title: [Plasma levels of folate and vitamin B(12) in patients with chronic liver disease].
abstract: BACKGROUND
  Patients with liver disease frequently experience changes in their nutritional status.
  
  
  OBJECTIVE
  To determine changes in vitamin B12 and folic acid plasma levels in patients with chronic cirrhosis and to assess whether these parameters may be useful in the etiologic diagnosis of this disease.
  
  
  METHODS
  Thirty-nine patients admitted for decompensated cirrhosis (29 with alcoholic etiology and 10 with non-alcoholic etiology) and 35 controls were prospectively studied. Plasma levels of vitamin B(12), folate acid, mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, and gamma-glutamyltransferase (GGT), among other parameters, were measured.
  
  
  RESULTS
  Vitamin B(12) levels were 1151+/-568pg/ml in patients with decompensated cirrhosis and 440+/-133pg/ml in controls (p<0.05). Plasma folate levels were 8.57+/-3.8ng/ml in controls and 6.68+/-2.74ng/ml in patients with cirrhosis (p<0.05). Folate levels were lower in patients with alcoholic cirrhosis (mean value, 5.7+/-2.1) than in those with non-alcoholic cirrhosis (9.3+/-2.6; p<0.0005). The vitamin B(12)/folate ratio discriminated alcoholic etiology better than other parameters such as AST, ALT, MCV, AST/ALT ratio and GGT.
  
  
  CONCLUSIONS
  Plasma levels of vitamin B12 in patients with decompensated chronic liver disease are high, whereas plasma folate levels are low. The ratio between vitamin B12 and folic acid may be useful in the differential diagnosis of the etiology of chronic liver disease.
authors.affiliation: Servicio de Digestivo, Hospital Donostia, Universidad del País Vasco, CIBEREHD, Instituto Carlos III, San Sebastián, Guipúzcoa, España. castro@medynet.com
authors.forename: Nerea
authors.initials: N
authors.lastname: Muro
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarasqueta
authors.forename: Inés
authors.initials: I
authors.lastname: Gil
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hijona
authors.forename: Angel
authors.initials: A
authors.lastname: Cosme
authors.forename: Juan
authors.initials: J
authors.lastname: Arenas
authors.forename: María E
authors.initials: ME
authors.lastname: Elosegui
authors.forename: Miren
authors.initials: M
authors.lastname: Sarasola
authors.forename: José
authors.initials: J
authors.lastname: Calpasoro
authors.forename: Juan I
authors.initials: JI
authors.lastname: Arenas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003937:Diagnosis, Differential; D004909:Erythrocyte Indices; D005260:Female; D005492:Folic Acid / Q000097:blood*; D005494:Folic Acid Deficiency / Q000097:blood / Q000453:epidemiology; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000175:diagnosis; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000150:complications; D017093:Liver Failure / Q000209:etiology; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D014805:Vitamin B 12 / Q000097:blood*; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D014805:Vitamin B 12