Institute of Nutritional Science, Justus Liebig University, Goethestrasse 55, D-35390, Giessen, Germany.
Present address: Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Justus Liebig University, Heinrich-Buff-Ring 26-32, D-35392, Giessen, Germany.
Nutr J. 2020 Jul 2;19(1):64. doi: 10.1186/s12937-020-00576-2.
Older people are reported to be prone to imbalances between cobalamin and folate status with possible adverse effects on health. This longitudinal study investigates dynamics and interactions of cobalamin and folate status in a cohort of community-dwelling older adults by considering possible influencing factors.
In total, 332 subjects ≥ 60 years were investigated over a mean observation period of 12 years. Data collection included serum cobalamin, folate and creatinine, dietary intakes of cobalamin, folate and alcohol, use of supplements, body composition, smoking behavior, and diseases. Linear mixed-effects models with repeated measurements were used to investigate the influence of variables on serum cobalamin and folate.
At baseline, median cobalamin intake exceeded the dietary reference value (DRV), while median folate intake was considerably below DRV. In most subjects, serum concentrations of both vitamins were within reference ranges. For serum cobalamin, apart from supplement use (Parameter estimate [95% confidence interval]: 130.17 [53.32, 207.01]), the main positive predictor was serum folate (4.63 [2.64, 6.62]). For serum folate, serum creatinine (10.85 [4.85, 16.86]), use of supplements (7.86 [5.05, 10.67]), serum cobalamin (0.01 [< 0.01, 0.01]), and dietary folate intake (0.02 [0.01, 0.03]) were positive predictors. No main effects of age, sex, body composition, alcohol intake or smoking were found after adjusting for simultaneous inference.
Advancing age, per se, is no risk factor for a decline in serum concentrations of cobalamin or folate in subjects ≥ 60 years. Suboptimal folate intake may limit the function of folate regarding the supply of methyl groups for methylation of cobalamin and subsequent creatine biosynthesis. The positive association of serum creatinine with folate deserves further exploration with regard to its possible relevance for maintaining energy dependent functional integrity in the course of ageing.
据报道，老年人容易出现钴胺素和叶酸状态之间的不平衡，这可能对健康产生不利影响。本纵向研究通过考虑可能的影响因素，调查了一个社区居住的老年人群体中钴胺素和叶酸状态的动态和相互作用。
共有 332 名年龄≥60 岁的受试者在平均 12 年的观察期内接受了调查。数据收集包括血清钴胺素、叶酸和肌酐、钴胺素、叶酸和酒精的饮食摄入量、补充剂的使用、身体成分、吸烟行为和疾病。使用线性混合效应模型进行重复测量，以研究变量对血清钴胺素和叶酸的影响。
在基线时，钴胺素的中位摄入量超过了膳食参考值（DRV），而叶酸的中位摄入量明显低于 DRV。在大多数受试者中，两种维生素的血清浓度都在参考范围内。对于血清钴胺素，除了补充剂的使用（参数估计[95%置信区间]：130.17[53.32，207.01]）之外，主要的正预测因子是血清叶酸（4.63[2.64，6.62]）。对于血清叶酸，血清肌酐（10.85[4.85，16.86]）、补充剂的使用（7.86[5.05，10.67]）、血清钴胺素（0.01[<0.01，0.01]）和膳食叶酸摄入量（0.02[0.01，0.03]）是正预测因子。在同时进行推理调整后，未发现年龄、性别、身体成分、酒精摄入量或吸烟等主要因素的影响。
年龄的增长本身并不是 60 岁及以上受试者血清钴胺素或叶酸浓度下降的危险因素。亚叶酸摄入不足可能会限制叶酸为钴胺素提供甲基供体以及随后的肌酸生物合成的功能。血清肌酐与叶酸的正相关关系值得进一步探讨，以了解其在衰老过程中维持与能量相关的功能完整性方面的可能相关性。
