Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial

• Published in: European journal of clinical nutrition 2003-11, Vol.57 (11), p.1426-1436
• Main Authors: Lewerin, C, Nilsson-Ehle, H, Matousek, M, Lindstedt, G, Steen, B
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Clinical Nutrition; Cyanocobalamin; Dietary supplements; Double-Blind Method; Epidemiology; Female; Folic acid; Folic Acid - administration & dosage; Folic Acid - blood; Folic Acid Deficiency - blood; Folic Acid Deficiency - drug therapy; Folic Acid Deficiency - epidemiology; Homocysteine; Homocysteine - blood; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolites; Methylmalonic Acid - blood; Multivariate analysis; Nutrient deficiency; Older people; original-communication; Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...); Public Health; Pyridoxine; Reference Values; Transferrin; Transferrins; Vitamin B; Vitamin B 12 - administration & dosage; Vitamin B 12 - blood; Vitamin B 12 Deficiency - blood; Vitamin B 12 Deficiency - drug therapy; Vitamin B 12 Deficiency - epidemiology; Vitamin B 6 - administration & dosage; Vitamin B 6 - blood; Vitamin B12; Vitamin B6; Vitamin deficiency
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1601707

Objectives : To investigate, in an elderly population: (1) the effects of oral B-vitamin therapy on P-tHcys, S-MMA and Hb/MCV, (2) the appropriate decision limit for ‘high’ metabolite concentrations and (3) the estimated prevalence of vitamin B 12 /folate deficiency on the basis of different decision limits. Design : Double-blind placebo-controlled intervention study. Setting : Outpatient clinic. Subjects : A total of 209 community-dwelling subjects, median age 76 y (range 70–93) y. Interventions : Four months of oral daily supplementation with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B 6 . Results : High P- tHcys was found in 64% of men and 45% of women, high S-MMA in 11% of both. Vitamin B 12 deficiency was observed in 7.2% and folate deficiency in 11% of all subjects. Health-related upper reference limits for the metabolites at the start were higher than the laboratory's upper reference limits. The latter were, however, similar to those of the vitamin replete group. There was a significant decrease in P-tHcys ( P