de Rooij S, van Bruggen R, Thijssen C, Hooijer C
Afd. Geriatrie, Slotervaartziekenhuis, Amsterdam.
Tijdschr Gerontol Geriatr. 1994 Mar;25(1):3-10.
Low serum vitamin B12 levels and vitamin B12 deficiencies are frequently found in the elderly. The full syndrome of a vitamin B12 deficiency is rather simple to diagnose. The large applicability of the vitamin B12 assay also gives rise to many probably incomplete features. Low/low-normal vitamin B12 levels in screening procedures raise uncertainty whether this finding represents deficiency and should be followed by supplementation. In this paper the occurrence of low serum levels of vitamin B12 are discussed. To assess the clinical relevance of low/low-normal outcomes supplementary diagnostic procedures will be needed. Within this scope we illustrate the d.o.s.-test and the MMA-assay. Especially the latter will probably provide more answers to the treatment question. Systematic research is needed to clarify this issue. Meanwhile supplementation of all low and low-normal outcomes of the B12-assay seems the best answer.
老年人中经常发现血清维生素B12水平低和维生素B12缺乏的情况。维生素B12缺乏的完整综合征相当容易诊断。维生素B12检测的广泛应用也导致了许多可能不完整的特征。筛查过程中维生素B12水平低/低正常会引发不确定性，即这一发现是否代表缺乏以及是否应随后进行补充。本文讨论了血清维生素B12水平低的情况。为评估低/低正常结果的临床相关性，将需要补充诊断程序。在此范围内，我们说明了d.o.s.试验和甲基丙二酸（MMA）检测。特别是后者可能会为治疗问题提供更多答案。需要进行系统研究以澄清这个问题。同时，对B12检测的所有低和低正常结果进行补充似乎是最好的答案。
