Metabolic evidence that deficiencies of vitamin B−12 (cobalamin), folate, and vitamin B−6 occur commonly in elderly people
Abstract
Measurements of the serum concentrations of the metabolites homocysteine, cystathionine, methylmalonic acid, and 2-methylcitric acid, which accumulates when vitamin B-12-, folate-, and vitamin B-6-dependent enzymatic reactions are impaired, should provide a better indication of intracellular deficiency of these vitamins. We measured the serum concentration of these vitamins and the four metabolites in 99 healthy young people, 64 healthy elderly subjects, and 286 elderly hospitalized patients. A low serum vitamin B-12 concentration was found in 6% and 5%, low folate in 5% and 19%, and low vitamin B-6 in 9% and 51%, and one or more metabolites were elevated in 63% and 83% of healthy elderly subjects and elderly hospitalized patients, respectively. These results strongly suggest that the prevalence of tissue deficiencies of vitamin B-12, folate, and vitamin B-6 as demonstrated by the elevated metabolite concentrations is substantially higher than that estimated by measuring concentrations of the vitamins.
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In polymorbid medical inpatients exclusively fed orally, documented or suspected micronutrient deficiencies should be repleted.
“In polymorbid medical inpatients exclusively fed orally, documented or suspected micronutrient deficiencies should be repleted.”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [94]
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ESPEN guideline on nutritional support for polymorbid medical inpatients
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“For example, a study by Joosten et al. found hospital inpatients > 65 years of age likely to be de fi cient in vitamin B12, folate and/or vitamin B6, even though the same subjects had apparently normal reported levels of the same micronutrients [94].”
Vitamin B12, folate, homocysteine and dementia: are they really related?
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Jung, H. Y., Kim, D. W., Nam, S. M., Kim, J. W., Chung, J. Y., Won, M.-H., Seong, J. K., Yoon, Y. S., Yoo, D. Y., & Hwang, I. K. (2017) · Biochimica et Biophysica Acta (BBA) - General Subjects · doi:10.1016/j.bbagen.2017.09.006 · Cited by 23 · see citing works
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Retracted
- Authors
- Joosten, E., van den Berg, A., Riezler, R., Naurath, H., Lindenbaum, J., Stabler, S., & Allen, R.
- Affiliations
- Witten/Herdecke University (DE)
- Corresponding author
- Joosten, E
- ORCID
- Joosten, E
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 1993-10
- Volume
- 58
- Issue
- 4
- Pages
- 468-476
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2131830106
- Cited by
- 322
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 9 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 9 · 2012: 3
- FWCI
- 13.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Porphyrin Metabolism and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- vitamin B12 deficiency, folate deficiency, vitamin B6 deficiency, homocysteine, cystathionine, methylmalonic acid, older adults, hospitalized older adults, vitamin metabolism
- MeSH terms
- Adult, Aged, Aged, 80 and over, Belgium, Female, Folic Acid Deficiency, Germany, Humans, Male, Middle Aged, Netherlands, Vitamin B 12 Deficiency, Prevalence, Vitamin B 6 Deficiency
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