Land of Birth

Genetic variants in 3′-UTRs of methylenetetrahydrofolate reductase (MTHFR) predict colorectal cancer susceptibility in Koreans

Vitamin B12 and folate levels in healthy Swiss senior citizens: a prospective study evaluating reference intervals and decision limits

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