Predictors of vitamin B12 deficiency: age and Helicobacter pylori load of antral mucosa.
OBJECTIVE
The aim of this study was to assess the frequency of vitamin B12 deficiency in patients with non atrophic gastric mucosa and any relationship between the presence of vitamin B12 deficiency and demographic, hematologic, and histopathologic parameters.


METHODS
Three hundred and ten patients with no gastric mucosal atrophy on histologic evaluation were included in the study. Chronic inflammation, neutrophil activity and H. pylori load were scored using the Sydney classification system. Variables that might influence or predict the presence of vitamin B12 deficiency (age, gender, hemoglobin, mean corpuscular volume, serum folate level, scores of histologic parameters) were evaluated by univariate/multivariate analysis.


RESULTS
The percentages of patients with vitamin B12 concentrations of < 250 pg/mL, < 200 pg/mL, and =100 pg/mL were 67.4%, 46.8% and 6.5% respectively. Patient age and all three histologic were inversely related to vitamin B12 deficiency (p<0.05). By multivariate analysis, factors independently associated with serum vitamin B12 deficiency were age and antral H. pylori load (p<0.05).


CONCLUSIONS
The higher frequency of vitamin B12 deficiency in this study compared with a western study may be a reflection of the effect of H. pylori infection on serum vitamin B12 level. In addition, age was shown to be an independent risk factor for vitamin B12 deficiency irrespective of gastric atrophy. It is already known that the presence of H. pylori on gastric mucosa influence serum vitamin B12 levels. Hematologic parameters are not useful in predicting the deficiency of this vitamin.
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey. yukselgumurdulu@hotmail.com
Yüksel
Y
Gümürdülü
Ender
E
Serin
Birol
B
Ozer
Fazilet
F
Kayaselçuk
Kemal
K
Kul
Cengiz
C
Pata
Mustafa
M
Güçlü
Gürden
G
Gür
Sedat
S
Boyacioğlu
D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000175:diagnosis / Q000453:epidemiology*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011706:Pyloric Antrum / Q000473:pathology; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis / Q000453:epidemiology*