Abstract
OBJECTIVE: To estimate the prevalence of vitamin B12 deficiency in adult South Asian patients. DESIGN: Retrospective chart review. SETTING: Family practice clinic in Toronto, Ont. PARTICIPANTS: Records of 988 South Asian patients. INTERVENTION: Of 1000 randomly selected records, we found 988 charts. From charts with at least one documented B12 level, we extracted data on age, mean corpuscular volume (MCV), hemoglobin and ferritin levels, and diet (if available). Descriptive and analytic statistics were calculated. MAIN OUTCOME MEASURES: Levels of serum B12 and factors associated with low levels of B12. RESULTS: B12 results were documented in 49% of charts; 46% of results showed deficiency. Patients older than 65 and vegetarians were more likely to be B12 deficient. Low serum B12 levels were positively correlated with low hemoglobin and ferritin levels and poorly correlated with low MCV levels. CONCLUSION: Many more South Asian patients than patients in the general population have vitamin B12 deficiency. A vegetarian diet seems a strong risk factor. A single low result, however, might not indicate true B12 deficiency.
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- Baik H. W., Russell R. M. Vitamin B12 deficiency in the elderly. Annu Rev Nutr. 1999;19:357–377. doi: 10.1146/annurev.nutr.19.1.357. [DOI] [PubMed] [Google Scholar]
- Booth G. L., Wang E. E. Preventive health care, 2000 update: screening and management of hyperhomocysteinemia for the prevention of coronary artery disease events. The Canadian Task Force on Preventive Health Care. CMAJ. 2000 Jul 11;163(1):21–29. [PMC free article] [PubMed] [Google Scholar]
- Carmel R. Current concepts in cobalamin deficiency. Annu Rev Med. 2000;51:357–375. doi: 10.1146/annurev.med.51.1.357. [DOI] [PubMed] [Google Scholar]
- Chambers J. C., Obeid O. A., Refsum H., Ueland P., Hackett D., Hooper J., Turner R. M., Thompson S. G., Kooner J. S. Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men. Lancet. 2000 Feb 12;355(9203):523–527. doi: 10.1016/S0140-6736(99)93019-2. [DOI] [PubMed] [Google Scholar]
- Herbert V. Staging vitamin B-12 (cobalamin) status in vegetarians. Am J Clin Nutr. 1994 May;59(5 Suppl):1213S–1222S. doi: 10.1093/ajcn/59.5.1213S. [DOI] [PubMed] [Google Scholar]
- Herrmann W., Schorr H., Purschwitz K., Rassoul F., Richter V. Total homocysteine, vitamin B(12), and total antioxidant status in vegetarians. Clin Chem. 2001 Jun;47(6):1094–1101. [PubMed] [Google Scholar]
- Hughes K., Ong C. N. Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore. J Epidemiol Community Health. 2000 Jan;54(1):31–34. doi: 10.1136/jech.54.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mezzano D., Kosiel K., Martínez C., Cuevas A., Panes O., Aranda E., Strobel P., Pérez D. D., Pereira J., Rozowski J. Cardiovascular risk factors in vegetarians. Normalization of hyperhomocysteinemia with vitamin B(12) and reduction of platelet aggregation with n-3 fatty acids. Thromb Res. 2000 Nov 1;100(3):153–160. doi: 10.1016/s0049-3848(00)00313-3. [DOI] [PubMed] [Google Scholar]
- Ray J. G., Cole D. E., Boss S. C. An Ontario-wide study of vitamin B12, serum folate, and red cell folate levels in relation to plasma homocysteine: is a preventable public health issue on the rise?. Clin Biochem. 2000 Jul;33(5):337–343. doi: 10.1016/s0009-9120(00)00083-7. [DOI] [PubMed] [Google Scholar]
- Refsum H., Yajnik C. S., Gadkari M., Schneede J., Vollset S. E., Orning L., Guttormsen A. B., Joglekar A., Sayyad M. G., Ulvik A. Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr. 2001 Aug;74(2):233–241. doi: 10.1093/ajcn/74.2.233. [DOI] [PubMed] [Google Scholar]
- Snow C. F. Laboratory diagnosis of vitamin B12 and folate deficiency: a guide for the primary care physician. Arch Intern Med. 1999 Jun 28;159(12):1289–1298. doi: 10.1001/archinte.159.12.1289. [DOI] [PubMed] [Google Scholar]
- Swain R. An update of vitamin B12 metabolism and deficiency states. J Fam Pract. 1995 Dec;41(6):595–600. [PubMed] [Google Scholar]
- Wright J. D., Bialostosky K., Gunter E. W., Carroll M. D., Najjar M. F., Bowman B. A., Johnson C. L. Blood folate and vitamin B12: United States, 1988-94. Vital Health Stat 11. 1998 Dec;(243):1–78. [PubMed] [Google Scholar]