Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults.
Am J Clin Nutr
; 114(4): 1286-1294, 2021 10 04.
Article
em En
| MEDLINE
| ID: mdl-34134144
ABSTRACT
BACKGROUND:
Atrophic gastritis (AG) and use of proton pump inhibitors (PPIs) result in gastric acid suppression that can impair the absorption of vitamin B-12 from foods. The crystalline vitamin B-12 form, found in fortified foods, does not require gastric acid for its absorption and could thus be beneficial for older adults with hypochlorhydria, but evidence is lacking.OBJECTIVES:
To investigate associations of AG and PPI use with vitamin B-12 status, and the potential protective role of fortified foods, in older adults.METHODS:
Eligible participants (n = 3299) not using vitamin B-12 supplements were drawn from the Trinity-Ulster and Department of Agriculture cohort, a study of noninstitutionalized adults aged ≥60 y and recruited in 2008-2012. Vitamin B-12 status was measured using 4 biomarkers, and vitamin B-12 deficiency was defined as a combined indicator value < -0.5. A pepsinogen III ratio <3 was considered indicative of AG.RESULTS:
AG was identified in 15% of participants and associated with significantly lower serum total vitamin B-12 (P < 0.001) and plasma holotranscobalamin (holoTC; P < 0.001), and higher prevalence of vitamin B-12 deficiency (38%), compared with PPI users (21%) and controls (without AG and nonusers of PPIs; 15%; P < 0.001). PPI drugs were used (≥6 mo) by 37% of participants and were associated with lower holoTC concentrations, but only in participants taking higher doses (≥30 mg/d). Regular, compared with nonregular, consumption of fortified foods (i.e., ≥5 and 0-4 portions/wk, respectively) was associated with higher vitamin B-12 biomarkers in all participants, but inadequate to restore normal vitamin B-12 status in those with AG.CONCLUSIONS:
Older adults who have AG and/or use higher doses of PPIs are more likely to have indicators of vitamin B-12 deficiency. Fortified foods, if consumed regularly, were associated with enhanced vitamin B-12 status, but higher levels of added vitamin B-12 than currently provided could be warranted to optimize status in people with AG.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Vitamina B 12
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Deficiência de Vitamina B 12
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Alimentos Fortificados
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Estado Nutricional
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Inibidores da Bomba de Prótons
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Gastrite Atrófica
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article