Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Comparison of anthropometric data and clinical health indicators according to the serum vitamin $B_{12}$ status in female older adults living in a rural area of Jeonla province, Korea

전라도 일부농촌지역 여성 노인의 혈중 비타민 $B_{12}$ 수준에 따른 신체계측치 및 임상건강지표들의 비교

  • Kwak, Chung Shil (Institute on Aging Seoul National University) ;
  • Cho, Ji Hyun (Institute on Aging Seoul National University) ;
  • Yon, Miyong (Nutrition Policy Team, Department of Health Industry & Policy, Korea Heallth Industry Development Institute)
  • 곽충실 (서울대학교 노화고령사회 연구소) ;
  • 조지현 (서울대학교 노화고령사회 연구소) ;
  • 연미영 (한국보건산업진흥원 보건산업정책단 영양정책팀)
  • Received : 2013.05.22
  • Accepted : 2013.06.17
  • Published : 2013.06.30
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Abstract

Subclinical vitamin $B_{12}$ deficiency is common in the elderly worldwide. We investigated the change of serum vitamin $B_{12}$ concentration with aging and compared anthropometric data and clinical health indicators between normal (${\geq}$ 340 pg/mL) and low (< 340 pg/mL) serum vitamin $B_{12}$ groups in 470 Korean women aged 65 years and over living in a rural area. Serum vitamin $B_{12}$ concentration showed inverse correlation with age (r = -0.0992, p < 0.05). The normal $B_{12}$ group showed significantly (p < 0.05) higher red blood cell count, hemoglobin, and hematocrit compared to the low $B_{12}$ group, however, no difference in mean corpuscular volume was observed between the two groups. The normal $B_{12}$ group showed significantly lower serum homocysteine concentration (p < 0.01) and prevalence of vitamin D (p < 0.01) or folate deficiency (p < 0.001). Bone mineral density (T-score) was significantly higher (p < 0.05) in the normal $B_{12}$ group, compared with that in the low $B_{12}$ group, and showed positive correlation (r = 0.1490, p < 0.01) with serum vitamin $B_{12}$ concentration after adjusting for age, body weight, and body mass index. No differences in anthropometric data, physical activity, and smoking and drinking habits were observed between the two groups. In conclusion, it could be suggested that older female adults with normal serum vitamin $B_{12}$ level would be less anemic and osteoporotic and more resistant to hyperhomocysteinemia associated chronic diseases than those with low serum vitamin $B_{12}$ level.

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References

  1. Stabler SP, Allen RH. Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr 2004; 24: 299-326 https://doi.org/10.1146/annurev.nutr.24.012003.132440
  2. Johnson MA. Nutrition and aging--practical advice for healthy eating. J Am Med Womens Assoc 2004; 59(4): 262-269
  3. Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, Noblet-Dick M, Maloisel F, Schlienger JL, Blicklé JF. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ 2004; 171(3): 251-259 https://doi.org/10.1503/cmaj.1031155
  4. Herbert V. Staging vitamin B-12 (cobalamin) status in vegetarians. Am J Clin Nutr 1994; 59(5 Suppl): 1213S-1222S
  5. Kwok T, Cheng G, Woo J, Lai WK, Pang CP. Independent effect of vitamin B12 deficiency on hematological status in older Chinese vegetarian women. Am J Hematol 2002; 70(3): 186-190 https://doi.org/10.1002/ajh.10134
  6. Baik HW, Russell RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr 1999; 19: 357-377 https://doi.org/10.1146/annurev.nutr.19.1.357
  7. Johnson MA, Hawthorne NA, Brackett WR, Fischer JG, Gunter EW, Allen RH, Stabler SP. Hyperhomocysteinemia and vitamin B-12 deficiency in elderly using Title IIIc nutrition services. Am J Clin Nutr 2003; 77(1): 211-220
  8. Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician 2003; 67(5): 979-986
  9. Sakuta H, Suzuki T, Yasuda H, Wakiyama H, Hase K. Plasma vitamin B12, folate and homocysteine levels in gastrectomized men. Clin Nutr 2005; 24(2): 244-249 https://doi.org/10.1016/j.clnu.2004.10.006
  10. Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr 2009; 89(2): 693S-696S https://doi.org/10.3945/ajcn.2008.26947A
  11. Lewerin C, Jacobsson S, Lindstedt G, Nilsson-Ehle H. Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly: implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy. Scand J Gastroenterol 2008; 43(9): 1050-1056 https://doi.org/10.1080/00365520802078341
  12. Chui CH, Lau FY, Wong R, Soo OY, Lam CK, Lee PW, Leung HK, So CK, Tsoi WC, Tang N, Lam WK, Cheng G. Vitamin B12 deficiency--need for a new guideline. Nutrition 2001; 17(11-12): 917-920 https://doi.org/10.1016/S0899-9007(01)00666-9
  13. Wei W, Liu YH, Zhang CE, Wang Q, Wei Z, Mousseau DD, Wang JZ, Tian Q, Liu GP. Folate/vitamin-B12 prevents chronic hyperhomocysteinemia- induced tau hyperphosphorylation and memory deficits in aged rats. J Alzheimers Dis 2011; 27(3): 639-650
  14. Setola E, Monti LD, Galluccio E, Palloshi A, Fragasso G, Paroni R, Magni F, Sandoli EP, Lucotti P, Costa S, Fermo I, Galli-Kienle M, Origgi A, Margonato A, Piatti P. Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia. Eur J Endocrinol 2004; 151(4): 483-489 https://doi.org/10.1530/eje.0.1510483
  15. He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC, Ascherio A. Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. Stroke 2004; 35(1): 169-174
  16. Ng TP, Feng L, Niti M, Kua EH, Yap KB. Folate, vitamin B12, homocysteine, and depressive symptoms in a population sample of older Chinese adults. J Am Geriatr Soc 2009; 57(5): 871-876 https://doi.org/10.1111/j.1532-5415.2009.02229.x
  17. Prodan CI, Cowan LD, Stoner JA, Ross ED. Cumulative incidence of vitamin B12 deficiency in patients with Alzheimer disease. J Neurol Sci 2009; 284(1-2): 144-148 https://doi.org/10.1016/j.jns.2009.05.005
  18. Tangney CC, Aggarwal NT, Li H, Wilson RS, Decarli C, Evans DA, Morris MC. Vitamin B12, cognition, and brain MRI measures: a cross-sectional examination. Neurology 2011; 77(13): 1276-1282 https://doi.org/10.1212/WNL.0b013e3182315a33
  19. Park S, Johnson MA. What is an adequate dose of oral vitamin B12 in older people with poor vitamin B12 status? Nutr Rev 2006; 64(8): 373-378 https://doi.org/10.1111/j.1753-4887.2006.tb00222.x
  20. Smith AD, Refsum H. Vitamin B-12 and cognition in the elderly. Am J Clin Nutr 2009; 89(2): 707S-711S https://doi.org/10.3945/ajcn.2008.26947D
  21. Garrod MG, Green R, Allen LH, Mungas DM, Jagust WJ, Haan MN, Miller JW. Fraction of total plasma vitamin B12 bound to transcobalamin correlates with cognitive function in elderly Latinos with depressive symptoms. Clin Chem 2008; 54(7): 1210-1217 https://doi.org/10.1373/clinchem.2007.102632
  22. Lim HS, Heo YR. Plasma total homocysteine, folate, and vitamin B12 status in Korean adults. J Nutr Sci Vitaminol (Tokyo) 2002; 48(4): 290-297 https://doi.org/10.3177/jnsv.48.290
  23. Kim HJ, Kim MK, Kim JU, Ha HY, Choi BY. Major determinants of serum homocysteine concentrations in a Korean population. J Korean Med Sci 2010; 25(4): 509-516 https://doi.org/10.3346/jkms.2010.25.4.509
  24. Kim J, Park MH, Kim E, Han C, Jo SA, Jo I. Plasma homocysteine is associated with the risk of mild cognitive impairment in an elderly Korean population. J Nutr 2007; 137(9): 2093-2097
  25. Kim G, Kim H, Kim KN, Son JI, Kim SY, Tamura T, Chang N. Relationship of cognitive function with B vitamin status, homocysteine, and tissue factor pathway inhibitor in cognitively impaired elderly: a cross-sectional survey. J Alzheimers Dis 2013; 33(3): 853-862
  26. Korean Society for the Study of Obesity. Diagnosis and therapy of obesity: Asia-Pacific area guideline. Seoul: Korean Society for the Study of Obesity; 2000
  27. Carmel R. Prevalence of undiagnosed pernicious anemia in the elderly. Arch Intern Med 1996; 156(10): 1097-1100 https://doi.org/10.1001/archinte.1996.00040041097008
  28. Kwak CS, Lee MS, Lee HJ, Whang JY, Park SC. Dietary source of vitamin B12 intake and vitamin B12 status in female elderly Koreans aged 85 and older living in rural area. Nutr Res Pract 2010; 4(3): 229-234 https://doi.org/10.4162/nrp.2010.4.3.229
  29. Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency-- an update. Haematologica 2006; 91(11): 1506-1512
  30. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med 2013; 368(2): 149-160 https://doi.org/10.1056/NEJMcp1113996
  31. Miller JW, Garrod MG, Rockwood AL, Kushnir MM, Allen LH, Haan MN, Green R. Measurement of total vitamin B12 and holotranscobalamin, singly and in combination, in screening for metabolic vitamin B12 deficiency. Clin Chem 2006; 52(2): 278-285
  32. Clarke R, Grimley Evans J, Schneede J, Nexo E, Bates C, Fletcher A, Prentice A, Johnston C, Ueland PM, Refsum H, Sherliker P, Birks J, Whitlock G, Breeze E, Scott JM. Vitamin B12 and folate deficiency in later life. Age Ageing 2004; 33(1): 34-41 https://doi.org/10.1093/ageing/afg109
  33. Bang SM, Lee JO, Kim YJ, Lee KW, Lim S, Kim JH, Park YJ, Chin HJ, Kim KW, Jang HC, Lee JS. Anemia and activities of daily living in the Korean urban elderly population: results from the Korean Longitudinal Study on Health and Aging (KLoSHA). Ann Hematol 2013; 92(1): 59-65 https://doi.org/10.1007/s00277-012-1563-6
  34. den Elzen WP, van der Weele GM, Gussekloo J, Westendorp RG, Assendelft WJ. Subnormal vitamin B12 concentrations and anaemia in older people: a systematic review. BMC Geriatr 2010; 10: 42 https://doi.org/10.1186/1471-2318-10-42
  35. Kuo HK, Sorond FA, Chen JH, Hashmi A, Milberg WP, Lipsitz LA. The role of homocysteine in multisystem age-related problems: a systematic review. J Gerontol A Biol Sci Med Sci 2005; 60(9): 1190-1201 https://doi.org/10.1093/gerona/60.9.1190
  36. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, Porcellini E, Licastro F. Homocysteine and folate as risk factors for dementia and Alzheimer disease. Am J Clin Nutr 2005; 82(3): 636-643
  37. Hooshmand B, Solomon A, Kåreholt I, Rusanen M, Hänninen T, Leiviskä J, Winblad B, Laatikainen T, Soininen H, Kivipelto M. Associations between serum homocysteine, holotranscobalamin, folate and cognition in the elderly: a longitudinal study. J Intern Med 2012; 271(2): 204-212 https://doi.org/10.1111/j.1365-2796.2011.02484.x
  38. Houston DK, Johnson MA, Nozza RJ, Gunter EW, Shea KJ, Cutler GM, Edmonds JT. Age-related hearing loss, vitamin B-12, and folate in elderly women. Am J Clin Nutr 1999; 69(3): 564-571
  39. Meng S, Ciment S, Jan M, Tran T, Pham H, Cueto R, Yang XF, Wang H. Homocysteine induces inflammatory transcriptional signaling in monocytes. Front Biosci 2013; 18: 685-695 https://doi.org/10.2741/4131
  40. Herrmann M, Widmann T, Colaianni G, Colucci S, Zallone A, Herrmann W. Increased osteoclast activity in the presence of increased homocysteine concentrations. Clin Chem 2005; 51(12): 2348-2353 https://doi.org/10.1373/clinchem.2005.053363
  41. Sakamoto W, Isomura H, Fujie K, Deyama Y, Kato A, Nishihira J, Izumi H. Homocysteine attenuates the expression of osteocalcin but enhances osteopontin in MC3T3-E1 preosteoblastic cells. Biochim Biophys Acta 2005; 1740(1): 12-16 https://doi.org/10.1016/j.bbadis.2005.03.004
  42. Dhonukshe-Rutten RA, Lips M, de Jong N, Chin A Paw MJ, Hiddink GJ, van Dusseldorp M, De Groot LC, van Staveren WA. Vitamin B-12 status is associated with bone mineral content and bone mineral density in frail elderly women but not in men. J Nutr 2003; 133(3): 801-807
  43. Ouzzif Z, Oumghar K, Sbai K, Mounach A, Derouiche el M, El Maghraoui A. Relation of plasma total homocysteine, folate and vitamin B12 levels to bone mineral density in Moroccan healthy postmenopausal women. Rheumatol Int 2012; 32(1): 123-128 https://doi.org/10.1007/s00296-010-1551-x
  44. Maggio D, Cherubini A, Lauretani F, Russo RC, Bartali B, Pierandrei M, Ruggiero C, Macchiarulo MC, Giorgino R, Minisola S, Ferrucci L. 25(OH)D Serum levels decline with age earlier in women than in men and less efficiently prevent compensatory hyperparathyroidism in older adults. J Gerontol A Biol Sci Med Sci 2005; 60(11): 1414-1419 https://doi.org/10.1093/gerona/60.11.1414
  45. Huang W, Shah S, Long Q, Crankshaw AK, Tangpricha V. Improvement of pain, sleep, and quality of life in chronic pain patients with vitamin D supplementation. Clin J Pain 2013; 29(4): 341-347 https://doi.org/10.1097/AJP.0b013e318255655d
  46. Pérez-López FR, Chedraui P, Fernández-Alonso AM. Vitamin D and aging: beyond calcium and bone metabolism. Maturitas 2011; 69(1): 27-36 https://doi.org/10.1016/j.maturitas.2011.02.014
  47. Kim YJ, Moon MS, Yang YJ, Kwon O. Relationship between serum 25-hydroxyvitamin D concentration and the risks of metabolic syndrome in premenopausal and postmenopausal women. Korean J Nutr 2012; 45(1): 20-29 https://doi.org/10.4163/kjn.2012.45.1.20
  48. Moon Y, Han SH. Vitamin D deficiency and cognitive dysfunction. Dement Neurocognitive Disord 2012; 11(4): 111-117 https://doi.org/10.12779/dnd.2012.11.4.111
  49. Kasayama S, Morita S, Otsuki M, Asanuma N, Saito H, Mukai M, Koga M. Independent association between insulin-like growth factor-I and dehydroepiandrosterone sulphate in women in middle adulthood. Clin Endocrinol (Oxf) 2007; 66(6): 797-802 https://doi.org/10.1111/j.1365-2265.2007.02815.x