VitB12 Levels Research Articles

Some biochemical tips in the etiopathogenesis of Pectus Excavatum

Pectus excavatum (PE) is the most common deformity among anterior chest wall abnormalities. Although many theories on the pathogenesis of PE have been described, the uncertainty is still going on whether it is a result of developmental, biochemical, or biomechanical reasons or their combination. The aim of this study was to evaluate the biochemical parameters that may cause or be associated with the development of PE between children with PE and their healthy peers. A total of 33 patients' medical records were retrospectively analyzed who followed up because of pectus excavatum between 2019 and 2021. A control group was formed from 32 healthy children from the hospital records with similar age and gender profiles as the patient group. The data from both groups were collected and statistically analyzed in terms of gender, age, and laboratory tests, including hemogram, Vit B12, Parathormone (PTH), Vit.D, Alkaline phosphatase (ALP), and serum Calcium (Ca) and Phosphor (P) levels. Compared to the control group, statistically, significantly higher serum ALP, P, and PTH levels with low Vit.B12 levels were detected. The significant difference in the levels of ALP, PTH, P, and Vit B12, which have an important place in the construction and development of osteochondral structures, may impair the remodeling capacity of the costosternal structure with the contribution of thoracic biomechanics. When PE deformity is noticed, if appropriate medical treatment such as vitamin and mineral supplements and diet regulation is applied to children in the follow-up process, the process can be slowed down, and the deformity can be alleviated.

Diagnostic Value of ATG5, Apo-Lipoprotein B-48, Thyroid Hormones, and Homocysteine in Patients with Alzheimer's Disease.

Alzheimer's disease (AD) is the most common form of dementia. In this study, serum levels of autophagy-related 5 (ATG5), apolipoprotein B-48, thyroid hormones, and homocysteine were examined in patients with AD to determine their diagnostic and predictive value for early diagnosis and prevention of AD. For this study, fifty serum samples were obtained from patients with AD and fifty serum samples from healthy controls. Serum levels of ATG 5, apo B48, thyroid hormones, homocysteine, vitamin B12, and folic acid were determined by ELISA. Spectrophotometry was used to determine serum lipid concentrations. The mean age of the case group was 69 ± 6.4 years and that of the control group was 67 ± 4.2 years. There were differences between the control and case groups in serum levels of homocysteine, apo B48, ATG5, hsCRP, LDL, HDL, cholesterol, and VitB12 (p < 0.05). According to the results of the ROC curve, measurements of serum levels of ATG5, homocysteine, and apo B48 have excellent performance in distinguishing patients with Alzheimer's disease from patients without AD. This study suggests that the measurement of serum levels of ATG5, homocysteine, and apo B48, along with other available biomarkers, can be helpful in the diagnosis and management of patients with AD in the early stages of their disease.

EVALUATION OF SERUM VITAMIN B12 LEVELS IN TYPE 2 DIABETES MELLITUS PATIENT ON METFORMIN THERAPY ATTENDING A TERTIARY CARE HOSPITAL

Background: Metformin for type 2 diabetes mellitus has more beneficial effect with few side effects like vitamin B12 deficiency. So, this study aimed to determine the level of vitamin B12 in patients with type 2 diabetes mellitus using metformin and its association with dose and duration of metformin use. Methods: This was descriptive, cross-sectional, hospital-based study. A total of 128 diabetic patients using metformin for more than 6 months were enrolled. After taking informed consent, considering exclusion criteria, level of serum B12 were quantified by chemiluminescent enzyme immunoassay. Vitamin B12 level &lt;300pg/dl as inadequate and ≥300pg/dl as adequate; metformin 1000mg as low dose; more than 1000mg as high dose were considered. Also, metformin used 1000mg /day taken as constant and comparing it with duration of &gt; 10 years with duration of &gt; 10 years. Data were entered in Microsoft Excel 2013 and analyzed on SPSS V25. Results: Our study results 62.5% had adequate (&gt;300pmol/l) and 37.5% had inadequate (≤300pmol/l) vitamin B12 level in patients with type 2 diabetes using metformin. Level of vitamin B12 deficiency was statistically associated with increasing dose of metformin used (p&lt;0.001) and long term used of metformin used (p&lt;019). Conclusions: This study concluded that there is prevalence of deficiency of Vit B12 level in type 2 diabetes mellitus patients using metformin. Also, this deficiency level depends on use of dose of metformin.

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.

Association of Vitamin B12 deficiency with long-term PPIs use: A cohort study.

BackgroundProton Pump inhibitors are widely used among the majority of the world's population as acid-suppressing medications. Proton Pump Inhibitors have been reported to cause intestinal damage and adverse gut microbiota changes affecting several mechanisms, including malabsorption, etc.AimIn order to gain a deeper understanding, we conducted a cohort analysis to assess the prevalence & association of Vitamin B12 deficiency in patients on long-term use of PPIs.MethodsThis single-center cohort study was conducted at the Department of Internal Medicine, KRL hospital in Islamabad, Pakistan from May 2021 to May 2022. Rao soft calculator with a 95% confidence interval and 5% error margin was used to find the estimated sample size. Vitamin B12 levels were analyzed using the Cobas e411 analyzer. Chi-square test, odds ratio, and t-tests were used for analysis.ResultsAmong the 1225 participants, more than half of the men (55.10%) had low levels of vitamin B12. Vit B12 levels were observed to be significantly lower in Omeprazole patients than in Pantoprazole patients. A vitamin B12 deficiency is 0.5 times more likely in patients taking PPIs. There is a substantial difference between the early and final levels of B12 indicated by the t-test.ConclusionAccording to our findings, long-term usage of PPIs is linked to an increased risk of vitamin B12 insufficiency specifically in men falling under the ages of 18 and 40.

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.

Effect of methylenetetrahydrofolate reductase C677T polymorphism on serum folate but not vitamin B12 levels in patients with H-type hypertension.

Hyperhomocysteinemia (HHcy) is a common complication in Chinese hypertensive patients and associated with methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, folate, and vitamin B12 (Vit B12) status. This study evaluated the associations of MTHFR C677T polymorphism, folate, and Vit B12 with H-type hypertension. 887 eligible patients with essential hypertension were included. Patients were divided into two groups according to the Hcy level, the H-type hypertension group and the normal hypertension group. Related risk factors such as MTHFR polymorphism, folate and Vit B12 status were analyzed in the two groups. Age, gender, SBP, DBP, MTHFR C677T genotype, folate and Vit B12 differed significantly between H-type hypertension and normal hypertension groups (P < 0.05). MTHFR 677TT variant, gender, folate, and Vit B12 were independent risk factors for the occurrence of H-type hypertension. The risk for TT carriers was 8 times higher than that of CC and CT carriers [OR (95% CI) 8.248 (5.274-12.899)]. Male patients had almost fivefold higher odds than female patients [OR (95% CI) 4.923 (2.741-8.842)]. Folate level of patients with H-type hypertension decreased with the C to T substitution of MTFHR C677T gene (P < 0.05), while Vit B12 level was not associated with the gene (P > 0.05). MTHFR 677TT variant, gender, folate, and Vit B12 were risk factors for the occurrence of H-type hypertension. Folate but not Vit B12 was associated with MTFHR C677T polymorphism in patients with H-type hypertension. Accordingly, the above factors may be considered in the prevention and treatment of hypertension.

Evaluation of the Anti-Inflammatory Impact of Vitamin D on Polycystic Ovary Syndrome and Endometriosis

Objective: Although numerous studies demonstrate the link between vitamin D and its anti-inflammatory effects, the correlations could not be fully explained. Platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) are investigated as biomarkers for diagnosis and follow-up in various obstetrics and gynecological studies. We aimed to evaluate the correlation between the anti-inflammatory effect of vitamin D and inflammatory parameters NLR and PLR in women with polycystic ovary syndrome (PCOS) and endometriosis. Materials and Methods: Serum 25-hydroxy vitamin D (25(OH)D) levels, complete blood count (CBC) parameters, NLR, PLR, Vitamin B12, and thyroid stimulating hormone (TSH) levels of 140 patients who applied to the Department of Obstetrics and Gynecology between 2010-2019 were evaluated. In our study, the levels of 25(OH)D, TSH, vitamin B12 and CBC measurements were analyzed simultaneously. SPSS 22.0 Windows version software was utilized in the data analysis, and p&lt;0.05 was accepted as statistical significance level. Results: There were significant differences in NLR (p=0.026) and lymphocytes count between PCOS and endometriosis groups (p=0.010). When we examined PCOS and endometriosis patients as a patient group; according to 25(OH)D vitamin levels, we found that NLR was significantly higher in the group with 25(OH)D vitamin levels below 20 ng/ml (p=0.017), vit B12 levels were significantly lower (p=0.034). Bivariate correlation analysis showed that vitamin D was negatively correlated with NLR (r=-0.196, p=0.050) in the patients with PCOS but not with endometriosis. Conclusion: This retrospective study assessed the association between vitamin D levels and the new inflammation biomarkers in patients with PCOS and endometriosis. The CBC and neutrophil/lymphocyte ratios are accessible and easily measurable biomarkers, therefore, evaluating the anti-inflammatory effect of vitamin D together with NLR is valuable for both PCOS and endometriosis.

ANEMIA IN PATIENTS WITH HEART FAILURE AND ITS CORRELATION WITH NT-PRO BNP: A RETROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN SOUTH INDIA

Objective: To assess the prevalence of nutritional of anemia in Heart Failure patients and its correlation with the serum levels of NT-pro BNP. Methods: This is a single-center retrospective observational study, conducted at a tertiary care hospital in south India. Patients admitted to hospital with clinical diagnosis of HF based on validated clinical criteria were included in the study. Anemia was dened as hemoglobin (Hb) &lt;13 g/dl for males and &lt;12 g/dl for females, based on World Health Organization denition. Anemia was classied based on complete Iron prole, including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT). Serum levels of Vit B12 and Folate also assayed. Plasma concentrations of NTpro-BNP levels were assessed and correlated with the above parameters. A total of 100 patients ofResults: HF (69% males and 31% females) were studied. Most of the patients were of high-functional NYHA class ( NYHA Class III 81%) and with Moderate LV systolic Dysfunction (44%). Iron Deciency (ID)anemia was present in 72% patients with 50.4% patients having absolute and 21.6% patients having functional ID. Females were having signicantly higher prevalence of ID than males (80.6% vs 68.1%; p = 0.002). The NTpro-BNP levels in patients with IDA were statistically signicant (with p&lt;0.01) when compared to patients with normal iron levels . Conclusion: This study concludes that ID is much more common in patients with Heart Failure compared to Vit B12 or Folic acid deciency. The NTpro- BNP levels are elevated to much higher values in patients of heart failure with comorbid iron deciency states. Treating ID along with the routine heart failure management may improve the Quality of Life in HF patients.

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.

COVID-19 Hastalarında Vitamin B12 Düzeyinin Prognoz Üzerine Etkisi

Objectives: It is known that vitamins have some effects such as suppressing viral replication, developing anti-inflammatory responses and that they increase immunity in COVID-19. This study aimed to investigate the correlation between the vitamin B12 (Vit B12) serum levels and the prognosis of the disease in patients with COVID-19. &#x0D; Material and Method: A total of 408 participants were included in the study. Sociodemographic information such as age, educational status, serum vitamin B12 levels, hemogram parameters, and clinical findings of the patients who were admitted for follow-up after the end of COVID-19 infection was evaluated retrospectively. Serum vitamin B12 level between 150-200 pg/mL was assessed as mild deficiency, the value between 100-150 pg/mL as severe deficiency and the value under 100 pg/mL as extremely severe deficiency. &#x0D; Results: Median age of the participants was 44.51 (18-88) years. The median Vit B12 level of the patients was 179.50 (75-641). Of the patients, 248 (60.70%) had Vit B12 deficiency. The rates of pneumonia and hospitalization were higher and fatigue and loss of taste/smell were more in patients with Vit B12 deficiency. NLR and PLR which are the inflammatory markers were higher in patients with Vit B12 deficiency. The rates of pneumonia and hospitalization were the highest in the severe Vit B12 deficiency group among the Vit B12 deficiency groups. &#x0D; Conclusion: The clinical progression was worse in COVID-19 patients with Vit B12 deficiency than those who had no Vit B12 deficiency. Therefore, it has been concluded that Vitamin B12 supplement can have positive effects on COVID-19 patients; however, more comprehensive further studies with longer duration and higher number of patients are needed.

To Study of the Correlation between Vitamin B12 Level and Thrombocytopenia in Dengue Fever and Malaria

Introduction: Thrombocytopenia is a common symptom of malaria, and typically occurs more frequently in Falciparam malaria. It appears that P. vivax does trigger thrombocytopenia, contrary to popular belief. Therefore, patients with low platelets and fever ought to be considered for malaria, though B12 deficiency does not always accompany malaria cases. Methods: This study was conducted at indoor patients at the NIMS hospital to investigate the relationship between vitamin B12 with thrombocytopenia associated with dengue fever and malaria. Patients were investigated for routine investigations such as CBC, ESR, RFT, RBS, LFT, PBF, VIT B12 LEVEL, Dengue profile and MP card test. In out of 125 patients,75 patients have dengue fever, and 50 patients have malaria fever. Result: In dengue fever out of 75 patients, 61 patients (81%) had thrombocytopenia with vitamin B12 deficiency (B12 level &lt;100 pg/l). In malaria out of 50 patients, 28 patients (56%) have thrombocytopenia with vitamin B12 level (B12 level &gt;300 pg/l), 22 patients (44%) have thrombocytopenia with vitamin B12 level normal (B12 level 201-300). Vitamin B12 level &lt; 190 pg/ml was found in 47(94%) patients with severe thrombocytopenia while 32 number (74%) patients with mild thrombocytopenia. In group with B12&lt;190 pg/ l need of SDP transfusion was significantly high i.e; (115.13±42.08) in comparison to other groups, as well as the recovery time of platelets to 20000/µl threshold, was found to be high in B12 &lt;190 pg/l group (42.60±8.89 days) as compared to other groups. Conclusion: Using platelet analysis by PBF, the results of this study were obtained. There is no clumping of platelets, and the platelets show the normal size, color, and shape.

Hypersegmented neutrophils in peripheral smear –An etiological analysis

Hypersegmentation of neutrophils is defined as presence of 5% or more neutrophils with five or more lobes or single neutrophil with 6 lobes. It is usually associated with deficiency of or failure to utilize cobalamin or folate and impaired DNA synthesis is the accepted mechanism for the morphological changes seen in megaloblastosis. Other causes of neutrophil hypersegmentation (NH) listed include microcytic hypochromic anemia(MHA) but the evidence for this is based mainly on a limited number of case studies in which MHAs with vit B12 and folic acid deficiency also were included. More studies are needed to establish itiological factors other than already established megaloblastic anemia.The present study was conducted in Department of Pathology in a tertiary care centre in Central Kerala, India. 100 cases peripheral smears with NH were evaluated. Aim of the study was to classify the itiological factors of NH in peripheral smears, study NH in microcytic hypochromic anemia and to check whether there is any connection between microcytic hypochromic anemia with NH and thrombocytosis. Complete blood count of all cases were taken using automated hematology analysers. Peripheral smear picture were correlated with the blood counts. Cases with MHA were examined for underlying vit B12 and folic acid deficiency. Study shows that 31% cases of peripheral smears with hypersegmentaion of neutrophils were pure microcytic hypochromic anemias with normal vitB12 and folic acid levels. Study also points to increased incidence thrombocytosis in pure MHA cases compared to other etiological factors.

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.