Low Serum Cobalamin Levels in a Population Study of 70- and 75-year-old Subjects. Gastrointestinal Causes and Hematological Effects

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 1989 May 1

PMID 2714146

Citations 4

Authors

H Nilsson-Ehle

S Landahl

G Lindstedt

L Netterblad

R Stockbruegger

J Westin

C Ahren

Affiliations

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Abstract

We examined causes and hematological consequences of low serum cobalamin (vitamin B12) concentration in two representative population samples of 70-year-old (N = 293) and 75-year-old subjects (N = 486). Subjects with values below 130 pmol/liter (4.8% and 5.6%, respectively) were investigated with Schilling test, upper gastrointestinal endoscopy, determination of serum gastrin and group I pepsinogens, and bone marrow examination. Gastrointestinal abnormalities of etiologic significance were found in 26 of the 32 examined subjects: atrophy of the gastric body mucosa (N = 16, with pernicious anemia in six), partial gastrectomy (N = 6), and intestinal malabsorption (N = 4). Megaloblastic hematopoiesis was found in 10 individuals, four of whom had macrocytic anemia. Our results indicate that low serum cobalamin concentration in the elderly is usually a consequence of disease rather than of high age per se and that gastric mucosal atrophy is a major etiologic factor.

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References

Nilsson-Ehle H, Jagenburg R, Landahl S, Lindstedt G, Swolin B, Westin J . Cyanocobalamin absorption in the elderly: results for healthy subjects and for subjects with low serum cobalamin concentration. Clin Chem. 1986; 32(7):1368-71. View

Magnus E . Serum vitamin B12 values in relation to functional B12 deficiency. Scand J Gastroenterol Suppl. 1974; 29:47-51. View

Christiansen P . The incidence of achlorhydria and hypochlorhydria in healthy subjects and patients with gastrointestinal diseases. Scand J Gastroenterol. 1968; 3(5):497-508. DOI: 10.3109/00365526809179909. View

Bailey L, Wagner P, Christakis G, Araujo P, Appledorf H, Davis C . Vitamin B12 status of elderly persons from urban low-income households. J Am Geriatr Soc. 1980; 28(6):276-8. DOI: 10.1111/j.1532-5415.1980.tb00534.x. View

Borch K . Epidemiologic, clinicopathologic, and economic aspects of gastroscopic screening of patients with pernicious anemia. Scand J Gastroenterol. 1986; 21(1):21-30. DOI: 10.3109/00365528609034616. View

Stockbruegger R, Cotton P, Menon G, BEILBY J, Bartholomew B, Hill M . Pernicious anaemia, intragastric bacterial overgrowth, and possible consequences. Scand J Gastroenterol. 1984; 19(3):355-64. View

Elsborg L, Lung V, BASTRUP-MADSEN P . Serum vitamin B12 levels in the aged. Acta Med Scand. 1976; 200(4):309-14. DOI: 10.1111/j.0954-6820.1976.tb08237.x. View

Salom I, Silvis S, DOSCHERHOLMEN A . Effect of cimetidine on the absorption of vitamin B12. Scand J Gastroenterol. 1982; 17(1):129-31. DOI: 10.3109/00365528209181056. View

Savage D, Lindenbaum J . Relapses after interruption of cyanocobalamin therapy in patients with pernicious anemia. Am J Med. 1983; 74(5):765-72. DOI: 10.1016/0002-9343(83)91064-1. View

10.

Wood I, Ralston M, Ungar B, COWLING D . VITAMIN B12 DEFICIENCY IN CHRONIC GASTRITIS. Gut. 1964; 5:27-37. PMC: 1552221. DOI: 10.1136/gut.5.1.27. View

11.

Irvine W, Cullen D, Mawhinney H . Natural history of autoimmune achlorhydric atrophic gastritis. A 1-15-year follow-up study. Lancet. 1974; 2(7879):482-5. DOI: 10.1016/s0140-6736(74)92013-3. View

12.

RINDER L, Roupe S, Steen B, Svanborg A . Seventy-year-old people in Gothenburg. A population study in an industrialized Swedish city. Acta Med Scand. 1975; 198(5):397-407. DOI: 10.1111/j.0954-6820.1975.tb19563.x. View

13.

Kolhouse J, Kondo H, Allen N, Podell E, Allen R . Cobalamin analogues are present in human plasma and can mask cobalamin deficiency because current radioisotope dilution assays are not specific for true cobalamin. N Engl J Med. 1978; 299(15):785-92. DOI: 10.1056/NEJM197810122991501. View

14.

ZAHALSKY A, Hutner S, Keane M, Burger R . Bleaching Euglena gracilis with antihistamines and streptomycin-type antibiotics. Arch Mikrobiol. 1962; 42:46-55. DOI: 10.1007/BF00425189. View

15.

Stockbruegger R, Seeberg S, Hellner L, Jaup B, DOTEVALL G . Intragastric bacteria and nitrite after short-term treatment with different doses of antimuscarinic drugs. Scand J Gastroenterol. 1984; 19(1):14-23. View

16.

Anderson B . INVESTIGATIONS INTO THE EUGLENA METHOD FOR THE ASSAY OF THE VITAMIN B12 IN SERUM. J Clin Pathol. 1964; 17:14-26. PMC: 480664. DOI: 10.1136/jcp.17.1.14. View

17.

JERZY GLASS G, Pitchumoni C . Structural and ultrastructural alterations, exfoliative cytology and enzyme cytochemistry and histochemistry, proliferation kinetics, immunological derangements and other causes, and clinical associations and sequallae. Hum Pathol. 1975; 6(2):219-50. View

18.

SCHILLING R . Intrinsic factor studies II. The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B12. J Lab Clin Med. 1953; 42(6):860-6. View

19.

Varis K . Epidemiology of gastritis. Scand J Gastroenterol Suppl. 1982; 79:44-51. View

20.

STRICKLAND R, Mackay I . A reappraisal of the nature and significance of chronic atrophic gastritis. Am J Dig Dis. 1973; 18(5):426-40. DOI: 10.1007/BF01071995. View