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Title: Cobalamin absorption and serum homocysteine and methylmalonic acid in elderly subjects with low serum cobalamin
Authors: Joosten, Etienne ×
Pelemans, Walter
Devos, P
Lesaffre, Emmanuel
Goossens, Willy
Criel, A
Verhaeghe, Raymond #
Issue Date: Sep-1993
Series Title: European journal of haematology vol:51 issue:1 pages:25-30
Abstract: We prospectively studied 41 consecutive elderly patients with serum cobalamin (vitamin B12) levels lower than 125 pmol/l. The protein-bound cobalamin absorption test (PBAT) was performed in 34 of them and in 27 selected elderly control patients. The lower decision limit was 0.18% and an abnormal test was detected in only 9 (26%) of the 34 patients with low serum cobalamin level. When the PBAT was compared to the Schilling (Dicopac method) test, a concordant result was found in 80%. Serum methylmalonic acid and/or total homocysteine concentrations were elevated in 75% (26/35) of the patients with low serum cobalamin levels but also in 30% (5/17) of the control patients. Of the 12 and 9 cobalamin-deficient patients with elevated serum levels of methylmalonic acid and homocysteine, normalization after cobalamin therapy was obtained in 11 and 5 respectively. In conclusion, determination of serum metabolites and their response to cobalamin therapy are a sensitive index of significant cobalamin deficiency and a useful means of distinguishing between cobalamin and folate deficiency. The PBAT offers little advantage over the Schilling test in diagnosing cobalamin malabsorption in elderly patients.
ISSN: 0902-4441
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Gerontology and Geriatrics
Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat)
Laboratory of Clinical Bacteriology and Mycology
× corresponding author
# (joint) last author

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