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2.
Isr Med Assoc J ; 23(1): 17-22, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33443337

RESUMO

BACKGROUND: Low folate levels are associated with megaloblastic anemia, neural tube defects, and an increased risk of cancer. Data are scarce regarding the sex aspect of this deficiency. OBJECTIVES: To assess sex differences in folate levels in a large cohort of patients and to investigate the effect of low folate levels on homocysteine concentrations. METHODS: Data were collected from medical records of patients examined at a screening center in Israel between 2000 and 2014. Cross sectional analysis was conducted on 9214 males and 4336 females. RESULTS: The average age was 48.4 ± 9.5 years for males and 47.6 ± 9.4 years for females. Average folate levels were 19.2 ± 8.6 and 22.4 ±10.3 nmol/L in males and females, respectively (P < 0.001). The prevalence of folate levels below 12.2 nmol/L was 19.5% in males compared to 11.6% in females (P < 0.001). In patients with low folate levels and normal B12 levels, homocysteine levels above 15 µmol/L were found in 32.4% of males and 11.4% of females (P < 0.001). Males had a significantly higher odds ratio (OR) of having folate levels below 12.2 nmol/L: OR 1.84 (95% confidence interval [95%CI] 1.66-2.05) in a non-adjusted model, and OR 2.02 (95%CI 1.82-2.27) adjusted for age, smoking status, body mass index, kidney function, albumin, and triglycerides levels. CONCLUSIONS: Folate levels are lower in males compared to females, which may contribute to the higher homocysteine levels found in males and thus to their increased risk of developing atherosclerosis and coronary artery disease.


Assuntos
Ácido Fólico/sangue , Homocisteína/sangue , Deficiência de Vitamina B 12 , Vitamina B 12/sangue , Estudos Transversais , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/epidemiologia
3.
Medicine (Baltimore) ; 99(14): e19700, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243408

RESUMO

BACKGROUND: To determine the prevalence of subacute combined degeneration (SCD) patients with normal or elevated serum vitamin B12 level and to identify clinical characteristics of these patients. METHODS: We searched PubMed, EMBASE, and Cochrane library, without language restriction up to June 2019 and included studies with SCD patients who were diagnosed with normal or elevated serum vitamin B12 levels. Meta-analysis was performed to estimate the prevalence of SCD in patients with normal or elevated serum vitamin B12 levels and compare the differences of clinical data between patients with low and no-low serum vitamin B12 level. RESULTS: Six studies were included in our analysis, with a total number of 181 patients involved. The pooled proportion in patients with no-low serum vitamin B12 level was 31.0% (95% confidence interval [CI]: 22.5-40.8). There was no significant difference in the level of hemoglobin (Mean difference (MD): -3.05, 95% CI: -12.42 to 6.33. P = 0.52) and erythrocyte mean corpuscular volume (MD: -2.37, 95% CI: -11.17 to 6.43, P = 0.60) between SCD patients with no-low and those with low serum vitamin B12 levels. The meta-analysis showed that the functional disability rating scale on admission in patients with low serum vitamin B12 level was no worse than that with normal or elevated serum vitamin B12 level (MD: 0.29, 95% CI: -0.58 to 1.16, P = 0.51). CONCLUSION: Decreased level of serum vitamin B12 may not be a necessity for the diagnosis of SCD. Approximately one third of the SCD patients have normal or elevated serum vitamin B12 level. No differences were found in clinical severity between patients with normal or elevated serum vitamin B12 level and those with low level of serum vitamin B12 on admission.


Assuntos
Degeneração Combinada Subaguda/diagnóstico , Vitamina B 12/sangue , Adulto , Idoso , Índices de Eritrócitos , Eritrócitos , Feminino , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Degeneração Combinada Subaguda/etiologia , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/complicações
4.
Medicina (Kaunas) ; 56(3)2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32245061

RESUMO

Background and objectives: Although laparoscopic sleeve gastrectomy (LSG) is effective for obesity management, postoperative vitamin B12 (B12) deficiency is of major concern. In this cross-sectional study, we assessed the levels of B12 and its related functional biomarkers, namely, total homocysteine (tHcy), methylmalonic acid (MMA), folate, methylcitric acid (MCA), and hemoglobin (Hb), in one-year postoperative LSG patients and matched controls. Materials and Methods: Plasma B12, tHcy, MMA, folate, and MCA were measured in matched controls (n = 66) and patients (n = 71) using validated liquid chromatography-tandem mass spectrometry techniques and protocols in the United Arab Emirates (UAE). Results: The median B12 concentration in patients (177 pmol/L) was significantly lower (p < 0.001) than in the controls (334.7 pmol/L). The tHcy and MMA levels were significantly increased (p < 0.001 and p = 0.011, respectively) and folate levels were significantly decreased (p = 0.001) in the LSG patients compared to the controls. Interestingly, no significant difference in MCA levels were observed between the two groups. The levels of tHcy and MMA were concomitantly increased with the decreased folate levels in postoperative LSG patients when compared with the controls. The Hb levels were significantly lower in males and females in the patient group compared with those in the control group, respectively (p = 0.005 and p = 0.043). Conclusions: This is the first report of serum levels of B12 and its functional biomarkers in postoperative LSG patients among a local population from the UAE. Our findings revealed significant alterations of the B12 biomarkers, total B12, MMA, and tHcy in one-year postoperative LSG patients.


Assuntos
Gastrectomia/efeitos adversos , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/diagnóstico , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/diagnóstico , Adulto , Biomarcadores/sangue , Cromatografia Líquida , Citratos/sangue , Estudos Transversais , Feminino , Ácido Fólico/sangue , Hemoglobinas , Homocisteína/sangue , Humanos , Masculino , Espectrometria de Massas , Ácido Metilmalônico/sangue , Emirados Árabes Unidos
5.
Acta Diabetol ; 57(9): 1073-1080, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32266492

RESUMO

AIM: The present study aimed to evaluate the combined effect of both dose and duration of metformin therapy on vitamin B12 levels in patients with type 2 diabetes mellitus (T2D). METHODS: We recruited 2887 patients with T2D between January 2018 and November 2019 and categorized them into two groups (metformin and non-metformin users) matched for age, mean duration of diabetes, and BMI. We calculated the "Metformin Usage Index" (MUI) which was defined as the product of the dose of metformin (mg) used and its duration divided by 1000. Vitamin B12 levels were compared between the two groups, and its association with MUI was assessed using correlation and multistep logistic regression analyses. RESULTS: Vitamin B12 levels < 200 pg/ml and between 200 and 300 pg/ml were noted among 24.5% and 34.5% metformin users, respectively; this was significantly higher than among non-metformin users (17.3% and 22.6%, respectively) [P < 0.001]. Overall, a vitamin B12 level < 300 pg/ml was found in 52.2% of the subjects. There was a significant association between an MUI > 5 and a high risk of vitamin B12 deficiency [P < 0.01]. The highest risk was observed among patients with an MUI > 15 [odds ratio (OR) 6.74, 95% CI 4.39-10.4] followed by patients with an MUI > 10 (OR 5.12, 95% CI 3.12-8.38). CONCLUSIONS: The MUI can be employed as a risk assessment tool for evaluation of vitamin B12 deficiency in patients with T2D. Further prospective studies are required to determine the MUI thresholds in populations with good nutritional statuses and low prevalence of vitamin B12 deficiency.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Metformina/administração & dosagem , Deficiência de Vitamina B 12/epidemiologia , Adulto , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Medição de Risco , Vitamina B 12/sangue , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/diagnóstico
6.
An Bras Dermatol ; 95(2): 165-172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32113676

RESUMO

BACKGROUND/OBJECTIVES: To investigate the association between vitiligo and metabolic syndrome. METHODS: A prospective cross-sectional study was conducted between 2014 and 2016. Study (n=155) and control groups (n=155) were evaluated for metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation criteria. Study group was divided into three groups according to their vitiligo area severity index and vitiligo disease activity score values (Group 1: 6.89 for VASI score, Group A: -1-0, Group B: 1-2 and Group C: 3-4 for vitiligo disease activity score respectively). MetS rates according to both criteria were compared between the vitiligo disease activity score and vitiligo area severity index groups. RESULTS: Metabolic syndrome rates were 37.4% and 40% in the study group and 19.4% and 26.5% in the control group according to National CholesterolEducation Program Adult Treatment Panel III and International Diabetes Federation criteria, respectively (p<001 and p=0.011). Metabolic syndrome was more frequent in vitiligo area severity index Groups 2 and 3 compared to vitiligo area severity index Group 1, and in vitiligo disease activity score Group C compared to vitiligo disease activity score Groups A and B. STUDY LIMITATIONS: Single center experience, absence of more specific oxidative-stress markers and lack of long-term follow-up of the patients. CONCLUSIONS: Frequency of metabolic syndrome was higher in patients with non-segmental vitiligo and the rate was higher in active/severe form of the disease.


Assuntos
Síndrome Metabólica/epidemiologia , Vitiligo/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Estudos Prospectivos , Valores de Referência , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Estatísticas não Paramétricas , Turquia/epidemiologia , Deficiência de Vitamina B 12/sangue , Vitiligo/sangue , Vitiligo/complicações , Adulto Jovem
8.
Support Care Cancer ; 28(11): 5235-5242, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32086566

RESUMO

PURPOSE: To determine the prevalence of anemia, and to evaluate the etiology and risk factors of anemia in patients with newly diagnosed cancer. METHODS: In this cross-sectional study, 310 patients with newly diagnosed cancer who were referred to a university hospital in Turkey over a 6-month period and 218 age-matched healthy individuals as controls were evaluated in terms of anemia: complete blood count (CBC), ferritin, transferrin saturation (TS%), serum iron (SI), cobalamin (B12), and folate levels. Carcinoma of the breast (21.3%), lung (12.9%), and gastrointestinal tract (GIT) (35.8%) accounted for the majority of the patients, and 44.7% of the patients had metastatic disease. RESULTS: Anemia was observed in 49.7% of patients with cancer and in 11.9% of healthy controls (p < 0.001). SI and TS% were lower in patients with cancer than in the controls (p < 0.001); however, the median serum ferritin level, which is also an acute-phase reactant, was higher in the patient group than the healthy matched controls (42.2 ng/mL and 41 ng/mL, respectively, p < 0.001). Folate and B12 deficiencies were seen more frequently in the cancer group than in the controls [6.5% and 0.9% (p < 0.001); 39.3% and 18.9% (p < 0.05), respectively]. In the cancer group, anemia was seen more frequently in the metastatic subgroup than in the non-metastatic subgroup (59.7% and 55.3%, respectively, p < 0.05). The prevalence of anemia was similar in both groups of patients with and without primary GIT cancers, as well as in patients who did and did not undergo tumor surgery (p > 0.05). CONCLUSION: This study showed that, at the time a patient is diagnosed as having cancer, the patient already has a significant risk for anemia, nearly five times that of healthy people. Having metastatic disease, and having nutritional deficiencies as iron, B12, and folate were evaluated as possible risk factors for anemia in patients with newly diagnosed cancer, whereas cancer with GIT localization and previous history of tumor surgery were not.


Assuntos
Anemia/epidemiologia , Neoplasias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Anemia/etiologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Ferritinas/sangue , Ácido Fólico/sangue , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/epidemiologia , Humanos , Ferro/sangue , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Prevalência , Fatores de Risco , Turquia/epidemiologia , Vitamina B 12/metabolismo , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/epidemiologia , Adulto Jovem
9.
Neth J Med ; 78(1): 10-24, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32043474

RESUMO

INTRODUCTION: Diagnosis of vitamin B12 deficiency is difficult, as there is no conclusive single test for this disorder. We evaluated the association of serum B12 and methylmalonic acid (MMA) with haematologic parameters and physical and cognitive functioning in an effort to use such clinical parameters to improve the interpretation of serum values. METHODS: We used data of participants > 19 years of age from NHANES 2011-2012 and 2013-2014, a cross-sectional survey in the United States. Functional status was assessed with questionnaires on current health condition, disability, hospital utilisation, cognitive functioning, mental health and depression, and physical functioning. Muscle strength assessed with a handgrip dynamometer was used as a performance parameter. Results were evaluated both for the entire population and participants of Western European descent. Because renal function influences MMA concentrations and is a proxy for both frailty and comorbidity, all results were additionally stratified for individuals with normal vs impaired renal function (eGFR < 60 ml/min). RESULTS: In total, data of 9645 participants (mean age 49 (SD 17) years, 49.3% males) were included. Out of all participants with serum B12 < 140, 140-300, and 301-1000 pmol/l, 56.2%, 13.5%, and 4.1%, respectively had elevated MMA. MMA concentrations were more strongly associated with poor functional status and physical performance than serum B12. We identified a significant and independent association of MMA concentrations, as well as haemoglobin and co-morbidity with muscle strength. CONCLUSIONS/INTERPRETATIONS: A large proportion of individuals with a decreased serum B12 concentration still has normal MMA concentrations. Elevated MMA concentrations were more strongly associated with poor functional performance than serum B12.


Assuntos
Cognição/fisiologia , Disfunção Cognitiva/sangue , Força da Mão/fisiologia , Ácido Metilmalônico/sangue , Deficiência de Vitamina B 12/sangue , Vitamina B 12/sangue , Adulto , Idoso , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estados Unidos , Adulto Jovem
10.
J Vet Intern Med ; 34(1): 13-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31758868

RESUMO

Disorders of cobalamin (vitamin B12 ) metabolism are increasingly recognized in small animal medicine and have a variety of causes ranging from chronic gastrointestinal disease to hereditary defects in cobalamin metabolism. Measurement of serum cobalamin concentration, often in combination with serum folate concentration, is routinely performed as a diagnostic test in clinical practice. While the detection of hypocobalaminemia has therapeutic implications, interpretation of cobalamin status in dogs can be challenging. The aim of this review is to define hypocobalaminemia and cobalamin deficiency, normocobalaminemia, and hypercobalaminemia in dogs, describe known cobalamin deficiency states, breed predispositions in dogs, discuss the different biomarkers of importance for evaluating cobalamin status in dogs, and discuss the management of dogs with hypocobalaminemia.


Assuntos
Doenças do Cão/sangue , Deficiência de Vitamina B 12/veterinária , Vitamina B 12/sangue , Animais , Biomarcadores/sangue , Cães , Deficiência de Vitamina B 12/sangue
12.
J Formos Med Assoc ; 119(2): 587-594, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31607629

RESUMO

BACKGROUND/PURPOSE: Our previous study found that 180 of 1064 atrophic glossitis (AG) patients have iron deficiency. This study assessed whether all AG patients with iron deficiency (so-called ID/AG patients) had iron deficiency anemia (IDA) and evaluated whether the ID/AG patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. METHODS: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 180 ID/AG patients and 532 healthy control subjects were measured and compared. RESULTS: We found that 180 ID/AG patients had significantly lower mean corpuscular volume (MCV) and lower mean blood Hb and serum iron levels as well as significantly higher mean serum homocysteine level than healthy control subjects (all P-values < 0.001). Moreover, 180 ID/AG patients had significantly higher frequencies of blood Hb (46.1%), serum iron (100.0%), vitamin B12 (8.3%), and folic acid (4.4%) deficiencies, hyperhomocysteinemia (16.1%), and serum GPCA positivity (31.1%) than 532 healthy control subjects (all P-values < 0.001). In addition, of 83 anemic ID/AG patients, 9 (10.8%) had pernicious anemia, 40 (48.2%) had normocytic anemia, 30 (36.2%) had IDA, and 4 (4.8%) had thalassemia trait-induced anemia. CONCLUSION: We conclude that ID/AG patients had significantly higher frequencies of blood Hb, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects. Normocytic anemia is the most common type of anemia in ID/AG patients, followed by IDA, pernicious anemia, and thalassemia trait-induced anemia.


Assuntos
Anemia Ferropriva/epidemiologia , Autoanticorpos/sangue , Deficiência de Ácido Fólico/epidemiologia , Glossite/epidemiologia , Hiper-Homocisteinemia/epidemiologia , Deficiência de Vitamina B 12/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Ferropriva/sangue , Anemia Perniciosa , Estudos de Casos e Controles , Comorbidade , Índices de Eritrócitos , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/sangue , Hematínicos , Hemoglobinas/análise , Humanos , Hiper-Homocisteinemia/sangue , Ferro/sangue , Masculino , Pessoa de Meia-Idade , Células Parietais Gástricas/imunologia , Taiwan/epidemiologia , Vitamina B 12/sangue , Deficiência de Vitamina B 12/sangue , Adulto Jovem
13.
Int J Vitam Nutr Res ; 90(1-2): 151-155, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30761942

RESUMO

Vitamin B12 (Cobalamin) deficiency, due to improper internalization of cobalamin, is a metabolic disorder prevalent in impoverished and elderly populations and is associated with megaloblastic anemia and dementia. It has been suggested that mutations in transcobalamin II (TCN2) or gastric intrinsic factor (GIF) proteins can alter their binding efficiency to cobalamin or reduce the ability of their receptors to internalize them. In this case-control study, the correlation between vitamin B12 deficiency and alternative alleles of TCN2 and GIF was investigated in a Jordanian population. One hundred individuals with vitamin B12 deficiency (B12 < 200 mg/mL) were enrolled in our study to evaluate the TCN2 and GIF polymorphisms. The control group (B12 > 200 mg/mL) included 100 individuals. Our results indicated a significant association between the homologous variant of the TCN2 gene (G776G) and vitamin B12 deficiency, and an intermediate phenotype in heterozygous individuals (p < 0.001, OR = 5.6, 95% CI = 2.95 to 10.63). The GIF gene, however, showed no correlation between the A68G variant and vitamin B12 deficiency (p = 0.2). This study expounds the association of TCN2 polymorphism with cobalamin levels in a Jordanian population and highlights the necessity of further studies to elucidate the molecular basis and impact of TCN2 and GIF genes polymorphisms on vitamin B12 deficiency and associated disorders.


Assuntos
Transcobalaminas , Deficiência de Vitamina B 12/sangue , Vitamina B 12/sangue , Idoso , Estudos de Casos e Controles , Humanos , Prevalência , Transcobalaminas/genética , Vitamina B 12/química , Vitamina B 12/metabolismo , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/genética
14.
QJM ; 113(1): 5-15, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30796433

RESUMO

The objective of this narrative review was to provide an update on oral and nasal vitamin B12 (cobalamin) therapy in elderly patients. Relevant articles were identified by 'PubMed' and 'Scholar Google' search from January 2010 to July 2018 and through hand search of relevant reference articles. Additional studies were obtained from references of identified studies, the 'Cochrane Library' and the 'ISI Web of Knowledge'. Data retrieved from international meetings were also used, as was information retrieved from commercial sites on the web and data from 'CARE B12' research group. For oral vitamin B12 therapy, four prospective randomized controlled trials, eight prospective studies, one systematic and four reviews fulfilled our inclusion criteria. The studies included mainly or exclusively elderly patients (≥65-year-olds). In all of the studies, the mean age of the patients was at least 70 years except for two. The present review documents that oral vitamin B12 replacement at 1000 µg daily proved adequate to cure vitamin B12 deficiency, with a good safety profile. The efficacy was particularly marked when considering the noticeable improvement in serum vitamin B12 levels and haematological parameters, such as haemoglobin level, mean erythrocyte cell volume and reticulocyte count. The effect of oral cobalamin treatment in patients presenting with severe neurological manifestations has not yet been adequately documented. For nasal vitamin B12, only a few preliminary studies were available. We conclude that oral vitamin B12 is an effective alternative to intramuscular vitamin B12 injections in elderly patients. Oral vitamin B12 treatment avoids the discomfort, inconvenience and cost of monthly injections.


Assuntos
Envelhecimento/fisiologia , Deficiência de Vitamina B 12/tratamento farmacológico , Vitamina B 12/administração & dosagem , Administração Intranasal , Administração Oral , Idoso , Suplementos Nutricionais , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina B 12/sangue , Vitamina B 12/metabolismo , Deficiência de Vitamina B 12/sangue
15.
J Formos Med Assoc ; 119(1 Pt 2): 377-383, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31277918

RESUMO

BACKGROUND/PURPOSE: Our previous study found 284 gastric parietal cell antibody (GPCA)-positive atrophic glossitis (AG) patients (so-called GPCA+AG patients in this study) in a group of 1064 AG patients. This study evaluated whether high-titer (GPCA titer ≥ 160) GPCA+AG patients had greater frequencies of anemia, vitamin B12 deficiency, macrocytosis, and hyperhomocysteinemia than low-titer (GPCA titer < 160) GPCA+AG patients. METHODS: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 117 high-titer GPCA+AG patients, 167 low-titer GPCA+AG patients, and 532 healthy control subjects were measured and compared. RESULTS: We found that 12.0%, 29.1%, 23.1%, 16.2%, 1.7%, and 23.1% of 117 high-titer GPCA+AG patients and 5.4%, 17.4%, 17.4%, 7.2%, 1.2%, and 14.4% of 167 low-titer GPCA+AG patients were diagnosed as having macrocytosis, blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. Moreover, both 117 high-titer and 167 low-titer GPCA+AG patients had significantly greater frequencies of macrocytosis, blood hemoglobin, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 532 healthy control subjects (all P-values < 0.05). In addition, 117 high-titer GPCA+AG patients also had greater frequencies of anemia (P = 0.029, statistically significant), serum vitamin B12 deficiency (P = 0.027, statistically significant), macrocytosis (P = 0.075, marginal significance), and hyperhomocysteinemia (P = 0.085, marginal significance) than 167 low-titer GPCA+AG patients. CONCLUSION: For GPCA+AG patients, high-titer GPCA+AG patients have greater frequencies of anemia, serum vitamin B12 deficiency, macrocytosis, and hyperhomocysteinemia than low-titer GPCA+AG patients.


Assuntos
Anemia Macrocítica/sangue , Autoanticorpos/sangue , Glossite/sangue , Hiper-Homocisteinemia/etiologia , Deficiência de Vitamina B 12/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Macrocítica/complicações , Anemia Macrocítica/imunologia , Atrofia , Estudos de Casos e Controles , Índices de Eritrócitos , Feminino , Ácido Fólico/sangue , Glossite/complicações , Glossite/imunologia , Hemoglobinas/análise , Homocisteína/sangue , Humanos , Ferro/sangue , Masculino , Pessoa de Meia-Idade , Células Parietais Gástricas/imunologia , Língua/patologia , Vitamina B 12/sangue , Deficiência de Vitamina B 12/complicações
16.
J Formos Med Assoc ; 119(3): 720-727, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31630933

RESUMO

BACKGROUND/PURPOSE: Our previous study found that 56 of 1064 atrophic glossitis (AG) patients have vitamin B12 deficiency. This study assessed whether the AG patients with vitamin B12 deficiency (B12D/AG patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. METHODS: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 56 B12D/AG patients and 532 healthy control subjects were measured and compared. RESULTS: We found that 56 B12D/AG patients had significantly lower mean blood Hb and serum iron levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values < 0.05). Moreover, 56 B12D/AG patients had significantly higher frequencies of macrocytosis (53.6%), blood Hb (64.3%), iron (26.8%), and folic acid (3.6%) deficiencies, hyperhomocysteinemia (89.3%), and serum GPCA positivity (55.4%) than 532 healthy control subjects (all P-values < 0.005). In addition, of 36 anemic B12D/AG patients, 22 (61.1%) had pernicious anemia (PA), 6 (16.7%) had macrocytic anemia other than PA, 4 (11.1%) had normocytic anemia, 3 (8.3%) had iron deficiency anemia (IDA), and one (2.8%) had microcytic anemia other than IDA and thalassemia trait-induced anemia. CONCLUSION: We conclude that B12D/AG patients have significantly higher frequencies of macrocytosis, blood Hb, iron, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. PA is the most common type of anemia in our B12D/AG patients.


Assuntos
Anemia/epidemiologia , Deficiência de Ácido Fólico/epidemiologia , Glossite/epidemiologia , Hiper-Homocisteinemia/epidemiologia , Deficiência de Vitamina B 12/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Autoanticorpos/sangue , Estudos de Casos e Controles , Comorbidade , Índices de Eritrócitos , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/sangue , Hematínicos , Hemoglobinas/análise , Humanos , Hiper-Homocisteinemia/sangue , Ferro/sangue , Masculino , Pessoa de Meia-Idade , Células Parietais Gástricas/imunologia , Vitamina B 12/sangue , Deficiência de Vitamina B 12/sangue
17.
BMJ Case Rep ; 12(12)2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31811099

RESUMO

Vitamin B12 deficiency and its sequelae are well described and reported, especially in vegetarians. However, its association with haemodynamic instability is not well identified. We report a case of a young man, previously healthy, presenting with fever, hypotension requiring vasopressors and pancytopenia. Extensive workup was unrevealing for possible infective, inflammatory or endocrine causes except for vitamin B12 deficiency. Fever and haematological parameters stabilised after adequate supplementation of cyanocobalamin (vitamin B12).


Assuntos
Deficiência de Vitamina B 12/diagnóstico , Vitamina B 12/uso terapêutico , Complexo Vitamínico B/uso terapêutico , Adulto , Diagnóstico Diferencial , Dieta Vegetariana , Febre/etiologia , Humanos , Hipotensão/etiologia , Masculino , Pancitopenia/etiologia , Vitamina B 12/administração & dosagem , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/tratamento farmacológico , Complexo Vitamínico B/administração & dosagem
18.
Biomed Res Int ; 2019: 1450536, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31886171

RESUMO

Background and Aim: As a worldwide infectious bacterium, H. pylori leads to stomach pathologies such as gastritis, peptic ulcer, gastric cancer, MALToma, and various extragastric manifestations. In our study, we aimed to investigate the association between serum vitamin B12 level and cytotoxin-associated gene-A (CagA) seropositivity, which is one of the virulence factors of Helicobacter pylori (H. pylori). Method: This study has been conducted on 289 patients who have met the inclusion criteria. Within these patients, 213 of them were H. pylori positive and 76 were negative. Vitamin B12 and CagA-IgG levels were assessed in consecutive dyspeptic patients undergoing upper endoscopy. Results: Out of 289 patients, 51.9% were women (n = 150) and H. pylori was detected in 213 (73.7%) patients. Histopathological evaluation with modified Sydney classification revealed lymphocyte infiltration in 66.8% (n = 193), activation in 46% (n = 133), metaplasia in 11.4% (n = 33), atrophy in 11.4% (n = 33), and lymphoid follicles in 21.1% (n = 61) of the patients. Within H. pylori-positive patients, the ratio of CagA positivity was 57.3% (n = 122). Low B12 vitamin level was significantly correlated with existence of H. pylori (p=0.02), CagA (p=0.002), lymphocyte (p=0.006), metaplasia (p=0.001), atrophy (p=0.001), and lymphoid follicles (p=0.006). Positivity of CagA has been detected to be statistically corelated with lymphocyte (p=0.001) and activation (p=0.005); however, the same relation was not present with atrophy (p=0.236). Conclusion: In conclusion, B12 deficiency was positively correlated with CagA positivity and gastric inflammatory activity.


Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Infecções por Helicobacter/genética , Helicobacter pylori/genética , Vitamina B 12/sangue , Adolescente , Adulto , Idoso , Antígenos de Bactérias/sangue , Atrofia/sangue , Atrofia/genética , Proteínas de Bactérias/sangue , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Infecções por Helicobacter/sangue , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Estômago/microbiologia , Estômago/patologia , Neoplasias Gástricas/sangue , Neoplasias Gástricas/genética , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Fatores de Virulência , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/genética , Deficiência de Vitamina B 12/microbiologia , Adulto Jovem
19.
Nutrients ; 11(12)2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31810343

RESUMO

BACKGROUND: Gastric function, Helicobacter pylori infection, and vitamin B12 (B12) dietary intake were assessed as predictors of serum B12. METHODS: H. pylori antibodies, gastric function, B12 dietary intake, and biochemical/hematological parameters were measured in 191 adult women from two rural communities in Querétaro, Mexico. RESULTS: The overall mean serum B12 concentration was 211 ± 117 pmol/L. The prevalences of low (≤ 148 pmol/L), marginal (148 to 221 pmol/L), and adequate (> 221 pmol/L) serum B12 were 28.4%, 31.1%, and 40.5%, respectively. Seventy-one percent of women tested positive for H. pylori antibodies. The prevalence of gastric function categories did not differ by serum B12 categories. The odds ratio for having low serum B12 was 2.7 (p = 0.01) for women with an intake below the estimated average requirement, 3.6 (p = 0.01) for those in the lowest tertile of total B12 intake, and 3.0 (p = 0.02) for those in the lowest tertile of B12 intake from animal source foods. Age and B12 intake were predictors of serum B12 concentrations [serum B12 (pmol/L) = 90.060 + 5.208 (B12 intake, µg/day) + 2.989 (age, years). CONCLUSIONS: Low serum B12 concentrations were associated with low B12 dietary intake but not with H. pylori infection or abnormal gastric function in rural Mexican women.


Assuntos
Dieta/efeitos adversos , Gastroenteropatias/epidemiologia , Infecções por Helicobacter/epidemiologia , Deficiência de Vitamina B 12/epidemiologia , Vitamina B 12/sangue , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Dieta/métodos , Inquéritos sobre Dietas , Feminino , Gastroenteropatias/sangue , Gastroenteropatias/etiologia , Infecções por Helicobacter/sangue , Infecções por Helicobacter/etiologia , Helicobacter pylori , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Estado Nutricional , Razão de Chances , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Vitamina B 12/análise , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/etiologia , Adulto Jovem
20.
Nutrients ; 11(12)2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31835560

RESUMO

As not much is known about the prevalence and predictors of nutritional deficiencies among vegans in the Czech Republic, we evaluated whether supplement use and duration of adherence to the vegan diet are associated with the risk of cobalamin and iron deficiencies. Associations between self-reported supplementation and duration of vegan diet with biomarkers of cobalamin (serum cobalamin, holotranscobalamin, homocysteine, folate) and iron status (serum ferritin, iron binding capacity, transferrin and saturation of transferrin) were assessed by cross-sectional analyses of medical data from a clinical nutrition center. Data from 151 (72 females) adult vegans (age 18-67 years), who were free of major chronic diseases and 85 (40 females) healthy non-vegans (age 21-47 years) were analyzed. Overall, vegans had significantly lower cobalamin, hemoglobin and ferritin levels, but higher folate and MCV values compared to non-vegans. Vegans not using cobalamin supplements were at higher risk of low plasma cobalamin than regularly supplementing vegans (OR: 4.41, 95% CI 1.2-16.16 for cobalamin, OR: 19.18, 95% CI 1.02-359.42 for holotranscobalamin), whereas no significant differences in cobalamin status related to duration of the vegan diet were observed. Regularly supplementing vegans had similar levels of cobalamin/holotranscobalamin as non-vegans. Despite lower ferritin and hemoglobin levels, there was no indication of a higher risk of iron-deficiency among vegans. To conclude cobalamin deficiency risk depends on supplementation status and not on the duration of an exclusive vegan diet, which underlines the need to integrate cobalamin status monitoring and counselling on supplement use in routine clinical care in the Czech Republic.


Assuntos
Anemia Ferropriva/epidemiologia , Dieta Vegana , Suplementos Nutricionais , Deficiência de Vitamina B 12/epidemiologia , Vitamina B 12/administração & dosagem , Adolescente , Adulto , Idoso , Anemia Ferropriva/sangue , Estudos Transversais , República Tcheca/epidemiologia , Feminino , Ferritinas/sangue , Ácido Fólico/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Veganos , Vitamina B 12/sangue , Deficiência de Vitamina B 12/sangue , Adulto Jovem
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