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1.
Am J Clin Nutr ; 111(4): 919-926, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32266401

RESUMO

BACKGROUND: Vitamin B-12 and folate deficiencies in women and children have important public health implications. However, the evidence is conflicting and limited on whether the influence of inflammation on biomarker concentrations may be sufficiently and consistently influenced by inflammation to require adjustment for interpreting concentrations or estimating population prevalence of deficiencies. OBJECTIVE: We examined correlations between concentrations of the inflammation biomarkers C-reactive protein (CRP) and α1-acid glycoprotein (AGP) and serum vitamin B-12 and serum and RBC folate among nonpregnant women of reproductive age (WRA; 15-49 yr) and preschool children (PSC; 6-59 mo). METHODS: We analyzed cross-sectional data from 16 nationally representative nutrition surveys conducted in WRA (n = 32,588) and PSC (n = 8,256) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project. Spearman correlations between CRP or AGP and vitamin B-12 or folate concentrations were examined, taking into account complex survey design effects. RESULTS: Correlations between inflammation and vitamin B-12 or folate were weak, with no clear pattern of association in either WRA or PSC. Correlation coefficients between CRP and vitamin B-12 for WRA and PSC ranged from -0.25 to 0.16, and correlations between AGP and vitamin B-12 ranged between -0.07 and 0.14. Similarly, correlations between CRP and serum folate ranged from -0.13 to 0.08, and correlations between AGP and serum folate between -0.21 and 0.02. Only 3 surveys measured RBC folate, and among them, correlations for WRA ranged from -0.07 to 0.08 for CRP and -0.04 for AGP (1 country). CONCLUSIONS: Based on the weak and inconsistent correlations between CRP or AGP and vitamin B-12 or folate biomarkers, there is no rationale to adjust for inflammation when estimating population prevalence of vitamin B-12 or folate deficiencies in WRA or PSC.


Assuntos
Anemia/sangue , Ácido Fólico/sangue , Vitamina B 12/sangue , Adolescente , Adulto , Anemia/genética , Anemia/imunologia , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Pessoa de Meia-Idade , Inquéritos Nutricionais , Orosomucoide/metabolismo , Adulto Jovem
2.
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
3.
Pediatrics ; 145(3)2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32019814

RESUMO

BACKGROUND AND OBJECTIVES: Vitamin B12 and folate are important for normal brain development. Our objective for this study was to measure the effects of 6-month supplementation of vitamin B12 and/or folic acid in early childhood on cognition when the children were 6 to 9 years old. METHODS: The study is a follow-up of a factorial randomized, double-blind, placebo-controlled trial in 1000 North Indian children. Children 6 to 30 months of age were randomly assigned to receive a placebo or 1.8 µg of vitamin B12, 150 mg of folic acid, or both daily for 6 months. After 6 years, we re-enrolled 791 of these children for cognitive assessments. We compared the scores of the main outcomes (the Wechsler Intelligence Scale for Children, Fourth Edition [India], the Crichton Verbal Scale, and subtests of the NEPSY-II) between the study groups. We also measured the associations between markers of the B vitamins (plasma cobalamin, folate, and total homocysteine concentrations) in early childhood and the cognitive outcomes. RESULTS: There were no differences between the intervention groups and the placebo group on the cognitive outcomes. Plasma cobalamin, folate, and total homocysteine concentrations in early childhood were associated with the cognitive outcomes at follow-up in the unadjusted models. These associations disappeared in models adjusted for relevant confounders. CONCLUSIONS: Our findings, from both an observational and a randomized design suggest that vitamin B12 and folate in children 6 to 36 months have limited public health relevance for long-term cognition.


Assuntos
Desenvolvimento Infantil , Cognição , Ácido Fólico/administração & dosagem , Vitamina B 12/administração & dosagem , Complexo Vitamínico B/administração & dosagem , Criança , Método Duplo-Cego , Feminino , Ácido Fólico/sangue , Homocisteína/sangue , Humanos , Índia , Testes de Inteligência , Desenvolvimento da Linguagem , Masculino , Vitamina B 12/sangue
4.
PLoS One ; 15(1): e0228109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978144

RESUMO

Irradiation of food at 50-55 kGy results in a profound, chronic demyelinating-remyelinating disease of the entire central nervous system (CNS) in cats, named Feline Irradiated Diet-Induced Demyelination (FIDID). This study examines the early stages of demyelination and long-term consequences of demyelination and remyelination on axon survival or loss. Myelin vacuolation is the primary defect leading to myelin breakdown, demyelination then prompt remyelination in the spinal cord and brain. There is no evidence of oligodendrocyte death. The spinal cord dorsal column is initially spared yet eventually becomes severely demyelinated with subsequent loss of axons in the core and then surface of the fasciculus gracilis. However remyelination of the sub-pial axons in the dorsal column results in their protection. While there was a lack of biochemical evidence of Vitamin B12 deficiency, the pathological similarities of FIDID with sub-acute combined degeneration (SCD) led us to explore treatment with Vitamin B12. Treatment led to recovery or improvement in some cats and neurologic relapse on cessation of B12 therapy. While the reason that irradiated food is myelinotoxic in the cat remains unresolved, nonetheless the neuropathological changes match exactly what is seen in SCD and its models and provide an ideal model to study the cellular and molecular basis of remyelination.


Assuntos
Doenças Desmielinizantes/patologia , Dieta , Degeneração Neural/patologia , Radiação , Doença Aguda , Animais , Axônios/patologia , Gatos , Doença Crônica , Doenças Desmielinizantes/sangue , Doenças Desmielinizantes/fisiopatologia , Modelos Animais de Doenças , Feminino , Macrófagos/patologia , Masculino , Metaboloma , Microglia/patologia , Bainha de Mielina/metabolismo , Degeneração Neural/sangue , Degeneração Neural/fisiopatologia , Neuropatologia , Remielinização , Medula Espinal/patologia , Medula Espinal/fisiopatologia , Fatores de Tempo , Vitamina B 12/sangue
5.
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
6.
Clin Biochem ; 76: 1-4, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31672645

RESUMO

INTRODUCTION: We describe the implementation of an Alberta-wide intervention aimed at educating clinicians about redundant vitamin B12 testing. We hypothesized that the introduction of an educational comment outlining recommended vitamin B12 test intervals would reduce the annual number of vitamin B12 tests performed. MATERIALS AND METHODS: We performed a cross-sectional observational study that included all vitamin B12 tests ordered in Alberta between May 1, 2017 and April 30, 2018. An educational comment was appended to all vitamin B12 test results in Alberta beginning May 2, 2017. Using a simple seasonal model, we compared predicted versus observed vitamin B12 test volumes for the 12-month period following the introduction of the educational comment. The sole outcome measured was the monthly change in volume of vitamin B12 testing. A cost-analysis of the effects of the intervention on test volumes was also performed. RESULTS: Over the sum of the first 12 months of the intervention, 18,000 more vitamin B12 tests were ordered compared to the predicted value in Alberta. With an estimated cost of $7 per test, this resulted in a $126,000 increase in costs for vitamin B12 testing provincially. CONCLUSIONS: An educational intervention aimed at limiting inappropriate vitamin B12 testing in Alberta did not alter testing as desired. Multiple utilization management strategies and a longer observation period may be needed to reduce redundant vitamin B12 testing.


Assuntos
Educação Médica Continuada/organização & administração , Vitamina B 12/sangue , Alberta , Estudos Transversais , Testes Diagnósticos de Rotina , Feminino , Humanos , Masculino
7.
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
8.
Exp Oncol ; 41(4): 357-362, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31868326

RESUMO

AIM: Currently there are some large-scale studies of elevated total vitamin B12 in relation to diseases and their prognosis. Aim of this retrospective study was to determine association of increased B12 as an additional diagnostic marker of oncohematological diseases by a statistical analysis of clinical data of 79,524 patients. MATERIALS AND METHODS: Overall Latvian population representative data on B12  testing in 79,524 patients were obtained from laboratory database. The following exclusion criteria were applied: fluctuating B12 results within a three-month period, elevated (> 100 U/L) alanine transaminase or aspartate transaminase, hepatitis (HAV, HBV, and HCV) infection, reduced glomerular filtration rate (< 45 mL/min/1.73 m2). As a control group, individuals with normal B12 level and any oncologic diagnosis (solid cancer or hematological malignancies) were selected. RESULTS: After application of step-by-step exclusion filters, 1,373 patients were left with significantly increased level of plasma B12 (> 1,700 pg/mL). Odds ratios for oncohematological diseases in total and myeloid leukemia (including acute, chronic and unspecified) in patient group with elevated B12 were found to be 6.0 (95% CI 4.7-7.6; p < 0.0001) and 19.2 (95% CI 13.1-28.0; p <0.0001), respectively, as compared to the control group. CONCLUSION: Elevated total B12 could be considered as a potential marker for oncohematological disorders.


Assuntos
Neoplasias Hematológicas/sangue , Leucemia Mieloide/sangue , Vitamina B 12/sangue , Biomarcadores Tumorais/sangue , Estudos de Coortes , Neoplasias Hematológicas/epidemiologia , Humanos , Letônia/epidemiologia , Leucemia Mieloide/epidemiologia
9.
Medicine (Baltimore) ; 98(47): e17970, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764802

RESUMO

Alzheimer disease (AD) is the most common neurodegenerative disease in the world. The relationship between AD and homocysteine (Hcy) is contradictory.A community-based investigation was conducted to find patients with AD in a vitamin B deficient population (≥55 years old) in Lüliang area in China. Venous blood samples were collected. Serum Hcy, folate, and vitamin B12 were measured. For each case, 4 controls were selected matched with age to evaluate the relationship between Hcy and AD.The crude prevalence of AD among people ages 55 years or older in this area was 8.60%. There were significant differences in serum Hcy and B12 between the case and control groups. We found that the higher level of serum Hcy was associated with a high risk of AD, and higher education level, higher folate and B12 concentration were protective factors to AD.Adjustment of diet structure and supplementation of folate and B12 may offer potential therapeutic measures in this area.


Assuntos
Doença de Alzheimer/sangue , Doença de Alzheimer/etiologia , Disfunção Cognitiva/sangue , Disfunção Cognitiva/etiologia , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/complicações , Ácido Fólico/sangue , Homocisteína/sangue , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/complicações , Vitamina B 12/sangue , Idoso , Idoso de 80 Anos ou mais , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Medicina (B Aires) ; 79(5): 391-396, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31671389

RESUMO

High serum levels of vitamin B12 or cobalamin, also called hypervitaminemia B12, is a frequently underestimated biological abnormality. According to the literature, some of the entities related to this finding are solid neoplasia (primary or metastatic) and acute or chronic hematological diseases. Other causes include liver disorders, monoclonal gammapathy of undetermined significance, renal failure and, less frequently, excess of vitamin B12 intake, inflammatory or autoimmune diseases, and transient hematological disorders (neutrophilia and secondary eosinophilia). This article reports on causes of hypervitaminosis B12, our experience and a review of the literature.


Assuntos
Transtornos Nutricionais/sangue , Transtornos Nutricionais/etiologia , Vitamina B 12/sangue , Lesão Renal Aguda/sangue , Lesão Renal Aguda/complicações , Doenças Hematológicas/sangue , Doenças Hematológicas/complicações , Humanos , Hepatopatias/sangue , Hepatopatias/complicações , Neoplasias/sangue , Neoplasias/complicações , Vitamina B 12/efeitos adversos
11.
Medicine (Baltimore) ; 98(46): e17918, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725641

RESUMO

BACKGROUND: Metformin can cause serum vitamin B12 deficiency, but studies on the influence of its duration and dose are lacking. We investigated vitamin B12 deficiency in patients with type 2 diabetes using metformin, in conjunction with other related factors. METHOD: This cross-sectional study included 1111 patients with type 2 diabetes who took metformin for at least 6 months. Serum vitamin B12 levels were quantified using a competitive-binding immunoenzymatic assay, and vitamin B12 deficiency was defined as serum B12 <300 pg/mL. Information on metformin use and confounding variables were collected from records or questionnaires and interviews. RESULT: Serum vitamin B12 deficiency occurred in 22.2% of patients (n = 247). After adjusting for confounders, a 1 mg increase in daily metformin dose was associated with a 0.142 pg/mL decrease in vitamin B12 (P < .001). Compared with a daily dose of <1000 mg, the adjusted odds ratios for 1000 to 1500, 1500 to 2000, and ≥2000 mg metformin were 1.72 (P = .080), 3.34 (P < .001), and 8.67 (P < .001), respectively. Vitamin B12 deficiency occurred less often in patients taking multivitamins (odds ratio 0.23; P < .001). After adjusting for confounding factors, there was no correlation between B12 deficiency and duration of metformin use. Serum homocysteine levels showed significant negative correlation with vitamin B12. CONCLUSION: Metformin at ≥1500 mg/d could be a major factor related to vitamin B12 deficiency, whereas concurrent supplementation of multivitamins may potentially protect against the deficiency. Serum homocysteine levels were negatively correlated with vitamin B12 levels, suggesting that B12 deficiency due to metformin use may occur at the tissue level. However, this hypothesis will require further study.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Deficiência de Vitamina B 12/induzido quimicamente , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Anemia/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Ácido Fólico/sangue , Homocisteína/sangue , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Masculino , Metformina/administração & dosagem , Metformina/efeitos adversos , Pessoa de Meia-Idade , Razão de Chances , República da Coreia , Fatores de Tempo , Vitamina B 12/sangue , Vitaminas
12.
Medicine (Baltimore) ; 98(39): e17334, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574870

RESUMO

RATIONALE: Subacute combined degeneration (SCD) is a disease caused by decreased vitamin B12 intake or metabolic disorders. It is more common in the elderly and rarely seen in children. Here, we report 2 pediatric cases of SCD in late-onset cobalamin C (CblC) deficiency. PATIENT CONCERNS: The patients complained of unsteady gait. Their physical examination showed sensory ataxia. Magnetic resonance imaging showed classic manifestations of SCD. The serum vitamin B12 level was normal, but urine methylmalonic acid and serum homocysteine levels were high. DIAGNOSIS: The pathogenic gene was confirmed as MMACHC. The 2 patients each had 2 pathogenic mutations C.482 G>A and C.271dupA and C.365A>T and C.609G>A in this gene. They were diagnosed with combined methylmalonic acidemia and homocysteinemia-CblC subtype. INTERVENTIONS: The patients were treated with methylcobalamin 500 µg intravenous injection daily after being admitted. After the diagnosis, levocarnitine, betaine, and vitamin B12 were added to the treatment. OUTCOMES: Twelve days after treatment, the boy could walk normally, and his tendon reflex and sense of position returned to normal. The abnormal gait seemed to have become permanent in the girl and she walked with her legs raised higher than normal. LESSONS: To the best of our knowledge, this is the first report of 2 cases of isolated SCD in children with late-onset CblC disorder. Doctors should consider that SCD could be an isolated symptom of CblC disorder. The earlier the treatment, the lower the likelihood of sequelae.


Assuntos
Proteínas de Transporte/genética , Homocistinúria , Degeneração Combinada Subaguda , Deficiência de Vitamina B 12/congênito , Vitamina B 12/análogos & derivados , Adolescente , Ataxia/diagnóstico , Ataxia/etiologia , Ataxia/terapia , Encéfalo/diagnóstico por imagem , Criança , Feminino , Homocisteína/sangue , Homocistinúria/diagnóstico , Homocistinúria/genética , Humanos , Injeções Intravenosas , Transtornos de Início Tardio , Imagem por Ressonância Magnética/métodos , Masculino , Ácido Metilmalônico/urina , Mutação , Oxirredutases , Degeneração Combinada Subaguda/diagnóstico , Degeneração Combinada Subaguda/etiologia , Degeneração Combinada Subaguda/fisiopatologia , Degeneração Combinada Subaguda/terapia , Resultado do Tratamento , Vitamina B 12/administração & dosagem , Vitamina B 12/sangue , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/genética , Complexo Vitamínico B/administração & dosagem
13.
Arq Bras Cir Dig ; 32(3): e1453, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644673

RESUMO

BACKGROUND: : Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period. AIM: To investigate nutritional status in 10 years follow-up. METHODS: : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records. RESULTS: : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake. CONCLUSIONS: : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.


Assuntos
Derivação Gástrica/reabilitação , Estado Nutricional/genética , Obesidade/cirurgia , Fenótipo , Adulto , Índice de Massa Corporal , Feminino , Ácido Fólico/sangue , Seguimentos , Humanos , Ferro/sangue , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/sangue , Transtornos Nutricionais/etiologia , Obesidade/complicações , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Vitamina B 12/sangue , Perda de Peso
14.
Ann Agric Environ Med ; 26(3): 489-495, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559809

RESUMO

INTRODUCTION AND OBJECTIVE: Deficits of vitamin resources constitute a significant public health problem, especially among the elderly population. The aim of the research was to determine the level of vitamin 25 (OH) D and vitamins from group B in the chronically ill elderly in domiciliary care, depending on functional capacity and coexisting diseases. MATERIAL AND METHODS: The pilot study included 137 patients staying in long-term domiciliary care. Samples of the participants' venous blood was obtained for laboratory tests. Centrifuged serum was used to determine the level of the following biochemical parameters: vitamin 25 (OH)D, B12, folic acid and total protein, albumin, triglycerides, total cholesterol and HDL cholesterol. Assessment of the functional status of patients was made by using the Barthel scale. RESULTS: More than ¾ of the patients with functional deficit (according to Barthel's score 0-85 points) were deficient in vitamin 25 (OH)D, while folic acid values were below the reference values in more than half of the patients. Respondents with lower functional efficiency were characterised by a reduced average value of vitamin 25 (OH)D and folic acid. CONCLUSIONS: The studied group of the chronically ill elderly was characterised by a deficiency of vitamin D3 and folic acid. Subjects with a functional impairment deficit show a reduced mean value of vitamin 25 (OH)D and folic acid in the blood serum, compared to the group of patients with higher mobility.


Assuntos
Envelhecimento/sangue , Doença Crônica/terapia , Vitamina B 12/sangue , Vitamina D/sangue , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Feminino , Ácido Fólico/sangue , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Locomoção , Masculino , Atividade Motora , Projetos Piloto , Triglicerídeos/sangue
15.
J Nutr Sci Vitaminol (Tokyo) ; 65(4): 309-317, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474680

RESUMO

Vitamin B12, folate, and ferritin are vital for the development of the nervous system, blood formation, and diverse metabolic functions. The aim of the current study is to evaluate the status of vitamin B12, folate and ferritin in the Jordanian population across distinct geographical locations. In this retrospective study, the cohort population included 2,880 Jordanian individuals with an average age of 47 y for males and 34 y for females (January 2014-December 2016). Vitamin B12, folate, and ferritin were measured in the blood samples by immunoassay on an automated instrument. Prevalence of low levels of vitamin B12 among males and females was similar across the four regions (24%). Equivalently high levels of folate were reported in males (24.4%) and females (23.4%). Additionally, 37.4% of males and 20.4% of females showed low levels of ferritin. Pearson's correlations did not show any association between age, vitamin B12, folate, and ferritin levels in both sexes. Univariate odd ratio (OR) and age-adjusted OR in males showed a significant decrease in low vitamin B12 risk in the region of Tafela when compared to Irbid. In conclusion, our results showed a significant difference in vitamin B12 levels between populations according to their geographical locations. Ferritin levels were low in almost a quarter of the Jordanian population with a high prevalence in males and females in Irbid and Maan, respectively. These differences might be associated with the genetic, dietary and lifestyle situation which requires further studies to elucidate the risk factors for vitamin B12 and ferritin deficiency.


Assuntos
Ferritinas/sangue , Ferritinas/deficiência , Ácido Fólico/sangue , Deficiência de Vitamina B 12/epidemiologia , Vitamina B 12/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Adulto Jovem
16.
J Vet Intern Med ; 33(5): 2005-2013, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31381203

RESUMO

BACKGROUND: Protein-losing enteropathy (PLE) because of chronic inflammatory enteropathy (CIE) in dogs is often treated with a combination of glucocorticoids and second-line immunosuppressant (SLI). This combined approach might not be necessary in all dogs. HYPOTHESIS/OBJECTIVES: To describe diagnostic features and outcomes of dogs with PLE treated with glucocorticoids alone (group P) or with glucocorticoids and SLI (group S). ANIMALS: Thirty-one dogs with PLE. MATERIAL AND METHODS: Retrospective analysis of signalment data from diagnostic procedures, treatment, and outcome of dogs with CIE/PLE (from 2015 to 2017), using the hospital's digital case database. Dogs with hypoalbuminemia and CIE were included. Because of a stepwise treatment algorithm, dogs were allocated to group P or S. Time to serum albumin concentrations ≥20 g/L and survival data were collected. Dogs were additionally categorized by their albumin and cobalamin serum concentrations. Multivariate and univariate analysis as well as Pearson's correlation and Kaplan-Maier survival analysis were performed. RESULTS: Seventeen dogs were included in group P and 14 in group S. World Small Animal Veterinary Association score of the duodenum was different between groups (P = .05), but none of the other examined data. Median time until serum albumin reached >20 g/L was 13 days. Median survival time after start of treatment was 85 days (range, 13-463 days) in group P and 166 days (range, 8-390 days) in group S. CONCLUSION AND CLINICAL IMPORTANCE: No routine diagnostic test was predictive of clinical response, treatment group, or outcome. Glucocorticoid treatment alone can be appropriate in dogs with PLE.


Assuntos
Doenças do Cão/diagnóstico , Doenças do Cão/tratamento farmacológico , Glucocorticoides/uso terapêutico , Imunossupressores/uso terapêutico , Enteropatias Perdedoras de Proteínas/veterinária , Animais , Cães , Quimioterapia Combinada , Enteropatias Perdedoras de Proteínas/diagnóstico , Enteropatias Perdedoras de Proteínas/tratamento farmacológico , Estudos Retrospectivos , Albumina Sérica/análise , Análise de Sobrevida , Resultado do Tratamento , Vitamina B 12/sangue
17.
J Vet Intern Med ; 33(4): 1627-1634, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31257669

RESUMO

BACKGROUND: Hypocobalaminemia, hypofolatemia and iron deficiency are associated with pregnancy-related anemia (PRA) and neonatal survival (NS) in women. Similar associations have not been investigated in pregnant bitches. OBJECTIVES: To investigate time course and associations of serum cobalamin, folate and iron status indicators with hematological variables and NS in pregnant bitches. ANIMALS: Forty-eight pregnant bitches. METHODS: A prospective cohort study. Pregnancy was confirmed by abdominal ultrasonography twice during mid- and late pregnancy, concurrently with blood sampling. Associations among pregnancy stage, NS and laboratory variables were assessed by generalized estimating equations. RESULTS: Compared with midpregnancy, serum cobalamin (adjusted mean [95% confidence interval, CI]) decreased at late pregnancy (430 pg/mL [394-466] versus 330 pg/mL [303-357], respectively; P < .001), whereas serum folate did not. Every increment of 1 in parity number or litter size corresponded to 28.6 pg/mL (95% CI, 5.6-51.6; P = .02) and 20.3 pg/mL (95% CI, 10.9-29.7; P < .001) decrease in serum cobalamin concentration. Compared with midpregnancy, serum iron (P < .001) and transferrin saturation (P = .01) increased at late pregnancy. The decrease in red blood cell count (P < .001) at late pregnancy was significantly, albeit weakly, correlated with decreasing serum folate concentration (r = 0.33; P = .02). None of the measures was associated with NS. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Pregnancy-related anemia was common at late pregnancy. Unlike in women, in pregnant bitches, serum iron and transferrin saturation were increased at late pregnancy. Future studies are warranted to investigate the clinical ramifications of hypocobalaminemia in pregnant bitches and the utility of prophylactic folate administration in mitigating PRA.


Assuntos
Ácido Fólico/sangue , Complicações Hematológicas na Gravidez/veterinária , Vitamina B 12/sangue , Animais , Animais Recém-Nascidos , Estudos de Coortes , Cães , Contagem de Eritrócitos/veterinária , Feminino , Ferro/sangue , Tamanho da Ninhada de Vivíparos , Paridade , Gravidez , Estudos Prospectivos , Transferrina/análise
18.
Medicina (Kaunas) ; 55(7)2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31277328

RESUMO

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400-800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25-40 mg/day), 3.6% of children for calcium (1000-1500 mg/day), 20% for magnesium (200-300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Micronutrientes/análise , Adolescente , Adulto , Cálcio/análise , Cálcio/sangue , Doença Celíaca/sangue , Doença Celíaca/tratamento farmacológico , Criança , Dieta Livre de Glúten/métodos , Suplementos Nutricionais/normas , Feminino , Ácido Fólico/análise , Ácido Fólico/sangue , Humanos , Ferro/análise , Ferro/sangue , Masculino , Micronutrientes/sangue , Cooperação do Paciente/psicologia , Vitamina B 12/análise , Vitamina B 12/sangue , Vitamina D/análise , Vitamina D/sangue , Zinco/análise , Zinco/sangue
19.
J Formos Med Assoc ; 118(9): 1299-1307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31202497

RESUMO

BACKGROUND/PURPOSE: Our previous studies found relatively higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with different types of oral mucosal diseases. This study evaluated whether patients with oral precancerous lesions (oral precancer patients) had significantly higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects. METHODS: The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects were measured and compared. RESULTS: We found significantly lower mean serum iron (for women only), vitamin B12, and folic acid levels and a significantly higher mean serum homocysteine level in oral precancer patients than in healthy control subjects (all P-values < 0.05). Moreover, 131 oral precancer patients had significantly higher frequencies of blood hemoglobin (3.1%), vitamin B12 (43.5%), and folic acid (46.6%) deficiencies and hyperhomocysteinemia (22.1%) than 131 healthy control subjects (all P-values < 0.05). Of 131 oral precancer patients, lower mean serum folic acid levels were found in 87 cigarette smokers than in 44 non-smokers (P = 0.002), in 26 smokers consuming > 20 cigarettes per day than in 61 smokers consuming ≤ 20 cigarettes per day (P = 0.024), and in 52 betel quid chewers than in 79 non-chewers (P = 0.051). CONCLUSION: There are significantly higher frequencies of anemia, serum vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in oral precancer patients than in healthy control subjects.


Assuntos
Autoanticorpos/sangue , Hiper-Homocisteinemia/sangue , Leucoplasia Oral/sangue , Doenças da Boca/sangue , Adulto , Idoso , Anemia/etiologia , Estudos de Casos e Controles , Índices de Eritrócitos , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/sangue , Hematínicos , Hemoglobinas/análise , Humanos , Ferro/sangue , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Células Parietais Gástricas/imunologia , Fatores Sexuais , Taiwan , Vitamina B 12/sangue , Deficiência de Vitamina B 12/sangue
20.
Int J Pharm ; 566: 299-306, 2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31150773

RESUMO

Vitamin B12 plays an essential role in one-carbon metabolism in the human body. A deficiency in this vitamin can lead to severe haematopoietic and neuropsychiatric disorders and is currently treated by oral or parenteral administration of exogenous vitamin. Unfortunately, the absorption of orally taken vitamin B12 is low and highly variable, while injections can cause pain and anxiety. Thus, an efficient alternative drug delivery system for overcoming these shortcomings is highly desirable. Novel polymeric microneedle (MN) arrays have the potential for minimally invasive transdermal treatment of vitamin B12 deficiency. Bilayer dissolving MN arrays (19 × 19 needles, 600 µm height) containing 135 µg vitamin B12 were cast using two different aqueous polymer blends. MN arrays showed sufficient mechanical strength for skin insertion, dissolved rapidly and delivered 72.92% of their drug load in vitro over 5 h. Ultimately, the potential of delivering a therapeutically relevant dose of vitamin B12 transdermally was demonstrated in vivo in Sprague-Dawley rats by comparison to subcutaneous injections. Maximum plasma levels of 0.37 µg/mL occurred 30 min post-MN application, highlighting the ability of fabricated MN arrays to rapidly deliver vitamin B12 transdermally.


Assuntos
Sistemas de Liberação de Medicamentos , Microinjeções , Agulhas , Vitamina B 12/administração & dosagem , Complexo Vitamínico B/administração & dosagem , Administração Cutânea , Animais , Feminino , Povidona/administração & dosagem , Povidona/farmacocinética , Ratos Sprague-Dawley , Pele/metabolismo , Absorção Cutânea , Suínos , Vitamina B 12/sangue , Vitamina B 12/farmacocinética , Complexo Vitamínico B/sangue , Complexo Vitamínico B/farmacocinética
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