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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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Association of vitamin B12, folate and homocysteine with functional and pathological characteristics of the elderly in a mountainous village in Sicily

Rosario Sebastiano Spada1 / Giuseppe Stella2 / Santa Calabrese3 / Paolo Bosco4 / Guido Anello5 / Rosa-Maria Guéant-Rodriguez6 / Antonino Romano7 / Lahoucine Benamghar8 / Thierry Fontaine9 / Jean-Louis Guéant10











Corresponding author: Rosario Sebastiano Spada, MD, Geriatric Unit, “Oasi” Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via Conte Ruggero, 73, 94018 Troina (EN), Italy Phone: +39-0935-653966, Fax: +39-0935-936694,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 2, Pages 136–142, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2007.065, February 2007

Publication History

October 25, 2006
December 15, 2006


Background: Homocysteine is associated with age, folate and vitamin B12. Our study investigated the functional and clinical characteristics of the elderly (aged 60–85 years) of San Teodoro, a village in Central Sicily, and evaluated associations with vitamin B12, folate and homocysteine.

Methods: Subjects (n=280) were examined after door-to-door recruitment using interview, physician examination and laboratory tests.

Results: A total of 19.3% of the population had a low blood level of folate (<7 nmol/L) and 3.2% had low vitamin B12 concentration (<100 pmol/L). The level of dependency, determined by the Barthel index, influenced homocysteine blood levels (p<0.0001), independent of age (p<0.0001), folate (p=0.0028) and vitamin B12 (p=0.0165). Homocysteine was significantly associated with stroke (p=0.0027) and peripheral arterial vascular disease (p=0.0001), but not with myocardial infarction, angina pectoris, venous thrombosis or cancer. Vitamin B12 was lower in myocardial infarction and higher in diabetes and venous thrombosis compared to the other diseases.

Conclusions: The prevalence of deficits in folate and vitamin B12 was paradoxically high in the mountainous northeastern area of Sicily. Our study also underlines the association of homocysteine with dependency of the elderly and with stroke and peripheral arteriopathy.

Clin Chem Lab Med 2007;45:136–42.

Keywords: aging; folate; peripheral arteriopathy; stroke; vitamin B12

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