Are children with cystic fibrosis who are treated with a proton-pump inhibitor at risk for vitamin B(12) deficiency?
BACKGROUND
In a recent study, the authors demonstrated the beneficial effect of proton-pump inhibitors (PPI) on fat malabsorption and bone mineral content in children with cystic fibrosis (CF). Prolonged use of PPI could result in vitamin B(12) deficiency as a consequence of impaired release of vitamin B(12) from food in a nonacid environment. The aim of this study was to evaluate the vitamin B 12 status of CF patients either treated with a PPI or not by measuring vitamin B(12) and homocysteine blood levels, the latter being a sensitive indicator of vitamin B(12) deficiency.


METHODS
The study population consisted of 20 CF patients, 11 patients treated with a PPI for at least 2 years and 9 patients not treated with a PPI, and 10 healthy, age-matched control participants. Homocysteine blood levels were measured by high-performance liquid chromatography, and vitamin B(12) levels were measured by a competitive protein-binding assay.


RESULTS
Vitamin B(12) levels were significantly higher in both CF groups compared with the control participants (PPI+, P = 0.02; PPI-, P = 0.009). There was no significant difference in vitamin B(12) levels between both CF groups. Homocysteine levels were normal and similar in all groups.


CONCLUSIONS
Cystic fibrosis patients treated with a PPI for at least 2 years show no signs of vitamin B(12) deficiency.
ter Heide
H
H
Department of Pediatrics, University Hospital Maastricht, Maastricht, The Netherlands.
Hendriks
H J
HJ
Heijmans
H
H
Menheere
P P
PP
Spaapen
L J
LJ
Bakker
J A
JA
Forget
P P
PP
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D064747:Lansoprazole; D008297:Male; D009853:Omeprazole / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000139:chemically induced* / Q000175:diagnosis
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D006710:Homocysteine; D009853:Omeprazole; D014805:Vitamin B 12