养老院和社区中住院老年人的维生素B12状况。

Dharmarajan T S, Ugalino J T, Kanagala M, Pitchumoni S, Norkus E P

Division of Geriatrics and Department of Biomedical Research, Our Lady of Mercy Medical Center, Bronx, New York, USA.

J Am Med Dir Assoc. 2000 Jan-Feb;1(1):21-4.

OBJECTIVE

To assess vitamin B(12) status in a large sample of hospitalized, inner-city older adults from nursing homes and communities with low socioeconomic status. To determine additionally if hypoalbuminemia can help identify older subjects who are at risk for vitamin B(12) deficiency.

DESIGN

A cross-sectional study of hospitalized, inner-city older residents.

SETTING

Acute Care Geriatrics Division, a 75-bed inpatient care service at Our Lady of Mercy Medical Center (OLMMC), a University Affiliate of New York Medical College.

PARTICIPANTS

A total of 466 older patients (aged 65 to 102 years) from the community (n = 374) and nursing homes (n = 92) who were admitted to the acute care geriatrics division from 1993 to 1996.

MEASUREMENTS

Patients admitted to the hospital had serum vitamin B(12) and albumin levels determined along with other nutritional parameters, routine blood tests, and physical examinations.

RESULTS

On admission, 19% of hospitalized subjects had marginal serum B(12) levels (200-350 pg/mL) and 6% had low serum B(12) levels (<200 pg/mL). Mean serum B(12) levels did not differ significantly between patients from nursing homes and those from the community. Sixty-four percent 64% of all patients had low serum albumin levels (alb < 3.5 g/dL), with patients from nursing homes showing significantly lower mean serum albumin than patients admitted from the community (P <.000). We observed no positive correlation between serum albumin and serum vitamin B(12) in our older hospitalized patients from either nursing homes or community.

CONCLUSIONS

In this sample of hospitalized older adults, 24% were found to have marginal or low serum B(12) status. Thus, we believe that periodic determinations of serum B(12) would be a useful addition to the general health and nutritional assessment in this age group. Our findings also suggest that hypoalbuminemia is not helpful as a predictor of low B(12) status in older hospitalized persons.

目的

评估大量来自养老院和社会经济地位较低社区的住院市中心老年人群的维生素B12状况。另外，确定低白蛋白血症是否有助于识别有维生素B12缺乏风险的老年受试者。

设计

对住院市中心老年居民进行的横断面研究。

地点

纽约医学院大学附属医院慈悲圣母医疗中心（OLMMC）的急性护理老年病科，这是一项拥有75张床位的住院护理服务。

参与者

1993年至1996年期间入住急性护理老年病科的466名老年患者（年龄65至102岁），其中来自社区的有374名，来自养老院的有92名。

测量指标

入院患者测定血清维生素B12和白蛋白水平，以及其他营养参数、常规血液检查和体格检查。

结果

入院时，19%的住院受试者血清B12水平处于临界值（200 - 350 pg/mL），6%的受试者血清B12水平较低（<200 pg/mL）。养老院患者和社区患者的平均血清B12水平无显著差异。所有患者中有64%血清白蛋白水平较低（白蛋白<3.5 g/dL），养老院患者的平均血清白蛋白水平显著低于社区入院患者（P<.000）。在我们来自养老院或社区的住院老年患者中，未观察到血清白蛋白与血清维生素B12之间存在正相关。