Comparison of anthropometric data and clinical health indicators according to the serum vitamin B12 status in female older adults living in a rural area of Jeonla province, Korea*

Chung Shil Kwak; Ji Hyun Cho; Miyong Yon

doi:10.4163/jnh.2013.46.3.239

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Kwak, Cho, and Yon: Comparison of anthropometric data and clinical health indicators according to the serum vitamin B12 status in female older adults living in a rural area of Jeonla province, Korea*

Original Article

J Nutr Health 2013;46(3):239-249.

Published online: 10 January 2013

DOI: https://doi.org/10.4163/jnh.2013.46.3.239

Comparison of anthropometric data and clinical health indicators according to the serum vitamin B₁₂ status in female older adults living in a rural area of Jeonla province, Korea^*

Chung Shil Kwak^1,^§, Ji Hyun Cho¹, Miyong Yon²

¹ Institute on Aging Seoul National University, Seoul 151–742, Korea

² Nutrition Policy Team, Department of Health Industry & Policy, Korea Heallth Industry Development Institute, Chungwon, Chungbuk 363–700, Korea

^§ To whom correspondence should be addressed. E-mail: kwakcs@snu.ac.kr

^* This work was supported by Ministry of Health and Welfare and Soonchang County in 2009 through Institute on Aging at Seoul National University, and National Research Foundation of Korea grant funded by the Korean government (NRF-2010–0008081).

Received 22 May 2013 Revised 13 June 2013 Accepted 17 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Subclinical vitamin B₁₂ deficiency is common in the elderly worldwide. We investigated the change of serum vitamin B₁₂ concentration with aging and compared anthropometric data and clinical health indicators between normal (≥ 340 pg/mL) and low (＜ 340 pg/mL) serum vitamin B₁₂ groups in 470 Korean women aged 65 years and over living in a rural area. Serum vitamin B₁₂ concentration showed inverse correlation with age (r = −0.0992, p ＜ 0.05). The normal B₁₂ group showed significantly (p ＜ 0.05) higher red blood cell count, hemoglobin, and hematocrit compared to the low B₁₂ group, however, no difference in mean corpuscular volume was observed between the two groups. The normal B₁₂ group showed significantly lower serum homocysteine concentration (p ＜ 0.01) and prevalence of vitamin D (p ＜ 0.01) or folate deficiency (p ＜ 0.001). Bone mineral density (T-score) was significantly higher (p ＜ 0.05) in the normal B₁₂ group, compared with that in the low B₁₂ group, and showed positive correlation (r = 0.1490, p ＜ 0.01) with serum vitamin B₁₂ concentration after adjusting for age, body weight, and body mass index. No differences in anthropometric data, physical activity, and smoking and drinking habits were observed between the two groups. In conclusion, it could be suggested that older female adults with normal serum vitamin B₁₂ level would be less anemic and osteoporotic and more resistant to hyperhomocysteinemia associated chronic diseases than those with low serum vitamin B₁₂ level. (J Nutr Health 2013; 46(3): 239 – 249)

Keywords: female older adults, serum vitamin B₁₂ concentration, clinical health indicator, aging.

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Table 1.

Change of average serum vitamin B₁₂ concentration with aging

Age (yr)	Serum B₁₂ (pg/mL)
65–69 (n = 109)	746.5 ± 26.6¹⁾
70–74 (n = 168)	710.2 ± 232.1
75–79 (n = 101)	690.0 ± 225.6
80 + (n = 92)	674.7 ± 208.0
Total (n = 470)	707.3 ± 225.6
Significance	NS ²⁾

¹⁾ Mean ± SD

²⁾ not significant at p ＜ 0.05 determined by ANO-VA/duncan multiple test

Table 2.

General characteristics according to the vitamin B₁₂ status

	Normal (n = 440)	Low (n = 26)	Significance
Age (yr)	74.3 ± 5.8¹⁾ (60–95)²⁾	74.6 ± 4.9 (67–86)	NS ³⁾
Education (yr)	01.8 ± 2.4 (0–12)	01.9 ± 2.6 (0–6)	NS
Children (person)	04.9 ± 1.6	05.0 ± 1.5	NS
Living arrangement
Alone	217 (47.4)	13 (50.0)
With only spouse	173 (37.7)	11 (42.3)	χ² = 1.4823
With children ± spouse	026 (05.7)	00 (00.0)	NS
Others	042 (09.2)	02 (07.7)
Economic status
High	014 (03.2)	00 (00.0)
Upper middle	107 (23.4)	08 (30.8)	χ² = 1.4963
Lower middle	212 (48.3)	11 (42.3)	NS
Low	106 (24.1)	07 (26.9)

¹⁾ Mean ± SD

²⁾ range (min-max)

³⁾ not significant at p ＜ 0.05 determined by t-test or χ²-test

Table 3.

Health related lifestyle and prevalence of self-reported chronic diseases according to the vitamin B₁₂ status

	Normal (n = 440)	Low (n = 26)	Significance
Self-assessed health status
Healthy	142 (32.3)¹⁾	03 (11.5)	χ² = 6.7913
Moderate	059 (13.4)	07 (26.9)	p ＜ 0.05
Bad	239 (54.3)	16 (61.6)
Supplementation or functional food intake within last 6 months
Yes	157 (36.0)	12 (46.1)	χ²⁾ = 1.1088
No	279 (64.0)	14 (53.9)	NS²⁾
Physical activity (hr/day)
＜ 2	162 (36.8)	09 (34.6)	χ² = 0.1336
2–3	042 (09.5)	03 (11.5)	NS
＞ 3	236 (53.6)	14 (53.9)
Medication (subscripted)
0	084 (19.3)	04 (16.0)	χ² = 0.3302
1–2	254 (58.2)	16 (64.0)	NS
≥ 3	098 (22.5)	05 (20.0)
Smoking
Currently yes	017 (03.9)	02 (07.7)	χ² = 3.9480
Smoked, but currently no	019 (04.3)	03 (11.5)	NS
Never	403 (91.8)	21 (80.8)
Drinking (time/month)	0.68 ± 1.60	0.74 ± 1.66	NS
0	217 (66.2)	14 (63.6)
0 ＜ and ≤ 1	062 (18.9)	04 (18.2)	χ² = 0.2147
1 ＜ and ≤ 3	027 (08.2)	02 (09.1)	NS
＞ 3	022 (06.7)	02 (09.1)
No. of chronic disease	2.01 ± 1.25³⁾	2.07 ± 1.05	NS
Prevalence of chronic diseases (%)
Diabetes	09.1	00.0	χ² = 2.5920, NS
Hypertention	42.4	38.5	χ² = 0.1537, NS
Bone & Joint disease	38.9	42.3	χ² = 0.1160, NS
Heart disease	10.3	11.5	χ² = 0.0440, NS
Kidney disease	01.4	00.0	χ² = 0.3600, NS
Digestive disease	11.4	19.2	χ² = 1.4472, NS
Hyperlipidemia	03.0	03.8	χ² = 0.0658, NS

¹⁾ n (%)

²⁾ not significant at p ＜ 0.05 determined by t-test or χ²-test

³⁾ Mean ± SD

Table 4.

Anthropometric data and bone mineral density according to the vitamin B₁₂ status

	Normal (n = 440)	Low (n = 26)	Significance^†
Hight (cm)	147.4 ± 5.9¹⁾	148.9 ± 6.50	NS ²⁾
Weight (kg)^‡	051.3 ± 8.6	52.7 ± 8.70	NS
BMI (kg/m ²)^‡	023.5 ± 3.2	23.7 ± 3.40	NS
Low weight ＜ 18.5	026 (05.9)³⁾	02 (07.7)
Normal 18.5 ≤ and ＜ 23.0	173 (39.3)	07 (26.9)	χ² = 1.8074
Overweight 23.0 ≤ and ＜ 25.0	101 (23.0)	08 (30.8)	NS
Obese 25.0 ≤	140 (31.8)	09 (34.6)
Body fat (%)	35.2 ± 3.90	35.5 ± 4.00	NS
Body muscle (%)	21.4 ± 2.30	21.7 ± 2.00	NS
WHR ⁴⁾ (%)	91.3 ± 6.60	90.9 ± 7.10	NS
Obese ≥ 85	374 (85.2)	20 (80.0)	χ² = 0.4980
Normal ＜ 85	065 (14.8)	05 (20.0)	NS
Arm cir (cm)	26.7 ± 3.30	26.7 ± 3.50	NS
Tibia cir (cm)	31.4 ± 3.00	31.3 ± 2.40	NS
BMD⁵⁾ (T-score)	–2.54 ± 1.13	–2.91 ± 0.74	p ＜ 0.05
Normal ≥ −1.0	041 (09.3)	00 (00.0)
Osteopenia −2.5 ≤ and ＜-1.0	150 (34.1)	07 (26.9)	χ² = 3.9573 NS
Osteoporosis ＜ −2.5	249 (56.6)	19 (73.1)	NS
BMD (Z-score)	0.13 ± 1.04	–0.20 ± 0.68	p ＜ 0.05
≥ 0	228 (51.8)	09 (34.6)
-1.0 ≤ and ＜ 0	157 (35.7)	14 (53.9)	χ² = 3.6541
≤ −1.0	055 (12.5)	03 (11.5)	NS

^† determined after adjusting for age, body weight and BMI

^‡ determined after adjusting for age

¹⁾ Mean ± SD

²⁾ not significant at p ＜ 0.05 determined by ANCOVA-test or χ density²-test

³⁾ n (%)

⁴⁾ waist/hip ratio

⁵⁾ bone mineral

Table 5.

Blood pressure and biochemical index for anemia according to the vitamin B₁₂ status

	Normal (n = 440)	Low (n = 26)	Significance^†
Blood pressure (mmHg)
Systolic	121.6 ± 16.2¹⁾	118.5 ± 16.4	NS ²⁾
Diastolic	75.3 ± 11.3¹⁾	073.1 ± 11.6	NS
Hypertension ³⁾	078 (17.7)⁴⁾	03 (11.5)	χ² = 0.6548
Normal	362 (82.3)	23 (88.5)	NS
Red blood cell (10⁶/μL)	4.08 ± 0.34¹⁾	03.92 ± 0.35	p ＜ 0.05
Normal ≥ 3.6	415 (94.3)	22 (84.6)	χ² = 3.9603
Low ＜ 3.6	025 (05.7)	04 (15.4)	p ＜ 0.05
Hemoglobin (g/dL)	012.4 ± 1.10¹⁾	012.0 ± 1.20	p ＜ 0.05
Normal ≥ 12	365 (83.0)	18 (69.2)	χ² = 3.1585
Low ＜ 12	075 (17.0)	08 (30.8)	NS
Hematocrit (%)	038.1 ±3.20¹⁾	036.6 ± 2.80	p ＜ 0.05
Normal ≥ 36	355 (80.7)	16 (61.5)	χ² = 5.5431
Low ＜ 36	085 (19.3)	10 (38.5)	p ＜ 0.05
MCV ⁵⁾ (fL.)	093.4 ± 4.40¹⁾	094.0 ± 6.50	NS
Microcytic ≤ 80	004 (00.9)	00 (00.0)
Normal 80 ＜ MCV ＜ 100	406 (92.3)	24 (92.3)	χ² = 0.2637 NS
Macrocytic ≥ 100	030 (06.8)	02 (07.7)	NS

^† determined after adjusting for age, body weight and BMI

¹⁾ Mean ± SD

²⁾ not significant at p ＜ 0.05 determined by ANCOVA test or χ²-test

³⁾ systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg

⁴⁾ n (%)

⁵⁾ Mean corpuscular volume

Table 6.

Blood measurement according to the vitamin B₁₂ status

	Normal (n = 440)	Low (n = 26)	Significance^†
Serum B₁₂ (pg/mL)	732.3 ± 202.4¹⁾	261.4 ± 77.8	p ＜ 0.001
Total protein (g/dL)	08.34 ± 1.34	08.82 ± 1.84	NS ²⁾
Normal ≥ 6.0	439 (99.8)³⁾	026 (100.0)	χ² = 0.0592
Low ＜ 6.0	001 (00.2)	000 (000.0)	NS
Albumin (g/dL)	04.86 ± 0.74	05.16 ± 1.02	p ＜ 0.05
Normal ≥ 3.5	439 (99.8)	026 (100.0)	χ² = 0.0592
Low ＜ 3.5	001 (00.2)	000 (000.0)	NS
Total cholesterol (mg/dL)	229.5 ± 57.7	237.5 ± 82.8	NS
High ＞ 220	231 (52.5)	010 (038.5)	χ² = 1.9375
Normal ≤ 220	209 (47.5)	016 (061.5)	NS
HDL-cholesterol (mg/dL)	058.1 ± 18.4	058.4 ± 24.0	NS
Normal (≥ 40)	379 (86.1)	023 (088.5)	χ² = 0.1120
Low (＜ 40)	061 (13.9)	003 (011.5)	NS
LDL-cholesterol (mg/dL)	137.3 ± 45.7	146.8 ± 63.5	NS
High >130	235 (54.4)	012 (046.1)	χ² = 0.5188
Normal ≤ 130	205 (46.6)	014 (053.9)	NS
Triglyceride (mg/dL)	191.1 ± 101.7	195.4 ± 96.6	NS
High ＞ 200	152 (34.6)	011 (042.3)	χ² = 0.6504
Normal ≤ 200	298 (65.4)	015 (057.7)	NS
25-(OH) D3 (ng/mL)	018.7 ± 5.5	17.2 ± 6.7	NS
Adequate ＞ 30	010 (02.3)	002 (07.7)
Moderate 20 ≤ and ＜ 30	157 (35.6)	006 (023.1)	χ² = 11.5916
Low 10 ≤ and ＜ 20	249 (56.6)	013 (050.0)	p ＜ 0.01
Deficient ＜ 10	024 (05.5)	005 (019.2)
Folate (ng/mL)	07.82 ± 3.98	08.13 ± 5.06	NS
Normal ≥ 3	430 (97.7)	022 (084.6)	χ² = 14.4836
Low ＜ 3	010 (02.3)	004 (015.4)	p ＜ 0.001
Homocysteine (μ mol/L)	015.3 ± 4.3	023.1 ± 12.7	p ＜ 0.001＜
High ＞ 17	120 (27.3)	015 (057.7)	χ² = 11.0397
Normal ≤ 17	320 (72.7)	011 (042.3)	p ＜ 0.001
hs-CRP (mg/L)	01.43 ± 2.92	01.64 ± 2.36	NS
Very high ＞ 3.0	039 (08.9)	003 (011.5)	χ² = 1.4537
High 1.0 ＜ and ≤ 3.0	113 (25.7)	009 (034.6)	χ² = 1.4537
Normal ≤ 1.0	288 (65.4)	014 (053.9)	NS
HBa1c (%)	06.11 ± 0.59	06.07 ± 0.39	NS
High ≥ 6.5	053 (12.1)	003 (011.5)	χ² = 0.0060
Normal ＜ 6.5	387 (87.9)	023 (088.5)	NS
DHEAS (μ g/dL)	032.8 ± 28.6	027.1 ± 14.4	NS
IGF-1 (ng/mL)	093.5 ± 44.0	088.9 ± 43.3	NS

^† determined after adjusting for age, body weight and BMI

¹⁾ Mean ± SD

²⁾ not significant at p ＜ 0.05 determined by ANCOVA test or χ²-test

³⁾ n (%)

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