Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects - PubMed (original) (raw)
Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects
D Z van Asselt et al. Am J Clin Nutr. 1998 Aug.
Abstract
Background: The reason for the high prevalence of mild cobalamin (vitamin B-12) deficiency in the elderly is poorly understood.
Objective: We aimed to determine the reason for this high prevalence.
Design: We examined cobalamin intake, the presence and severity of atrophic gastritis, the presence of Helicobacter pylori infection, and plasma cobalamin and methylmalonic acid (MMA) concentrations in 105 healthy, free-living, older subjects aged 74-80 y.
Results: Mild cobalamin deficiency, ie, low to low-normal plasma cobalamin concentrations (< 260 pmol/L) and elevated plasma MMA concentrations (> 0.32 micromol/L), were found in 23.8% of subjects; 25.7% of subjects were not cobalamin deficient (plasma cobalamin > or = 260 pmol/L and plasma MMA < or = 0.32 micromol/L). Six subjects (5.8%), including 1 with mild cobalamin deficiency, had dietary cobalamin intakes below the Dutch recommended dietary intake of 2.5 microg/d. Mildly cobalamin-deficient subjects had lower total (diet plus supplements) cobalamin intakes (median: 4.9 microg/d; 25th and 75th percentiles: 3.9, 6.4) than did non-cobalamin-deficient subjects (median: 6.3 microg/d; 25th and 75th percentiles: 5.4, 7.9) (P = 0.0336), mainly because of less frequent use of cobalamin supplements (8% compared with 29.6%; chi2 = 3.9, P = 0.048). Atrophic gastritis was found in 32.4% of the total study group: mild to moderate in 19.6% and severe in 12.7%. The prevalence of severe atrophic gastritis, but not mild-to-moderate atrophic gastritis, was higher in mildly cobalamin-deficient subjects (25%) than in non-cobalamin-deficient subjects (3.7%) (chi2 = 4.6, P = 0.032). The prevalence of immunoglobulin G antibodies to H. pylori was similar in mildly cobalamin-deficient subjects (54.2%) and in non-cobalamin-deficient subjects (44.4%) (chi2 = 0.5, P = 0.5).
Conclusions: The high prevalence of mild cobalamin deficiency in healthy, free-living, older Dutch subjects could be explained by inadequate cobalamin intake or severe atrophic gastritis in only 28% of the study population. Other mechanisms explaining mild cobalamin deficiency in older people must be sought.
Comment in
- Mild cobalamin deficiency in older Dutch subjects.
Russell RM. Russell RM. Am J Clin Nutr. 1998 Aug;68(2):222-3. doi: 10.1093/ajcn/68.2.222. Am J Clin Nutr. 1998. PMID: 9701175 No abstract available. - Mild cobalamin deficiency in older Dutch subjects.
Carmel R. Carmel R. Am J Clin Nutr. 1999 Apr;69(4):738-9. doi: 10.1093/ajcn/69.4.738. Am J Clin Nutr. 1999. PMID: 10197577 No abstract available.
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