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ORIGINAL ARTICLE
Year : 2011  |  Volume : 134  |  Issue : 4  |  Page : 432-439

Vitamin B 12 deficiency & levels of metabolites in an apparently normal urban south Indian elderly population


1 Department of Medicine, St. John's Medical College Hospital, Bangalore, India
2 Department of Clinical Nutrition & Clinical Psychology, St. John's Medical College Hospital, Bangalore, India
3 Department of Core Biochemistry, St. John's Medical College Hospital, Bangalore, India
4 Department of Psychiatry, St. John's Medical College Hospital, Bangalore, India
5 Department of Nutrition, St. John's Medical College Hospital, Bangalore, India

Correspondence Address:
Vineeta Shobha
Associate Professor, Department of Medicine, St. John's Medical College Hospital, Sarjapur Road, Bangalore 560 034
India
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Source of Support: None, Conflict of Interest: None


PMID: 22089603

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Background & objectives : There is no published literature on the extent of vitamin B 12 deficiency in elderly Indians as determined by plasma vitamin B 12 levels and methylmalonic acid (MMA) levels. Vitamin B 12 deficiency is expected to be higher in elderly Indians due to vegetarianism, varied socio-economic strata and high prevalence of Helicobacter pylori infection. We therefore, studied the dietary habits of south Indian urban elderly population and measured vitamin B 12 , MMA red cell folate and homocysteine (Hcy) levels. Methods: Healthy elderly urban subjects (175, >60 yr) were recruited. Detailed history, physical examination and neurological assessment were carried out. Food Frequency Questionnaire (FFQ) for dietary analysis for daily intake of calories, vitamin B 12 , folate and detailed psychological assessment for cognitive functions was carried out. Blood samples were analyzed for routine haematology and biochemistry, vitamin B 12 , red cell folate, MMA and Hcy. Results: The mean age of the study population was 66.3 yr. Median values for daily dietary intake of vitamin B 12 and folate were 2.4 and 349.2 μg/day respectively. Sixty two (35%) participants consumed multivitamin supplements. Plasma vitamin B 12 level and the dietary intake of vitamin B 12 was significantly correlated (P=0.157). Plasma vitamin B 12 and Hcy were inversely correlated (P= -0.509). Red cell folate was inversely correlated with Hcy (P= -0.550). Significant negative correlation was observed between plasma vitamin B 12 and MMA in the entire study population (P= -0.220). Subjects consuming vitamin supplements (n=62) had significantly higher plasma vitamin B 12 levels, lower MMA levels and lower Hcy levels. There was no significant correlation between plasma vitamin B 12 , MMA, Hcy and red cell folate and any of the 10 cognitive tests including Hindi Mental Status Examination (HMSE). Interpretation & conclusions : Our study is indicative of higher vitamin B 12 (2.4 μg/day) intakes in urban south Indian population. Thirty five per cent of the study population consumed multivitamin supplements and therefore, low plasma vitamin B 12 levels were seen only in 16 per cent of the study subjects. However, MMA was elevated in 55 per cent and Hcy in 13 per cent of the subjects.


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