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PLASMA METHYLMALONIC ACID IN RELATION TO SERUM COBALAMIN AND PLASMA HOMOCYSTEINE IN A PSYCHOGERIATRIC POPULATION AND THE EFFECT OF COBALAMIN TREATMENT

✍ Scribed by KARIN NILSSON; LARS GUSTAFSON; ROGER FÄLDT; ANDERS ANDERSON; IVAR VAARA; ROLAND NILSSON; BENGT ALM; BJÖRN HULTBERG


Publisher
John Wiley and Sons
Year
1997
Tongue
English
Weight
117 KB
Volume
12
Category
Article
ISSN
0885-6230

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✦ Synopsis


Cobalamin de®ciency seems to be a relatively common condition in psychogeriatric patients. To elucidate the diagnostic possibility of cobalamin de®ciency we have in this study analysed three markers for cobalamin de®ciency, plasma methylmalonic acid, plasma homocysteine and serum cobalamin, in 96 psychogeriatric patients. Patients were divided into four groups according to serum cobalamins above or below 150 pmol/l and normal ( `19.9 mmol/l) or increased plasma homocysteine. The upper reference limit (95th percentile) for plasma methylmalonic acid in 100 healthy subjects was established to 0.42 mmol/l. The mean value of methylmalonic acid was increased only in the group of patients with serum cobalamin below 150 pmol/l and increased plasma homocysteine compared to the other groups. In this group six (46%) out of 13 patients exhibited increased plasma methylmalonic acid, whereas in the other groups the frequency of increased plasma methylmalonic acid only varied from 10 to 13%. During cobalamin supplementation the most pronounced decrease of plasma methylmalonic acid also occurred in the group of patients with low serum cobalamin levels and increased plasma homocysteine. Only 39% of the initial mean value for plasma methylmalonic acid was noted after 7±10 days of cobalamin administration.