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Low serum cobalamin levels in a population study of 70- and 75-year-old subjects

Gastrointestinal causes and hematological effects

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Abstract

We examined causes and hematological consequences of low serum cobalamin (vitamin B 12)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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Authors and Affiliations

  1. Department of Medicine, Gothenburg University, Östra Hospital, S-416 85, Göteborg, Sweden

    Herman Nilsson-Ehle MD, Sten Landahl MD, PhD, Göran Lindstedt MD, PhD, Lisbeth Netterblad MLSO, Reinhold Stockbruegger MD, PhD, Jan Westin MD, PhD & Christer Åhren MD, PhD

  2. Department of Geriatrics and Long-term Care, Vasa Hospital, Gothenburg University, Sweden

    Herman Nilsson-Ehle MD, Sten Landahl MD, PhD, Göran Lindstedt MD, PhD, Lisbeth Netterblad MLSO, Reinhold Stockbruegger MD, PhD, Jan Westin MD, PhD & Christer Åhren MD, PhD

  3. Departments of Clinical Chemistry, Medicine II, and Pathology, Sahlgren's Hospital, Gothenburg University, Sweden

    Herman Nilsson-Ehle MD, Sten Landahl MD, PhD, Göran Lindstedt MD, PhD, Lisbeth Netterblad MLSO, Reinhold Stockbruegger MD, PhD, Jan Westin MD, PhD & Christer Åhren MD, PhD

Authors
  1. Herman Nilsson-Ehle MD
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  2. Sten Landahl MD, PhD
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  3. Göran Lindstedt MD, PhD
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  4. Lisbeth Netterblad MLSO
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  5. Reinhold Stockbruegger MD, PhD
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  6. Jan Westin MD, PhD
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  7. Christer Åhren MD, PhD
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Additional information

This study is part of the Gerontological and Geriatric Population Study in Gothenburg, Sweden (project group: A. Svanborg, H. Djurfelt, and S. Landahl).

This study was supported by grants from the Delegation for Social Research within the Ministry of Health and Social Affairs, the Gothenburg Administration of Social Services, the Gothenburg Medical Services Administration, the Swedish Medical Research Council, the Gothenburg Medical Society, and Wilhelm and Martina Lundgren's Foundation.

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Nilsson-Ehle, H., Landahl, S., Lindstedt, G. et al. Low serum cobalamin levels in a population study of 70- and 75-year-old subjects. Digest Dis Sci 34, 716–723 (1989). https://doi.org/10.1007/BF01540343

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  • DOI: https://doi.org/10.1007/BF01540343

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