Journal Article


Mary R. Cahill
Ivan J Perry
Anthony P Fitzgerald
Kanthi Perera
Bahman Honari
Sharon Cadogan
Janas Harrington
Trish Hyland
Therese McNamee



thyrotropin transaminases vitamin b 12 deficiency blood epidemiology folic acid deficiency male celiac disease hematologic diseases smoking aged deficiency vitamin b 12 ireland humans middle aged adverse effects adult hypothyroidism iron folic acid receptors transferrin gamma glutamyltransferase female

Haematinic deficiency and macrocytosis in middle-aged and older adults. (2013)

Abstract To assess the prevalence and determinants of haematinic deficiency (lack of B12 folate or iron) and macrocytosis in blood from a national population-based study of middle-aged and older adults. A cross-sectional study involving 1,207 adults aged ≥45 years, recruited from a sub-study of the Irish National Survey of Lifestyle Attitudes and Nutrition (SLÁN 2007). Participants completed a health and lifestyle questionnaire and a standard food frequency questionnaire. Non-fasting blood samples were obtained for measurement of full blood count and expert morphological assessment, serum ferritin, soluble transferrin receptor assay (sTfR), B12, folate and coeliac antibodies. Blood samples were also assayed for thyroid function (T4, TSH), liver function, aminotransferase (AST) and gamma-glutamyl transferase (GGT). The overall prevalence (95% C.I.) of anaemia (Hb <13.5 g/dl men and 11.3 g/dl women) was 4.6% (2.9%-6.4%) in men and 1.0% (0.2%-1.9%) in women. Iron deficiency (ferritin <17 ng/ml men and <11 ng/ml in women) was detected in 6.3% of participants (3.7% in males and 8.7% in females, p<0.001). Based on both low ferritin and raised sTfR (>21 nmol/ml) only 2.3% were iron-deficient. 3.0% and 2.7% were found to have low levels of serum folate (<2.3 ng/ml) and serum B12 (<120 ng/l) respectively. Clinically significant macrocytosis (MCV>99fl) was detected in 8.4% of subjects. Strong, significant and independent associations with macrocytosis were observed for lower social status, current smoking status, moderate to heavy alcohol intake, elevated GGT levels, deficiency of folate and vitamin B12, hypothyroidism and coeliac disease. The population attributable fraction (PAF) for macrocytosis associated with elevated GGT (25.0%) and smoking (24.6%) was higher than for excess alcohol intake (6.3%), folate deficiency (10.5%) or vitamin B12 (3.4%). Haematinic deficiency and macrocytosis are common in middle-aged/older adults in Ireland. Macrocytosis is more likely to be attributable to an elevated GGT and smoking than vitamin B12 or folate deficiency.
Collections Ireland -> University College Cork -> PubMed

Full list of authors on original publication

Mary R. Cahill, Ivan J Perry, Anthony P Fitzgerald, Kanthi Perera, Bahman Honari, Sharon Cadogan, Janas Harrington, Trish Hyland, Therese McNamee

Experts in our system

Mary R Cahill
University College Cork
Total Publications: 25
Ivan J Perry
University College Cork
Total Publications: 203
Anthony P Fitzgerald
University College Cork
Total Publications: 78
Sharon L Cadogan
University College Cork
Janas Harrington
University College Cork
Total Publications: 67