scholarly journals Masked vitamin B12 and folate deficiency in the elderly

1985 ◽  
Vol 54 (3) ◽  
pp. 613-619 ◽  
Author(s):  
G. M. Craig ◽  
C. Elliot ◽  
K. R. Hughes

1. A high incidence of vitamin B12 or folate deficiency, or both, may be found in the elderly, particularly those in hospital. This report concerns fifty cases detected in an inner-city-area geriatric unit during the course of routine clinical investigation. The majority had none of the classical haematological signs of vitamin B12 or folate deficiency, and all the patients reported had a mean corpuscular volume (MCV) of less than 100 fl.2. There was a significant negative correlation between the MCV and the erythrocyte folate (P< 0.01), supporting earlier published work using a low serum folate as an index of folate deficiency.3. There was no correlation between the MCV and the serum vitamin B12. Published work differs on this point.4. Serum iron, total Fe-binding capacity and percentage Fe saturation results were available in forty patients in this series. There was a significant positive correlation between the serum Fe and the MCV (P<0.01) and 34% of patients had haematological evidence of Fe deficiency. In the majority, however, there was no evidence that associated Fe deficiency had masked the haematological signs of vitamin B12 or folate deficiency.5. More attention should be paid to the problem of ‘masked’ vitamin B12 and folate deficiency in the elderly. There is a case for routine screening of the elderly for vitamin B12 and folate deficiency irrespective of the MCV.

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018007 ◽  
Author(s):  
Sajid Soofi ◽  
Gul Nawaz Khan ◽  
Kamran Sadiq ◽  
Shabina Ariff ◽  
Atif Habib ◽  
...  

ObjectiveTo determine the prevalence and possible factors associated with anaemia, and vitamin B12and folate deficiencies in women of reproductive age (WRA) in Pakistan.MethodsA secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels <12 g/dL, vitamin B12deficiency as serum vitamin B12levels of <203 pg/mL (150 pmol/L) and folate deficiency as serum folate levels <4 ng/mL (10 nmol/L).ResultsA total of 11 751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95% CI 1.04 to 1.09) P<0.00, food insecure with moderate hunger (RR 1.03; 95% CI 1.00 to 1.06) P=0.02, four or more pregnancies (RR 1.03; 95% CI 1.01 to 1.05) P<0.00, being underweight (RR 1.03; 95% CI 1.00 to 1.05) P=0.02, being overweight or obese (RR 0.95; 95% CI 0.93 to 0.97) P<0.00 and weekly intake of leafy green vegetables (RR 0.98; 95% CI 0.95 to 1.00) P=0.04. For vitamin B12deficiency, a positive association was observed with rural population (RR 0.81; 95% CI 0.66 to 1.00) P=0.04, living in Khyber Pakhtunkhwa province (RR 1.25; 95% CI 1.11 to 1.43) P<0.00 and living in Azad Jammu and Kashmir (RR 1.50; 95% CI 1.08 to 2.08) P=0.01. Folate deficiency was negatively associated with daily and weekly intake of eggs (RR 0.89; 95% CI 0.81 to 0.98) P=0.02 and (RR 0.88; 95% CI 0.78 to 0.99) P=0.03.ConclusionsIn Pakistan, anaemia, and vitamin B12and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12and folate deficiencies among Pakistani women.


1966 ◽  
Vol 8 (4) ◽  
pp. 220-225 ◽  
Author(s):  
A.A. Dawson ◽  
D. Donald
Keyword(s):  

2021 ◽  
Author(s):  
Sanmei Chen ◽  
Takanori Honda ◽  
Jun Hata ◽  
Satoko Sakata ◽  
Yoshihiko Furuta ◽  
...  

ABSTRACT Background Folate and vitamin B-12 are essential nutrients for normal cell growth and replication, but the association of serum folate and vitamin B-12 concentrations with mortality risk remains uncertain. Objective This study was performed to investigate the associations of serum folate and vitamin B-12 concentrations with mortality risk and test whether the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism modifies these associations. Methods A total of 3050 Japanese community residents aged ≥40 y were prospectively followed-up for mortality between 2002 and 2012. Cox proportional hazards models and restricted cubic splines were used to estimate HRs and 95% CIs of mortality. Results During a median follow-up period of 10.2 y, 336 participants died. Higher serum folate concentrations were associated with lower risks of all-cause mortality [multivariable-adjusted HR: 0.73; 95% CI: 0.56, 0.96 for the second tertile (8.8–12.2 nmol/L; median 10.4 nmol/L) and HR: 0.61; 95% CI: 0.46, 0.80 for the third tertile (≥12.5 nmol/L; median 15.6 nmol/L) serum folate concentrations compared with the first tertile (≤8.6 nmol/L; median 7.0 nmol/L)]. This association remained significant in all sensitivity analyses. Spline analyses showed a steady decline in all-cause mortality risk with increasing serum folate concentrations up to 20–25 nmol/L. This association persisted regardless of the MTHFR C677T genotypes. For serum vitamin B-12, the multivariable-adjusted HR of 1.32 (95% CI: 0.97, 1.79) of all-cause mortality was marginally significantly greater in the first tertile compared with the second tertile. This association was attenuated and nonsignificant after the exclusion of participants with a history of cardiovascular disease or cancer, or participants aged ≥85 y at baseline, or deaths in the first 3 y of follow-up. Conclusions Serum folate concentrations were inversely associated with the risk of all-cause mortality in Japanese adults. Serum vitamin B-12 concentrations were not consistently associated with all-cause mortality risk after accounting for reverse-causation bias.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ankita Kankaria ◽  
Mona Duggal ◽  
Parul Chawla Gupta ◽  
Limalemla Jamir ◽  
Akash Kumar ◽  
...  

Abstract Objectives To study the nutritional status and prevalence of RBC folate, Serum folate and vitamin D deficiency among adolescents. Methods A cross sectional pilot study was carried out among 96 adolescents visiting outpatient department for refraction at tertiary care hospital in North India. Anthropometric data was obtained for height in centimetres and weight in kilograms. A pretested questionnaire was used to capture quantitative data. Venous blood samples were collected where red blood cell (RBC), serum folate and serum Vitamin D concentrations were measured. Anaemia was defined as normal, mild, moderate and severe as Hb > 12gm/dl, 11–11.9 gm/dl, 8–10.9 gm/dl and < 8 gm/dl respectively. Serum folate deficiency was defined as serum folate < 7 nmol/l, and RBC folate deficiency and insufficiency were defined as RBC folate < 305 nmol/l and & < 748 nmol/l, respectively. Vitamin D deficiency, insufficiency and sufficiency was defined as 25(OH)D < 20 ng/ml, 20–29 ng/ml and ≥ 30 ng/ml respectively. Descriptive statistics and inferential statistics were used. Results Almost 46% of adolescents were malnourished (10.4% were underweight, 35.4% were overweight or obese) and mean BMI was 19.7 kg/meter2 however it did not differ significantly across gender. As compared to boys more girls were vegetarian by diet. The mean concentrations for Hb, serum folate and RBC folate were 12.7 (95% CI: 12.4, 13.0) gm/dl, 15.1 (95% CI 12.5, 17.7) nmol/L and 492.9 (95% CI 431.9, 553.9) nmol/L, respectively. Mean concentration for Hb was significantly different across gender (p – 0.0). Around 17% of adolescents were anaemic, 60% were deficient for serum folate and 79% were deficient for RBC folate. Mean serum vitamin D levels were 18 ng/dl (95% CI: 17.0, 22.3) no significant difference found across gender. A total of 62.5% were deficient and 28% were insufficient for vitamin D (ng/ml). Around 50% of the adolescents lack adequate sleep (<8 hours) and increase vitamin D levels were associated with increase sleep duration (r-0.02, p-0.02). Conclusions The nutritional status of adolescents in this study is poor and reflects a need to conduct a community-based study which can help in planning strategies to improve nutritional status during critical period of adolescence Funding Sources nil. Supporting Tables, Images and/or Graphs


2020 ◽  
Vol 111 (4) ◽  
pp. 919-926 ◽  
Author(s):  
Melissa F Young ◽  
Junjie Guo ◽  
Anne Williams ◽  
Kyly C Whitfield ◽  
Sabiha Nasrin ◽  
...  

ABSTRACT Background Vitamin B-12 and folate deficiencies in women and children have important public health implications. However, the evidence is conflicting and limited on whether the influence of inflammation on biomarker concentrations may be sufficiently and consistently influenced by inflammation to require adjustment for interpreting concentrations or estimating population prevalence of deficiencies. Objective We examined correlations between concentrations of the inflammation biomarkers C-reactive protein (CRP) and α1-acid glycoprotein (AGP) and serum vitamin B-12 and serum and RBC folate among nonpregnant women of reproductive age (WRA; 15–49 yr) and preschool children (PSC; 6–59 mo). Methods We analyzed cross-sectional data from 16 nationally representative nutrition surveys conducted in WRA (n = 32,588) and PSC (n = 8,256) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project. Spearman correlations between CRP or AGP and vitamin B-12 or folate concentrations were examined, taking into account complex survey design effects. Results Correlations between inflammation and vitamin B-12 or folate were weak, with no clear pattern of association in either WRA or PSC. Correlation coefficients between CRP and vitamin B-12 for WRA and PSC ranged from −0.25 to 0.16, and correlations between AGP and vitamin B-12 ranged between −0.07 and 0.14. Similarly, correlations between CRP and serum folate ranged from −0.13 to 0.08, and correlations between AGP and serum folate between −0.21 and 0.02. Only 3 surveys measured RBC folate, and among them, correlations for WRA ranged from −0.07 to 0.08 for CRP and −0.04 for AGP (1 country). Conclusions Based on the weak and inconsistent correlations between CRP or AGP and vitamin B-12 or folate biomarkers, there is no rationale to adjust for inflammation when estimating population prevalence of vitamin B-12 or folate deficiencies in WRA or PSC.


1978 ◽  
Vol 40 (1) ◽  
pp. 9-15 ◽  
Author(s):  
T. A. B. Sanders ◽  
F. R. Ellis ◽  
J. W. T. Dickerson

1. The concentrations of vitamin B12 and folate in the serum and folate in the erythrocytes were determined and full blood counts made on a series of caucasian vegans and omnivore controls.2. The blood counts and films were normal in all the vegans and no subject had a haemoglobin concentration below the lower limit of normality.3. Although within the normal range, male but not female vegans had lower values for erythrocyte counts and higher values for mean corpuscular volume and mean corpuscular haemoglobin than their controls regardless of whether they were taking vitamin B12 supplements or not.4. The mean serum vitamin B12 concentration was lower in the vegans not taking vitamin B12 supplements and in those using foods supplemented with the vitamin than in the controls, but in no subject was it below 80 ng/l.5. The serum folate concentrations were higher in the vegans than in their controls. The mean value for erythrocyte folate tended to be greater in the vegans not taking vitamin B12 supplements. No subject had an erythrocyte folate concentration of less than 100μg/l.6. It is concluded that megaloblastic anaemia is very rare in caucasian vegans and that a diet consisting entirely of plant foods is generally adequate to promote normal blood formation providing it is composed of a mixture of unrefined cereals, pulses, nuts, fruit and vegetables and is supplemented with vitamin B12.


2021 ◽  
pp. 160-161
Author(s):  
Dinesh Kumar ◽  
Mahesh Kumar Gupta ◽  
Sunil Gothwal ◽  
Umesh Gurjar ◽  
Kailash Kumar Meena ◽  
...  

BACKGROUND- Exact incidence of ITS is not known but it was accounted for 0.2 to 2% pediatric hospital admissions in 1962 and reduced to 0.2% currently in India. Aims of this study to estimate Vitamin B level 12 and folate in children with Infantile Tremor Syndrome METHODS- This Hospital based cross sectional observational study was conducted in, Sir Padampat Mother and Child Health Institute (SPMCHI), SMS Medical College, Jaipur. RESULTS- The mean serum B level was highest in children aged 13-18 months (117.40 pg/ml) and was lowest in children aged 12 6-12 months (67.90 pg/ml). This difference in B level in different age groups was statistically not signicant (p>0.05). The mean 12 serum folate level was highest in children aged 6-12 months (17.32 ng/ml) followed by children aged 13-18 months (15.53 ng/ml) and was lowest in children aged >18 months (13.70 ng/ml). This difference in folate level in different age groups was statistically not signicant (p>0.05). CONCLUSION- Present study ndings suggest that serum vitamin B and folate levels are decreased in children with Infantile 12 Tremor Syndrome.


1975 ◽  
Vol 33 (3) ◽  
pp. 415-424 ◽  
Author(s):  
R. C. Siddons ◽  
Fredericka Jacob

1. Measurement of the vitamin B12 content of baboon tissues showed that the liver contained the highest concentration, followed by the pituitary, kidney, heart, spleen and pancreas.2. The dietary vitamin B12 requirement of the baboon for the maintenance of satisfactory body stores was between 1 and 2 μg/d.3. Satisfactory liver vitamin B12 stores were invariably associated with serum levels above 125 pg/ml, whereas liver levels were usually low when the serum level was below 50 pg/ml.4. Increased methylmalonic acid (MMA) excretion after a valine load occurred when the liver vitamin B12 level was less than 0·40 μg/g. L- and DL-valine were approximately equally effective as precursors of MMA, whereas sodium propionate, whether given orally or intra-peritoneally, was less effective.5. The distribution of radioactivity along the wall of the intestinal tract after an oral dose of [57Co]cyanocobalamin suggested that the distal half of the small intestine was the main site of vitamin B12 absorption. However, the utilization of vitamin B12 put direct into the middle part of the small intestine was much lower than that of an oral dose.6. The unsaturated vitamin B12-binding capacity of baboon serum was not related to the serum vitamin B12 level. There was a significant difference between the unsaturated vitamin B12-binding capacities of the two subspecies of baboon (Papio cynocephalus cynocephalus and P. cynocephalus anubis) studied.


2003 ◽  
Vol 15 (2) ◽  
pp. 63-67 ◽  
Author(s):  
J. Rösche ◽  
C. Uhlmann ◽  
R. Weber ◽  
W. Fröscher

Background:Folate deficiency is common in patients with epilepsy and also occurs in patients with depression or cognitive deficits.Objective:This study investigates whether low serum folate levels may contribute to depressive mood and difficulties in mental processing in patients with epilepsy treated with anti-epileptic drugs inducing the cytochrome P450.Methods:We analysed the serum folate levels, the score in the Self Rating Depression Scale (SDS) and the results of a bedside test in mental processing in 54 patients with epilepsy.Results:There was a significant negative correlation between the serum folate levels and the score in SDS and significant positive correlations between the score in SDS and the time needed to process an interference task or a letter-reading task.Conclusions:Low serum folate levels may contribute to depressive mood and therefore to difficulties in mental processing. Further studies utilizing total plasma homocysteine as a sensitive measure of functional folate deficiency and more elaborate tests of mental processing are required to elucidate the impact of folate metabolism on depressive mood and cognitive function in patients with epilepsy.


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