Naurath H J, Joosten E, Riezler R, Stabler S P, Allen R H, Lindenbaum J
Department of Geriatric Medicine, University Witten-Heddecke, Velbert, Germany.
Lancet. 1995 Jul 8;346(8967):85-9. doi: 10.1016/s0140-6736(95)92113-3.
In a prospective, multicentre, double-blind controlled study, the effect of an intramuscular vitamin supplement containing 1 mg vitamin B12, 1.1 mg folate, and 5 mg vitamin B6 on serum concentrations of methylmalonic acid (MMA), homocysteine (HCYS), 2-methylcitric acid (2-MCA), and cystathionine (CYSTA) was compared with that of placebo in 175 elderly subjects living at home and 110 in hospital. Vitamin supplement and placebo were administered eight times over a 3-week period. Vitamin supplement but not placebo significantly reduced all four metabolite concentrations at the end of the study in both study groups. The maximum effects of treatment were usually seen within 5-12 days. Initially elevated metabolite concentrations returned to normal in a higher proportion of the vitamin than of the placebo group: 92% vs 20% for HYCS; 82% vs 20% for MMA; 62% vs 25% for 2-MCA; and 42% vs 25% for CYSTA. The response rate to vitamin supplements supports the notion that metabolic evidence of vitamin deficiency is common in the elderly, even in the presence of normal serum vitamin levels. Metabolite assays permit identification of elderly subjects who may benefit from vitamin supplements.
在一项前瞻性、多中心、双盲对照研究中，将含有1毫克维生素B12、1.1毫克叶酸和5毫克维生素B6的肌肉注射维生素补充剂对175名居家老年受试者和110名住院老年受试者血清中甲基丙二酸（MMA）、同型半胱氨酸（HCYS）、2-甲基柠檬酸（2-MCA）和胱硫醚（CYSTA）浓度的影响与安慰剂进行了比较。维生素补充剂和安慰剂在3周内给药8次。在两个研究组中，维生素补充剂而非安慰剂在研究结束时显著降低了所有四种代谢物的浓度。治疗的最大效果通常在5-12天内出现。与安慰剂组相比，维生素组中最初升高的代谢物浓度恢复正常的比例更高：HCYS为92%对20%；MMA为82%对20%；2-MCA为62%对25%；CYSTA为42%对25%。对维生素补充剂的反应率支持了这样一种观点，即维生素缺乏的代谢证据在老年人中很常见，即使血清维生素水平正常。代谢物检测可以识别可能从维生素补充剂中受益的老年受试者。
