Evaluation of serum Vitamin B12 level and related nutritional status among apparently healthy obese female individuals.

OBJECTIVE: Obesity is a major public health problem and great risk for not only cardiovascular diseases but also cancer, musculoskeletal, and gynecological diseases. This study was aimed to investigate the association between serum Vitamin B12 (vitB12), body mass index (BMI), and nutritional status among obese women. METHODS: This cross-sectional study enrolled consecutive female subjects. The consumptions of red meat, fish, bovine liver, egg, and mushroom were recorded. According to the Dietary Reference Intakes, the patients were categorized as insufficiency and sufficiency. Three cutoff points were defined for vitB12 status: (1) Deficiency if vitB12 is <200 pg/mL; (2) insufficiency if vitB12 is 250-350 pg/mL, and (3) sufficient if vitB12 is ≥350 pg/mL. According to BMI, the patients were assigned to nonobese and obese groups. BMI, serum vitB12 level, consumptions of red meat, fish, bovine liver, egg, and mushroom were evaluated and compared between two groups. RESULTS: Mean level of vitB12 was 247.8 ± 10.4 pg/mL and significantly associated with consumption of egg (P = 0.031), bovine liver (P = 0.004), mushroom (P = 0.040), and red meat (P = 0.003). VitB12 was significantly higher in nonobese than obese group (282.5 ± 106.8 vs. 242.5 ± 107.5 pg/mL, P = 0.001). The ratio of vitB12 deficiency was significantly higher in obese than nonobese group (37.6% vs. 24.7%; P = 0.019). VitB12 level was negatively correlated with BMI (r = -0.155; P< 0.001), but not insulin resistance (r = -0.172; P = 0.062). CONCLUSION: Obesity was associated with low level of vitB12 in obese women, and more likely to be vitB12 deficient. Consumption of certain types of food contributes to increase vitB12 level.

Melatonin may have a role in the pathogenesis of functional dyspepsia in males.

OBJECTIVE: Pathogenesis of functional dyspepsia (FD) is complex. Melatonin is synthesized in enterochromaffin cells (EC) of the digestive system. It may influence gut function. The aim of this study is to evaluate the serum melatonin levels in FD patients. PATIENTS AND METHODS: A total of 57 FD patients, and 12 healthy controls were enrolled in this study between 2008-2010 years. Diagnosis of FD was established based on the Rome III Criteria. Blood samples were taken at 10 a.m. and serum samples were stored in -85°C. Serum melatonin levels were determined by an enzyme-linked immunosorbent assay (ELISA) kit. (polyclonal Kennaway G280 anti-melatonin antibody, Bühlmann Laboratories AG, Schönenbuch, Switzerland). RESULTS: Twenty-three (40.3%) patients were male, and, mean age was 44.3 ± 12.1 years. Mean age of control group was 38.5 ± 11.8 years, and 7 of them were male. The mean serum concentration of melatonin in patients and control group were 31.19 ± 43.4 pg/ml and 14.8 ± 20.9 pg/ml, respectively (p < 0.05). Melatonin levels were significantly higher in male patients (38.6 ± 55 pg/ml vs 12.8 ± 22 pg/ml, p < 0.05). However, melatonin levels were similar in females (p > 0.05). CONCLUSIONS: The serum melatonin levels were significantly higher in male patients with functional dyspepsia. High nocturnal melatonin secretion may play a role in the pathogenesis of functional dyspepsia, especially in males.

Infliximab in inflammatory bowel disease: attention to adverse events.

OBJECTIVE: To assess the efficacy and adverse effects of infliximab in patients with Crohn's disease and ulcerative colitis who are resistant to conventional therapy or having fistulising type Crohn's disease. PATIENTS AND METHODS: The patients with a diagnosis of inflammatory bowel disease received infliximab between 2007 and 2009 were followed-up prospectively. Infliximab 5 mg/kg was given at week 0, 2, 6, and every 8 weeks thereafter. Early and late adverse events occurring during the treatment were recorded for each patient. RESULTS: There were 36 patients [mean age 35±12, 17 male] included in the study. Thirty-two (88%) patients were receiving concomitant long-term immunosuppressive therapy. Complete or partial response was obtained in 75% of all patients. At least one adverse event was observed in 10 (28%) patients. Anaphylaxis was seen in 2 (6%) patients, mild acute infusion reaction in 2 (6%) patients, hypotension in 2 (6%) patients, respiratory distress in 2 (6%) patients, skin rash and eruptions in 2 (6%) patients, one hypertension (3%) and one (3%) tightness in the chest. Treatment was continued in all except patients with anaphylaxis. No infection, tumour or cases of death were observed. CONCLUSIONS: Several adverse events might be observed in patients who receive infliximab. Care should be given to patients whom treatment was restarted after a break in regard to anaphylaxis. No serious adverse event was observed during infliximab treatment except allergic events.