Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults (original) (raw)
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The Journal of nutrition, 2003
The prevalence of vitamin B-12 deficiency increases with age, probably resulting from malabsorption of food-bound B-12 secondary to gastric atrophy. On the basis of this assumption, the Institute of Medicine (IOM) recommends those aged >50 y consume crystalline vitamin B-12. There is limited information on the prevalence of gastric atrophy in the elderly and whether the IOM recommendation would be effective. The objective of this study was to assess predictors of vitamin B-12 status and their interactions in free-living elderly. Individuals (n = 57) with deficient plasma vitamin B-12 (p-B12 < 148 pmol/L) were compared with 68 individuals with marginal p-B12 (148-221 pmol/L) and 52 with normal p-B12 (>221 pmol/L) in a cross-sectional sample (n = 1546) of elderly (>60 y) Latinos in California. Associations were examined among p-B12 and serum gastrin, vitamin B-12 intake from food and crystalline sources, and medications that putatively affect vitamin B-12 absorption. Serum...
Levels of vitamin B12 in colombian patients with chronic atrophic gastritis
Revista …, 2010
We present a group of 75 Colombian adults who were diagnosed with chronic atrophic gastritis in accordance with the Sydney criteria. 28% of the group had vitamin B12 deficiencies: 9% were diagnosed with Pernicious anemia. Hemoglobin and mean corpuscular volume were not correlated with vitamin B12 deficiency. We found no statistical association of vitamin B12 deficiency with gender, patients over 60 years of age, or the presence of Helicobacter pylori (H. pylori). The average age of patients with vitamin B12 deficiency or pernicious anemia is less than that traditionally reported for these diseases
Journal of Clinical Epidemiology, 2004
Objective: Acid-suppressant drugs are commonly prescribed for elderly patients, a population in which vitamin B 12 deficiency is a common disorder. The purpose of this study was to examine the possible association between use of prescription histamine H-2 receptor antagonists (H2RA) or proton pump inhibitors (PPI) and vitamin B 12 deficiency in older adults. Study Design and Setting: This was a case-control study in a University-based geriatric primary care setting. Among patients aged 65 years or older with documented serum vitamin B 12 studies between 1990 and 1997, 53 vitamin B 12-deficient cases were compared with 212 controls for past or current use of prescription H2RA/PPI according to information in subjects' medical records. Results: Controlling for age, gender, multivitamin use, and Helicobacter pylori infection, chronic (у12 months) current use of H2RA/ PPI was associated with a significantly increased risk of vitamin B 12 deficiency (OR 4.45; 95% CI 1.47-13.34). No association was found between past or short-term current use of H2RA/PPI and vitamin B 12 deficiency. Conclusion: These findings support an association between chronic use of H2RA/PPI by older adults and development of vitamin B 12 deficiency. Additional studies are needed to confirm these findings.
Assessment of vitamin B12 tissue stores in elderly proton pump inhibitor users
Cogent Medicine
Background: Adults over the age of 65 years are more prone to gastroesophageal reflux and, as such, are commonly prescribed proton pump inhibitors (PPIs). PPIs inhibit gastric acid secretion which can have adverse effects on vitamin B 12 absorption. This quasi-experimental study was conducted to determine whether chronic use (≥1 year) of proton pump inhibitors (PPIs) results in decreased vitamin B 12 in adults aged 68-94 years, as indicated by increased urinary methylmalonic acid (uM-MA). Methods: Fifteen men and women who had been using PPIs daily for a minimum of one year were recruited. Fifteen subjects not using PPIs were age (±3 years) and gender matched to the subjects taking PPIs. Tissue stores of vitamin B 12 were determined using uM-MA. Results: The majority of subjects in this study resided in assisted care living facilities (55.66%) and the remaining subjects (43.33%) were free living. There were no significant differences in uM-MA levels between those using PPIs (Mdn = 1.1 μg uM-MA/mg creatinine), and those not using PPIs (Mdn = 1.1 μg uM-MA/mg creatinine) (p = 0.75). Conclusion: Chronic use of PPIs did not alter vitamin B 12 in healthy individuals aged 68-94 years. Larger studies are indicated to validate these findings.
Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects
The American journal of clinical nutrition, 1998
The reason for the high prevalence of mild cobalamin (vitamin B-12) deficiency in the elderly is poorly understood. We aimed to determine the reason for this high prevalence. 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. 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 ...
International Journal for Vitamin and Nutrition Research, 2006
Vitamin B-12 deficiency is prevalent among the elderly population but it is often unrecognized because the clinical manifestations are not present. Objective: To evaluate the effects of a nutritional supplement fortified with vitamin B-12 on well nourished, free-living elderly subjects. Patients and methods: Healthy elderly subjects attending two of four clinics were allocated to receive, over six months’ duration, a nutritional supplement with 3.8 µg of vitamin B-12. Subjects attending the other two clinics served as controls. Serum vitamin B-12 levels were measured at baseline and 6 months after the supplementation was started. Results: After 6 months of consuming the supplement fortified with vitamin B-12, serum B-12 concentration increased from 350.1 ± 166.5 pmol/L to 409.0 ± 166.1 and decreased in the control group from 319.4 ± 129.1 to 290.1 ± 135.7 (ANOVA, p < 0.005). Conclusion: A supplementation with 3.8 µg /day of vitamin B-12 led to significant improvements in the seru...
The Journal of nutrition, 2007
The BOSSANOVA study, a randomized double-blind trial, was designed to test the ability of very low oral doses of vitamin B-12 to increase the serum vitamin B-12 concentration in elderly subjects with food-bound vitamin B-12 malabsorption, and to determine whether there was a dose response. We also aimed to quantitatively assess the most efficient dose to be added to flour in addition to folic acid (flour cofortification with vitamin B-12 and folic acid). Sixty-seven patients were randomly assigned to 1 of 6 groups receiving various daily oral doses of vitamin B-12 (i.e., 2.5, 5, 10, 20, 40, or 80 microg/d) for 30 d. The dose-response was tested for different biological variables using a mixed model, taking into account the variable's initial value (between-subject effect), a linear log-dose effect, and a linear log (dosextime) interaction, where time was d 15 or d 30. We planned to determine the amount of oral vitamin B-12 that would increase the serum vitamin B-12 concentration...
Bangladesh Medical Journal
The Suppression of gastric acid by long term use of PPI may decrease iron and vitamin B12 absorption and might be causing iron and vitamin B12 deficiency anaemia. This comparative cross-sectional study was conducted among patients with peptic ulcer disease from November 2017 to March 2020; attending in the Internal Medicine department of Bangabandhu Sheikh Mujib Medical University (BSMMU). A total of 80 patients were included and divided into group-A (PPIs user) and group-B (non-PPI user), each group containing 40 patients each. The group-A included patients who were taking PPIs for more than one year and aged from 18 to 70 years and group-B the control group who were not taking PPIs for atleast 1(one) year. The data were analysed by Statistical Package for the Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA).The study shown that male were 18(45%) and 19(47.5%) in group A and B respectively and female were 22(55%) and 21(52.5%) in group A and B respectively...