Vitamin B12 deficiency in African American and white octogenarians and centenarians in Georgia

Abstract

Objective-Test the hypotheses that vitamin B12 deficiency would be prevalent in octogenarians and centenarians and associated with age, gender, race/ethnicity, living arrangements (community or skilled nursing facility), animal food intake, B-vitamin supplement use, atrophic gastritis, folate status, and hematological indicators.Design-Population-based multi-ethnic sample of adults aged 80 to 89 and 98 and above. Setting-Northern Georgia in the United States.Participants-Men and women aged 80 to 89 (octogenarians, n = 80) and 98 and older (centenarians, n = 231).Measurements-Wilcoxon signed-rank tests, Fisher's exact tests, and logistic regression analysis was used to examine the associations of vitamin B12 status with the variables of interest.Results-After excluding participants receiving vitamin B12 injections (n = 17), the prevalence of vitamin B12 deficiency was higher in centenarians than in octogenarians (35.3% vs. 22.8%, p < 0.05, defined as plasma vitamin B12 < 258 pmol/L and serum methylmalonic acid > 271 nmol/L and methylmalonic acid > serum 2-methylcitrate) and in both age groups was correlated with significantly higher homocysteine (p < 0.05) and lower plasma and red cell folate (p < 0.01), but was not related to hemoglobin, anemia, mean cell volume, or macrocytosis. In logistic regression analysis, the probability of being vitamin B12-deficient was significantly increased by being a centenarian vs. Two of the authors (SPS and RHA) and the University of Colorado hold patents on the use of assays for total homocysteine and other metabolites to diagnose vitamin B12 and folate deficiencies, and a company has been formed at the University of Colorado to perform such assays.

Prevalence and predictors of subclinical micronutrient deficiency in German older adults: Results from the population-based KORA-Age study

“…Direct comparison of our findings with other studies is hampered by the lack of international consensus as to which nutritional biomarker (biochemical and/or functional), which assay methodology, and which cut off point should be used to define a subclinical micronutrient deficiency in older adults [23,37]. Nevertheless, our population-based data is in line with previous studies that have suggested that subclinical vitamin D and B 12 deficiencies are prevalent public health problems among older adults [12,15,[38][39][40][41][42].…”

Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery

“…Iron and transferrin saturation showed predicted relationships (17). Similarly, vitamin B12 levels were associated with ethnicity and insulin resistance (likely secondary to use of metformin) (18)(19)(20).…”

Monitoring of vitamin B-12 nutritional status in the United States by using plasma methylmalonic acid and serum vitamin B-12

“…We reviewed serum vitamin B-12 concentrations to determine the sufficiency using cutoff values of ,148 pmol/L (21-24), 200 pmol/L (25)(26)(27), and 258 pmol/L (7,28,29). We also used vitamin B-12 status based on the cutoffs that Stabler et al (30) originally proposed and that we modified for this analysis.…”

“…For this analysis, we added an additional cutoff of .296 pmol/L (.400 pg/mL) to the original Stabler et al criteria (30). We classified elevated MMA using 2 concentrations: .376 nmol/L (31)(32)(33)(34)(35) and .271 nmol/L (24,28,32,(36)(37)(38)(39). We also examined 4 categories of MMA based on the above cutoffs (.376 and .271 nmol/L) and .210 nmol/L (14,23,40,41).…”