Serum Vit B12 Research Articles

Genetic variants of folate metabolism and the risk of multiple sclerosis

ABSTRACT Background and aims Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) of unknown cause. Alterations in one-carbon metabolism have impact in the pathophysiology by genetic susceptibility to MS and increased the risk of MS. The aim of this study was to investigate the contribution of the gene polymorphism on Methylenetetrahydrofolate Reductase (MTHFR), Methionine Synthase Reductase (MTRR), Methionine Synthase (MTR) enzymes and of the essential factors (homocysteine, Hcy; cysteine, Cys; and vitamin B12, VitB12) in folate metabolism. Methods Eligible MS patients (n = 147) and health controls (n = 127) were participated. The gene polymorphisms were analyzed by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) and the levels of plasma Hcy, Cys and VitB12 were measured by Enzyme Linked Immunuabsorbent Assay (ELISA). Results and conclusion Our results showed that the levels of Hcy and VitB12 were lower and the levels of Cys were higher in MS compared to controls. The observation of high Cys values in all 3 gene polymorphisms suggests that the transsulfiration pathway of Hcy is directed towards Cys formation since the methionine synthesis pathway does not work. We could not find any association with all gene polymorphisms with the risk of MS. The T allele of MTHFR C677T and G allele of MTR A2756G are risk factors for serum Cys level on MS. As for MTR A2756G, serum vitB12 was observed in MS patients with G allele.

Status of Vitamin B12 Deficiency among Lactating Mothers at Six Weeks Postpartum at a Tertiary Care Hospital, West Bengal, India

Introduction: Vitamin B12 (vit B12) deficiency is a preventable disorder and has dire consequences on the neurological development of the infant. The only source of vit B12 for exclusively breastfed newborns is their mother’s milk. So, determining the status of maternal vit B12 levels during early lactation is vital. In India, very few studies have documented vit B12 deficiency among lactating mothers, especially eastern region remains unexplored. Aim: To estimate the prevalence of vit B12 deficiency among healthy lactating mothers attending the postpartum clinic at six weeks at a Tertiary Care Hospital of West Bengal, India and also to compare the haematological values between vit B12 deficient and sufficient groups among the lactating mothers. Materials and Methods: An observational cross-sectional study was conducted in the Department of Biochemistry in collaboration with postpartum clinic of Calcutta National Medical College, West Bengal, India. The study was carried out over a period of two months, from July 2022 to August 2022. Serum vit B12, serum ferritin and haematological parameters {Haemoglobin (Hb), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin Concentration (MCHC)} were measured in 121 apparently healthy lactating women attending the postpartum clinic for a regular check-up at six weeks. Detailed socioclinical history and dietary history was taken from each participant and these variables were compared between vit B12 deficient and sufficient groups. Pearson’s Chi-square test, Fisher’s-exact test, Mann-Whitney U test were applied to analyse the data. Results: The total study population comprised of 121 mothers with an average age of 25.65±3.71 years and 75% of them consumed non vegetarian diet. A prevalence of 19 (15.7%) deficiency of vit B12 was found among the lactating mothers at six weeks postpartum. Mothers who were vegetarian, multigravida and with complaints of paraesthesia were more associated to cobalamin deficiency. The vit B12 deficient mothers had significantly higher erythrocyte indices than the sufficient group but none of the values were in the megaloblastic range. Conclusion: The vit B12 deficiency was prevalent during early lactation in 19 (15.7%) lactating mothers. The first postnatal visit at six weeks might be the most feasible period to screen and supplement these women to prevent long term sequelae in both mother and child. Haematological parameters were of limited use in identifying vit B12 deficiency during lactation.

Evaluation of Vitamin B12, Folic Acid, Ferritin and Vitamin D Levels in Obsessive Compulsive Disorder

Aims: Obsessive compulsive disorder (OCD) is a heterogeneous disorder characterized by obsessions and compulsions. Despite the studies, etiopathogenesis is not fully understood. Pharmacological and psychosocial interventions in OCD may be insufficient due to limited knowledge of etiopathogenesis. Therefore, it is important to find inexpensive and easily determined biochemical parameters related to etiopathogenesis. In this study, the relationship between OCD and vitamin B12 (VitB12), folic acid (FA), vitamin D (VitD) and ferritin was investigated.
 Material and Method: 50 patients with OCD (12 female, 38 male) and 50 healthy controls (HC) (13 female, 37 male) were included in this retrospective study. Serum VitB12, FA, ferritin and 25-OH VitD levels of both groups were compared.
 Results: VitB12 (p

One Anastomosis Gastric Bypass Surgery: Consequences Over Ascorbic Acid, Cobalamin, Calciferol, and Calcium

Background: Nutrient deficiency after malabsorptive bariatric procedure is a common phenomenon. The study aims to determine the prevalence of nutritional insufficiencies (specific with Ascorbic acid, Cobalamin, calciferol and calcium) in obese population opting for One Ananstomosis Gastric Bypass surgery (OAGB), and also to understand the association of these nutrients with change in Body Mass Index (BMI) after the surgery.
 Methods: One hundred fifty subjects comprising males and females aged 20-60 years were randomly selected at a bariatric center in India. Subjects belonged to both grade III and grade II obesity. Plasma aa, serum vitB12, serum VitD3 and serum calcium concentrations were prospectively assessed at 0m, 3m, and 6m of surgery through high-performance liquid chromatography.
 Result: The values of nutrients beyond the standard levels are considered as deficiency. Both follow up values showed a significant increase in cobalamin, Calciferol, and ascorbic acid levels compared to baseline data.
 Conclusion: Nutrition depletion and deficiency are often seen in post bariatric cases. The contributing factors included high BMI, food intolerance, and non-adherence to supplements and correct dietary regimens. With the correction of weight and comorbidities, the levels also showed a stable and positive level.
 Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 695-708

Serum vitamin B12 is a promising auxiliary index for the diagnosis of methylmalonic acidemia in children: A single center study in China

Background and aimsVitamin B12 (cobalamin, VitB12) is an essential coenzyme of methylmalonyl-CoA mutase and methionine synthase. Variations in VitB12 metabolism, absorption, transport, or intake may cause changes in methylmalonic acidemia (MMA) biomarkers. We aimed to investigate whether serum Vitamin B12 levels could be used in the early detection of MMA. Materials and methodsWe included 241 children with MMA and 241 healthy matched controls. We measured serum VitB12 levels by an enzyme immunoassay and investigated the relationship between abnormal VitB12 levels and hematologic parameters as potential risk factors for MMA symptoms. ResultsCompared with controls, the serum levels of VitB12 were increased in the MMA group (p < 0.001). Serum VitB12 distinguished patients with MMA from healthy children (p < 0.001). Serum VitB12 combined with homocysteine and ammonia identified cblC and mut type MMA, respectively (p < 0.001). Homocysteine, folate, ammonia, NLR, and red blood cells contributed to serum VitB12 in cblC type MMA (p < 0.001); homocysteine, ammonia, and red blood cells, contributed in mut type MMA (p < 0.001); and elevated VitB12 was an independent predictor of MMA clinical onset (p < 0.001). ConclusionSerum VitB12 can be used as an early diagnostic biomarker for MMA in children.

Nutritional deficiency and MTHFR gene polymorphism in obstetrics

: This study was carried out to determine the association of folic acid deficiency, vitamin B12 deficiency, hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with obstetrical events linked to folic acid deficiency like neural tube defects (NTD); unexplained abruption placentae (AP), recurrent pregnancy loss (RPL) and preterm labour(PTL).: In the present study 87 pregnant females with past or present history of either neural tube defect (NTD), abruptio placentae, recurrent pregnancy loss (RPL) or preterm labour and 100 pregnant females without any such history were enrolled. Serum levels of folic acid, vitamin B12 and homocysteine in these females were estimated using chemiluminescence and Polyacrylamide gel electrophoresis (PAGE) was used to detect MTHFR gene polymorphism.: No significant association was observed between serum folic acid levels and NTD (p = 0.495), RPL (p = 0.832) or preterm labour (p = 0.724). However, folic acid deficiency had significant association with the occurrence of abruptio placenta (p = 0.001). Serum vit B12 deficiency was found to be a significant risk factor only in patients with RPL. Increased homocysteine revealed significant association with RPL (p= 0.024), abruption placentae (p=0.002) and preterm labour (0.015). No polymorphism in MTHFR gene could be revealed in the above pregnancy complications.: In the present study, deficiency of folic acid was uncommon probably due to its routine supplementation throughout the first trimester. However, preconceptional folic acid supplementation still needs to be emphasized to build up adequate folic acid levels required during embryogenesis. The relationship between vit B12 and RPL needs studies on larger number to establish the association before supplementation is suggested. MTHFR677 gene polymorphism may have remained undetected due to small sample size.

Association of MTHFR C667T Polymorphism, Homocysteine, and B Vitamins with Senile Cataract.

Senile cataract has become the leading cause of visual impairment and even blindness in the world, but there are few reports on its relationship with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. This study is aimed to investigate the correlation between MTHFR gene polymorphisms or its enzyme metabolites and senile cataract. From January 2019 to June 2020, 663 patients with senile cataract at the Mianyang Central Hospital were enrolled as the observation group, and 646 healthy subjects were randomly selected as the control group. MTHFR gene polymorphisms (i.e., CC, CT, or TT genotypes) and serum homocysteine (HCY), folic acid (FOL), vitamin B12 (VitB12), and vitamin B6 (VitB6) levels were detected. The mutation rate of MTHFR C677T and HCY levels in the observation group were significantly higher than those in the control group, whereas FOL, VitB12, and VitB6 were significantly lower. With an increase in the MTHFR C677T mutation, HCY showed an upward trend, whereas FOL and VitB12 showed a decreasing trend in both the observation and control groups. Multiple logistic regression analysis showed that HCY and FOL were associated with senile cataract and MTHFR mutations; VitB12 was only associated with senile cataract. Compared to that with the CC genotype, CT and TT genotypes were associated with an increased senile cataract risk. Monitoring MTHFR gene polymorphisms and changes in serum HCY, FOL, and VitB12 levels could provide references in predicting senile cataract.

Adolesanlarda B12 eksikliği ve Helikobakter Pylori Sıklığı

Abstract:&#x0D; Aim: Low intake of Vitamin B12 (vit B 12) with malabsorptions are the most critical factors causing the deficiency. Vit B 12 deficiency has also been associated with Helicobacter pylori (HP) gastritis in previous studies. This study's main goal is to find a similar relation with recent studies or an opposite conclusion. For this purpose we choose the most suitable group; patients with the same two diseases HP gastritis and vit B 12 deficiency.&#x0D; Patients and methods: The whole study was conducted retrospectively. İn the study we included 19 patients (mean age: 15.6 ± 1.3 years ). The B12 levels of patients undergoing upper gastroscopy for any reason were studied. We tried to figure out whether B12 deficiency and HP positivity were statistically significant. The Electrochemiluminescence immunoassay method has been used for serum vit B12 level measurement. &#x0D; Results: There are 15 (62.5%) patients with neurological symptoms and 6 (25.0%) patients with fatigue and weakness. Only 3 (12.5 %) patients have no symptoms. There was no statistical significance between these groups (p=0.224). There are 18 (75%) patients with HP positivity. HP positive and negative patients have levels of B12 108.6 ± 31.1 pg/mL and 113.5 ± 41.2 pg/mL respectively (p=973).&#x0D; &#x0D; Conclusion: There were no statistical significance with vitamin B 12 levels in HP-positive patients and HP-negative patients. İt sure be beneficial to use a bigger aspect patients group to have better results between HP infection and vitamin B 12 deficiency relation.

A Study of Plasma Homocysteine Level in Children with Autism

Background: Autism is a neurodevelopmental disorder that appears in early life. B6 and B12, and folate support homocysteine (Hcy) metabolism. Hence, any defect to them leads to Hcy accumulation in the body. Hcy, vitamins B12, B6 and folate are important in psychiatric disorders such dementia, schizophrenia, and autism. This study intended to compare the plasma Hcy levels in normal and autistic cases to find out whether there is difference between the levels of Hcy in plasma of autistic and normal children.&#x0D; Methods: This case control study enrolled 60 children who were allocated in two groups 30 with autism and other 30 as controls. All patients were exposed to full history taking, physical examination, mental status examination, hearing test, routine lab investigations and specific lab investigations (serum folic acid, plasma vitamin B12 and Hcy level).&#x0D; Results: Childhood Autism Rating Scale (CARS) level among autistic children was 49.400 ± 5.840. The mean plasma Hcy level was considerably higher in children with autism than controls (P value&lt; 0. 01). The mean serum folic acid level and vit B12 level was significantly reduced in autistic cases than controls (P value&lt; 0. 01). There was a statistically significant positive correlation between plasma Hcy level (µmol/L) and CARS level in children with autism (P value&lt; 0. 01).&#x0D; Conclusions: Children with autism have increased levels of Hcy, and decreased levels of folic acid and vit B12. So, Hcy may be used as a clinical biomarker for early diagnosis and managing of autistic children.

Is Vitamin B12 Level a Reliable Predictor of Psychosis Severity in Male Patients with Megaloblastic Anemia at a Single Tertiary Hospital?

BackgroundMegaloblastic anemia (MA) occurs due to ineffective erythropoiesis, which results from impaired DNA synthesis in the hematopoietic precursors and intramedullary hemolysis. MA’s most common cause is nutritional deficiencies of either cobalamin (vitamin B12) or folate (vitamin B6). This study aims to determine the association between MA caused by vitamin B12 deficiency and psychosis among psychotic male patients in Mental Health Hospital at Taif, Saudi Arabia.MethodsFifty psychotic male patients, aged 48.58±1.72, were recruited from the Mental Health Hospital at Taif, Saudi Arabia, in addition to 54 sex-matched healthy controls. The following tests were run: complete blood count (CBC), liver function tests (LFT), serum levels of vitamin B12, folate, and C-reactive protein (CRP).ResultsThe CBC showed that RBCs count, haemoglobin, haematocrit, platelets count, mean platelets volume (MPV), and absolute lymphocyte count were significantly lower in psychotic patients versus healthy controls (P=0.007, P=0.002, P=0.001, P=0.004, P=0.0001, and P=0.005, respectively). In contrast, the eosinophil absolute count and basophil percentage were significantly higher in psychotic patients versus controls (P=0.009, P=0.0001, respectively). Vitamin B12 levels were insignificantly decreased in psychotic patients versus healthy group. There were significant negative correlations between serum levels of VitB12 and negative symptoms (r=−0.381, P=0.006) and hallucination (r=−0.297, P=0.036).ConclusionThese findings indicate no link between MA induced by VitB12 insufficiency and psychosis among psychotic patients. However, low serum VitB12 can predict the severity of some psychosis signs, including hallucinations and negative symptoms. Therefore, monitoring VitB12 levels and its supplementation in psychotic patients is recommended to improve their symptoms.

A Study on Distribution and Association of CD320, a Receptor for Active Vitamin B12, in Pregnant Mothers and their Newborns Cord Blood

Objective: Our objective was to study the levels and relation between CD320 receptors in anaemic mothers in their last trimester of pregnancy and their newborns after birth. Methods: Association between CD320, VitB12, active B12 levels in mothers with anaemia were analysed before they underwent labor and in blood collected from their newborns after labor. Regression analysis was performed in order to assess the relation between the mothers and their neonatal vitamin CD320 levels in relation to their Vit B12 status. Results: Among the 200 pregnant mothers recruited, 59% were anaemic. CD320 levels were significantly higher in anaemic mothers (414.09 ±10.75 pg/ml) when compared with cord blood (372.25 ± 7.81 pg/ml). CD320 levels were higher in both mother and cord blood with Vit B12 deficiency, however, were lower in mothers with active B12 deficiency. CD320 levels in cord blood were positively associated with haemoglobin (r value 0.8, p value 0.42) of mothers and negatively with serum folate (r value -0.15; p value 0.23), Vit B12(r value -0.21; p value0.28) and active Vit B12 levels (r value -0.25; p value0.03) in mothers. Conclusion: CD320 levels in cord blood positively correlated with haemoglobin of mothers and negatively with folic acid and B12 status. A negative trend (p=0.0024) was observed between maternal and neonatal CD320 levels.

Evaluation of serum folate, vitamin B12 and homocysteine among blood donors in Lagos State University teaching hospital, Lagos, Nigeria

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Folate, vitamin B12 deficiency and hyperhomocysteinaemia have been reported as important risk factors for the development of cardiovascular events and ischaemic stroke. These vitamin deficiencies are also implicated in the pathogenesis of several diseases like anaemia, dementia, Alzheimer’s disease and cancers. This study determined the serum levels of vitamins B12, folate, and homocysteine among blood donors in the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a descriptive, cross-sectional study done among blood donors at the donor clinic of LASUTH Ikeja, Lagos, Nigeria. One hundred blood donors who met the donor inclusion criteria of LASUTH were recruited consecutively into the study.&lt;strong&gt; &lt;/strong&gt;Five ml of venous blood was collected from each consenting participant into ethylene Diamine Tetra-acetic Acid (EDTA) and plain bottles for the determination of full blood count and folate, vitamin B12/homocysteine respectively. Data were analyzed with statistical package for social science version 23.0, the p value was set at ≤0.05.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the study participants was 33.36±8.31 years. The mean serum homocysteine, folate and VitB12 levels among the study participants were 5.59±9.14 nmol/l, 21.57±4.15ng/ml and 1694.38±592.83 pg/ml respectively. About 8% of the study participants had serum homocysteine levels more than 15nmol/L, 4% had vitamin B12 levels less than 203pg/ml while all 100 participants had normal folate levels of 4ng/ml and above.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The prevalence of hyperhomocysteinemia, vitaminB12 and folate deficiencies among blood donors in LASUTH is low.&lt;/p&gt;

THE IMPACT OF AGE, SEX, AND SOCIO-ECONOMIC STATUS ON SERUM VITAMIN B12, FOLATE CONCENTRATION AND IRON STATUS IN TURKISH CHILDREN: A CROSS-SECTIONAL STUDY

Objective: The aim of this study is to evaluate the effects of age, sex, and socio-economic status (SES) on concentrations of vitamin B12 (vit-B12), folate, iron, and ferritin through the pediatric age span, and to show the relationship of these nutrients with blood count parameters such as hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), and red cell distribution (RDW). Material and Method: The study comprised of 30,504 venous blood samples (54.5% of girls and 45.5% of boys). The study group was stratified; group I: 1-6 years (n=3,870), group II: 7-12 years (n=11,019), and group III: 13-18 years (n=15,615). Serum vit-B12, folate, ferritin, iron and total iron-binding capacity (TIBC) were measured using a Beckman Coulter DXI 800, and the blood count was analyzed using a Sysmex XE 2100 analyzer. Results: The Hb, Hct, MCV, and RDW levels were significantly different between the age groups of boys and girls (p&lt;0.001, for all). Hb and Hct were the highest in boys aged 13-18 years, and higher than those of girls in the same age group (p&lt;0.001). The MCV and RDW were also significantly different across the age groups (p&lt;0.001). The iron deficiency prevalences were 12.3% and 4.2% for the girls and boys respectively. Serum folate and vit-B12 showed decrement with age across the age groups. The prevalences of vit-B12 deficiency were 27.1% and 28.3% and 6.0% and 6.8% for folate deficiency for girls and boys. Iron, TIBC,&nbsp;and ferritin levels were significantly different between the high and medium SES. Conclusion: The results of this study are important in that the monitorization of ferritin, vit-B12, and folate levels greatly contribute to clinical practice because of the roles of vit-B12, folate, and iron in mental, emotional, and metabolic development. However, there is a need for larger and multicenter studies that can represent the nutrients of Turkish children and adolescents nationwide.

Significant increase of serum B12 levels with high-dose oral vitamin B12 supplementation with or without intrinsic factor after Roux-en-Y gastric bypass: A randomized controlled trial

VitB12 deficiency is frequently encountered after RYGB. Low-dose oral supplements are not sufficient to avoid this deficiency, often implying treatment with intramuscular injections. As IF plays an important role in vitB12 absorption, there might be an additional effect in adding IF to oral vitB12 supplements. This randomized, monocentric, double-blind, placebo-controlled trial evaluates the short-term effect of high-dose (1000 μg) oral vitB12 supplementation on serum vitB12 levels after RYGB. 225 patients were randomized into three treatment arms: vitB12, vitB12 in combination with intrinsic factor (vitB12IF) or placebo. Serum vitB12 levels 6 months postoperatively were significantly higher in patients receiving vitB12 compared to placebo (p < 0.001). A mean decrease of 197.6 (SD ± 37) ng/L vitB12 and an augmentation of 154 (SD ± 97.8) ng/L and 202.3 (SD ± 113) ng/L were respectively observed in the placebo, vitB12 and vitB12IF groups. Our study shows no significant benefit in adding IF compared to high dose oral vitB12 without IF (p = 0.711). High-dose oral vitB12 supplements significantly increase serum vitB12 levels after RYGB, confirming the efficacy of such treatment, without a significant benefit of adding IF to the vitB12 supplement. • RCT comparing high-dose oral vitB12 ± Intrinsic factor supplementation after RYGB with placebo. • Serum vitB12 declines without supplementation after Roux-en-Y gastric bypass (RYGB). • High-dose oral vitB12 supplementation increases serum vitB12 levels after RYGB. • Addition of intrinsic factor has no significant benefit on postoperative vitB12 level.

Vitamin B12 Deficiency and Clinical Neuropathy with Metformin Use in Type 2 Diabetes.

Introduction: Type 2 diabetes (T2DM), which is more prevalent (more than 90% of all diabetes cases) and the main driver of the diabetes epidemic, now affects 5.9% of the world’s adult population, with almost 80% of the total in developing countries. At present, 537 million adults (20–79 years) are living with diabetes—1 in 10. This number is predicted to rise to 643 million by 2030 and 783 million by 2045. In India, reports show that 69.2 million people are living with diabetes (8.7%) as per 2015 data. Long-term metformin treatment is a known pharmacological cause of vitamin B12 (Vit B12) deficiency, as was evident within the first 10–12 years after it started to be used. Methods: This was a cross-sectional study conducted in the Postgraduate Department of Medicine in one of the tertiary hospitals in Kashmir. A total of 1600 consecutive patients with T2DM were taken for the study. Out of which 700 patients met the inclusion criteria. These 700 patients were divided into two groups: those taking metformin, and those who were not on metformin. Cumulative metformin doses were recorded in patients taking metformin, using history of dose and duration of treatment. Serum Vit B12 levels were taken for all patients. Based on the results of Vit B12 levels, patients were classified into normal levels (20 pmol/L), possible B12 deficiency (150–220 pmol/l), and definite deficiency (<150 pmol/L). Results: Our results depicted that patients on prolonged metformin therapy showed an increase in Vit B12 deficiency by 11.16%. The prevalence of clinical neuropathy in the metformin-exposed group was 45%, whereas, a prevalence of 31.8% was found in the non-metformin group. The mean age of patients with neuropathy was higher than those without neuropathy (59.01 ± 7.14 vs. 49.95 ± 7.47) (p-value < 0.514, statistically insignificant). Conclusions: In our study, we found that metformin use is associated with Vit B12 deficiency, which is dependent upon the cumulative dose of metformin. Importantly, prolonged metformin use is also associated with an increase in the prevalence of clinical neuropathy.

The independent association between vitamin B12 and insomnia in Chinese patients with type 2 diabetes mellitus: a cross-sectional study

Background/objectivesInsomnia is highly prevalent in patients with type 2 diabetes mellitus (T2DM). This study therefore evaluated the associations between various micronutrients and insomnia in patients with T2DM.Subjects/methodsBetween January 2018 and December 2020, a total of 418 T2DM patients with or without insomnia were recruited. Clinical and biochemical parameters, as well as micronutrient levels, were measured in each participant. Insomnia and sleep quality were assessed using the Athens Insomnia Scale and Pittsburgh Sleep Quality Index, respectively.ResultsInsomnia was found in 24.16% of patients with T2DM. Compared with T2DM patients without insomnia, patients with insomnia had significantly higher levels of vitamin B12 (VitB12). Increased VitB12 was an independent risk factor for insomnia (OR 1.61 [1.06–2.45], P = 0.03). A cut-off value of 517.50 pg/ml VitB12 (P = 0.01, AUC 0.61, standard error 0.04) predicted insomnia risk. Moreover, increased VitB12 levels in patients with insomnia were closely correlated with the use of mecobalamin.ConclusionsThis study suggests that elevated serum VitB12 level is independently associated with the incidence of insomnia and predicts increased insomnia risk in Chinese patients with T2DM.

Vitamin B12: A Non-invasive Biomarker for Monitoring Hepatocellular Carcinoma Development among Egyptian HCV-Infected Patients

Several studies have revealed an association between the high serum levels of vitamin B12 (vit B12) and the stage of chronic liver diseases. This study analyzes serum vit B12 levels among Egyptian hepatitis C virus (HCV) and hepatocellular carcinoma (HCC) patients. The serum levels of vit B12 were examined in HCV patients without cirrhosis (HCV group, n=30), with cirrhosis (HCV+cirrhosis group, n=24), HCC patients (HCC group, n=30), and healthy individuals (control group, n=16). Serum vit B12 levels increased significantly in HCV+cirrhosis and HCC groups compared with the control group. HCC patients showed a significant increase in vit B12 levels compared with HCV patients with cirrhosis. Moreover, HCV patients without cirrhosis showed no significant increase in vit B12 level than the control group. Also, patients with fibrosis scores (F) from F2 to F4 showed a significant increase in serum vit B12 levels compared with the control group. Regarding correlations with liver functions, serum vit B12 was negatively correlated with serum albumin level and positively correlated with total bilirubin level. Interestingly, serum vit B12 was also positively correlated with serum AFP level. This clinical study revealed that the level of vit B12 could be used as a non-invasive biomarker to monitor liver fibrosis and HCC development among HCV-infected patients.

Etiology of serum vitamin B12 elevation 1 month after bariatric surgery: A case-control study based on China population.

Few studies have reported an increase in vitamin B12 (VitB12) levels after bariatric surgery. This study reports the phenomenon and adverse reactions of serum VitB12 elevation 1 month after surgery and explores the possible etiologies.Retrospective analysis was performed on VitB12 data for 112 patients from January 2018 to October 2019. Then, 87 patients were included between November 2019 and August 2020. They were divided into 2 groups according to the level of VitB12 after surgery, and the demographic and clinical data were analyzed. Then, LASSO regression model analysis and multiple logistic regression analysis were performed to explore the risk factors for VitB12 elevation after surgery.Retrospective data showed that the VitB12 level was significantly increased 1 month after surgery. Comparison of data between the 2 groups found that more patients also had diabetes in the nonelevated group. The postoperative folic acid and VitB12 levels of the elevated group were significantly higher than those of the nonelevated group. More patients had concurrent constipation in the elevated group than in the nonelevated group. Two meaningful variables in LASSO regression analysis were incorporated into the multivariate logistic regression analysis, and constipation was found to be an independent risk factor for the increase in VitB12 after surgery. Of the 199 patients in this study, 111 patients had elevated VitB12 levels after surgery. Among them, 7 patients had peripheral nerve symptoms.Constipation is an independent risk factor for increased VitB12 levels after surgery. High levels of VitB12 may cause some peripheral nerve symptoms. Therefore, it is necessary to pay attention to patients with postoperative constipation, monitor their VitB12 level as soon as possible, and take measures to improve constipation to avoid some adverse reactions caused by elevated VitB12 levels.

Association of MTHFR C677T variant genotype with serum folate and Vit B12 in Iranian patients with colorectal cancer or adenomatous polyps

BackgroundThe incidence of colorectal cancer (CRC) has increased during recent years in Iran and other developing countries. Clinical studies suggest that essential folate dietary intake and moderate deficiency of methylenetetrahydrofolate reductase (MTHFR) may protect and reduce the risk of CRC. The present study aimed to investigate the clinical significance of C677T polymorphism within the MTHFR gene and its correlation with the serum folate and Vit B12 in the Iranian population suffering from CRC.MethodsBlood samples were taken from 1017 Iranian individuals (517 cases and 500 controls) who were referred for colonoscopy. TaqMan probe assay was performed for C677T MTHFR polymorphism. Sera were fractionated from the blood samples of 43 patients and controls and folate and Vit B12 concentrations were measured by a monobind kit. The correlation of MTHFR polymorphisms and folate/vitamin-B12 with CRC risk was analyzed.ResultsIn the current study, we found the frequency of three different genotypes of MTHFR polymorphism in the Iranian population i.e., CC, CT, and TT, to be 51.31, 26.73, 21.96 and 61, 32.2, 6.8 in case and control groups, respectively. The homozygote genotype of MTHFR rs1801133 polymorphism is associated with an increased risk of CRC by 3.68, 1.42, and 3.74-fold in codominant, dominant, and recessive models respectively (p value < 0.01). Our study revealed that there was no significant difference between the amount of folate and Vit B12 in the case and control groups (p value > 0.05).ConclusionsThis study revealed that there was no significant difference between the amount of folate and Vit B12 in the case and control groups. Furthermore, our results demonstrated a higher risk association for 677TT and 677TT + C677T genotypes of MTHFR compared with 677CC carriers among CRC patients.

Association of vitamin B12 deficiency with metformin use in patients with type 2 diabetes treated in the largest tertiary care hospital in Qatar.

Background: Data on the effect of metformin on serum vitamin B12 (VitB12) level in patients with type 2 diabetes mellitus (T2DM) in Qatar are limited; therefore, we aimed to assess the prevalence of VitB12 deficiency and its related factors among patients with tbl2DM treated with metformin at Hamad General Hospital in Doha, Qatar, from January 1, 2017, to December 31, 2017.Methods: This cross-sectional analytical study involved patients with tbl2DM aged ≥ 18 years who used metformin for at least 3 months. The serum VitB12 was quantified on a chemiluminescent enzyme immunoassay analyzer using Cobas e 801 module, Roche, and VitB12 deficiency was defined as serum VitB12 level of ≤ 145 pmol/L. All data were obtained from the patients’ electronic medical records.Results: The study recruited 3124 eligible patients with tbl2DM. The overall prevalence of metformin-associated VitB12 deficiency was 30.7% [95% confidence of interval, 0.290–0.323]. A significant difference exists in the median VitB12 levels between the VitB12-normal and VitB12-deficient groups [129 vs. 286; p < 0.001]. Compared with the VitB12-normal group, the VitB12-deficient group had higher mean body mass index (BMI) (p < 0.001) and consumed higher doses of metformin (p = 0.001). They also more often used sulfonylurea (p = 0.004), dipeptidyl peptidase-4 inhibitor (p < 0.001), thiazolidinediones (p < 0.001), glucagon-like peptide 1 [GLP-1] receptor agonists (p < 0.001), alpha-glucosidase inhibitor (p < 0.001), and H2 blocker/proton pump inhibitors [PPI] (p < 0.001) than the VitB12-normal group. Moreover, the VitB12-normal group consumed more calcium supplements (p < 0.001) than the VitB12-deficient group. In the multivariate analysis, independent risk factors for metformin-associated VitB12 deficiency in patients with tbl2DM include high daily dose of metformin >2000 mg, male gender, high BMI, smoking, sulfonylurea, dipeptidyl peptidase-4 inhibitor, H2 blockers/PPI, low fasting blood glucose, and low hemoglobin.Conclusion: This study showed a high prevalence of VitB12 deficiency in patients with tbl2DM taking metformin and a significant negative correlation between the daily dose of metformin and serum VitB12 level. Therefore, regular screening for serum VitB12 is necessary in patients with tbl2DM on metformin treatment, especially those who have the abovementioned risk factors.