Wolters Maike, Hermann Silke, Hahn Andreas
Institute of Food Science, Department of Applied Chemistry, University of Hanover, Hanover, Germany.
Am J Clin Nutr. 2003 Oct;78(4):765-72. doi: 10.1093/ajcn/78.4.765.
Prior investigations found that elderly persons are at higher risk than are younger persons for B vitamin deficiency, which leads to elevated plasma total homocysteine (tHcy) concentrations that are associated with an increased risk for certain diseases such as coronary artery disease. To date, published data have shown decreased vitamin status and elevated tHcy among the elderly.
We evaluated the dietary intake and the blood status of various B vitamins and tHcy and methylmalonic acid (MMA) concentrations in 178 younger (60-70-y-old) female seniors.
Dietary intake was assessed with a 3-d diet record. Thiamine, riboflavin, and vitamin B-6 activity coefficients of erythrocyte transketolase (EC 2.2.1.1), erythrocyte glutathione reductase (EC 1.6.4.2), and erythrocyte alpha-aspartic aminotransferase (EC 2.6.1.1) were used as functional indexes for the status of the 3 vitamins, respectively. Concentrations of serum and red blood cell folate, serum cobalamin and MMA, and plasma tHcy were measured.
Indexes of thiamine, pyridoxine, and cobalamin indicated insufficient status in one-third of the women, whereas tHcy and MMA concentrations were elevated in 17.4% and 9.6% of the women, respectively. An association between vitamin intake and vitamin concentration in the blood was found only for folate. The mean tHcy concentration in subjects in the lowest quartile of serum folate concentration was 23% higher than that in subjects in the highest quartile. There was no association between riboflavin and tHcy concentrations. MMA was positively correlated with age and inversely correlated with serum cobalamin concentration.
Even in younger, well-educated, female seniors, the prevalence of low B vitamin status and elevated plasma tHcy concentration is high. Thiamine, pyridoxine, folate, and cobalamin supplementation should be considered.
先前的调查发现,老年人比年轻人更容易出现B族维生素缺乏,这会导致血浆总同型半胱氨酸(tHcy)浓度升高,而tHcy浓度升高与某些疾病(如冠状动脉疾病)的风险增加有关。迄今为止,已发表的数据显示老年人的维生素状态下降且tHcy升高。
我们评估了178名年龄在60至70岁的年轻女性老年人的各种B族维生素的膳食摄入量、血液状态以及tHcy和甲基丙二酸(MMA)浓度。
采用3天饮食记录评估膳食摄入量。分别将红细胞转酮醇酶(EC 2.2.1.1)、红细胞谷胱甘肽还原酶(EC 1.6.4.2)和红细胞α-天冬氨酸转氨酶(EC 2.6.1.1)的硫胺素、核黄素和维生素B-6活性系数用作这3种维生素状态的功能指标。测量血清和红细胞叶酸、血清钴胺素和MMA的浓度以及血浆tHcy。
硫胺素、吡哆醇和钴胺素指标表明三分之一的女性状态不足,而分别有17.4%和9.6%的女性tHcy和MMA浓度升高。仅发现叶酸的维生素摄入量与血液中维生素浓度之间存在关联。血清叶酸浓度处于最低四分位数的受试者的平均tHcy浓度比处于最高四分位数的受试者高23%。核黄素与tHcy浓度之间无关联。MMA与年龄呈正相关,与血清钴胺素浓度呈负相关。
即使在年轻、受过良好教育的女性老年人中,B族维生素状态低下和血浆tHcy浓度升高的患病率也很高。应考虑补充硫胺素、吡哆醇、叶酸和钴胺素。