Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous autoimmune disease characterized by diverse clinical manifestations in the oral cavity, with a pathogenesis that remains incompletely understood. Aim of this study was to evaluate antinuclear antibodies (ANA) as well as vitamin status in blood samples collected from OLP patients. Fifty OLP patients and 25 healthy controls were included in the study. This study explores the correlation between OLP, elevated ANA titers and elevated Vitamin B6 levels, hypothesizing that a shared autoimmune mechanism or metabolic dysregulation may link these findings. Forty-seven patients (94%) with OLP and 11 patients (44%) in the healthy control group had increased ANA-titers (≥1:100) (p<0.001). Vitamin B6 was increased in 24 patients (48%) in the OLP group while it was normal in the control group (p<0.001). While ANA testing is not intended to diagnose OLP, the high prevalence observed in this cohort may reflect systemic immune activation or dysregulation in OLP patients. Elevated vitamin B6 (pyridoxine) levels were identified in a subset of OLP cases; however, it remains uncertain whether this finding reflects a contributory role in disease pathogenesis or an epiphenomenon.

Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate whether serum vitamin B12, folate, homocysteine (Hcy), and ferritin levels are associated with PS risk. Methods: This study analyzed data from 1930 adults aged 45–76 years who had normal muscle quantity at baseline. Serum biomarkers were assessed at baseline and PS defined by low HS was determined at 6-year follow-up. The modified Poisson regression method was employed to calculate multivariable risk ratios (RRs) and 95% confidence intervals (CIs). Results: Among all participants, PS risk was inversely related to serum vitamin B12 levels (p = 0.06), while it was lowest in the high-normal ranges of serum Hcy (12.1–15 μmol/L) and ferritin (101–200 ng/mL) levels. The RRs (95% CIs) for PS risk were 0.73 (0.60, 0.89) and 0.75 (0.64, 0.87) for high-normal Hcy and ferritin categories, respectively, compared with the lowest category. On examining the associations of elevated Hcy and ferritin levels with PS risk, age was identified as a significant modifier for elevated Hcy levels (&gt;15 μmol/L) (p for interaction &lt; 0.05); a reduced risk was observed in younger participants, whereas an increased risk was noted in older participants. Conclusions: These findings suggest that high-normal ferritin levels may be optimal for alleviating PS risk, irrespective of age, and that elevated Hcy levels could be detrimental for older adults in preventing PS risk.

Childhood anemia is a very common problem in India, out of which more than one-third is attributed to vitamin B12 deficiency. To follow up on a girl with recurrent anemia who was later diagnosed with hereditary intrinsic factor deficiency. An eight-year-old girl presented with recurrent anemia, easy fatigability, poor appetite, and abdominal pain for one month. The hemoglobin was 4.3 g/dL, and the peripheral smear showed a dimorphic picture. Serum vitamin B12 was severely low at <50 pg/mL. After a packed red blood cell transfusion, she was advised to take oral vitamin B12 and iron supplements. Her symptoms and vitamin B12 levels did not improve on follow-up, which led to suspicion of a congenital intrinsic factor deficiency (proven by whole exome sequencing). The child is currently doing well on monthly vitamin B12 injections. This case highlights the importance of considering rare inherited causes in a child with recurrent severe anemia, even in regions where nutritional deficiencies are common.

To investigate the clinical efficacy and safety of totally laparoscopic radical subtotal gastrectomy with preservation of the cardia and partial gastric fundus in the treatment of middle-upper gastric cancer. A retrospective cohort study was conducted on 41 patients with middle and upper gastric cancer admitted to Fudan University Shanghai Cancer Center from January to June 2025. The patients were divided into an observation group (n=21) and a control group (n=20) according to the surgical method. The observation group underwent totally laparoscopic radical subtotal gastrectomy with cardia and partial fundus preservation, while the control group received laparoscopic total gastrectomy. Perioperative surgical indicators, postoperative recovery, complications, pathological results, and follow-up data on nutritional status were observed and compared between the two groups. All patients in both groups successfully completed the surgery without conversion to open surgery or surgical modification during the operation. The average total operative time in the observation group was (156.1±14.2) min, which was significantly shorter than (169.8±6.7) min in the control group (P < 0.05). There were no significant differences in the time of digestive tract reconstruction and intraoperative blood loss between the two groups (P>0.05). The average time to first oral water intake, first liquid diet intake and postoperative hospital stay in the observation group were (2.1±0.4) d, (3.4±0.5) d and (6.3±0.5) d, respectively, all significantly shorter than those in the control group (2.9±0.6) d, (3.9±0.5) days and (7.1±1.0) d, all P < 0.05. No perioperative complications such as anastomotic leakage or postoperative bleeding occurred in either group. Pathological results showed no significant differences in postoperative pathological stage and number of dissected lymph nodes between the two groups (P>0.05). No tumor recurrence or metastasis was identified during the postoperative follow-up period.The proportion of patients with decreased body mass index (BMI) compared with preoperative level in the observation group was 23.8%, which was significantly lower than 50.0% in the control group (P=0.046). The serum vitamin B12 level in the observation group 3 months after surgery was (416.0±145.3) ng/L, significantly higher than (315.0±128.2) ng/L in the control group (P=0.026). Totally laparoscopic radical subtotal gastrectomy with cardia and partial fundus preservation can ensure the radicality of tumor resection for middle and upper gastric cancer. Compared with laparoscopic total gastrectomy, it has the advantages of shorter operative time, faster postoperative recovery, better maintenance of postoperative nutritional status and quality of life in patients, with reliable safety. It may serve as a novel individualized therapeutic option for patients with middle and upper gastric cancer.

Vitamin B6 predicts poor outcomes in geographically distinct populations with primary sclerosing cholangitis.

Alcohol abuse is a leading cause of preventable deaths. Alcohol affects brain function and metabolism, including GABA transmission and vitamin B6 (VB6) levels. VB6 is a cofactor for GABA synthesis and degradation; however, the interaction between VB6 deficiency and alcohol consumption remains unknown. We utilized dietary VB6 manipulations and Drosophila models with mutations in pyridox(am)ine-5'-phosphate oxidase (PNPO), a key enzyme in converting dietary VB6 to active VB6, to examine this. Our findings demonstrate that PNPO deficiency reduces alcohol aversion and increases alcohol consumption, whereas alcohol consumption worsens VB6 deficiency, suggesting a vicious cycle. Biochemically, PNPO deficiency and alcohol exposure converge on amino acid metabolism, altering levels of inhibitory neurotransmitters GABA and glycine. Moreover, PNPO deficiency and alcohol exposure synergistically lead to lethality, which can be rescued by low dose but not high dose VB6 supplementation. These results highlight the significance of VB6 in public health, especially in alcohol use and alcohol toxicity.

Background: Type 2 Diabetes Mellitus (T2DM) is a common metabolic disorder often associated with diabetic peripheral neuropathy manifested by pain, paresthesia and sensory impairment. The first line treatment for T2DM, metformin has been associated with decreased intestinal uptake of vitamin B12 with prolonged use. (de Jager et al., 2010; Reinstatler et al., 2012) Vitamin B12 deficiency may therefore play a role in the neurological dysfunction and aggravate neuropathic symptoms. However, the link between vitamin B12 levels and the severity of neuropathic pain in metformin-treated patients is still not adequately examined. Method: This is a cross-sectional observational study which was conducted at the Department of General Medicine, Guntur General Hospital (GGH), which is a tertiary care teaching hospital serving a diverse semi-urban and rural population. The study was carried out in a period of a year i.e. December 2023 - December 2024. Results: Mean age of participants was 61.1±10.6 years. Vitamin B12 deficiency was seen in 25.6% of the patients and clinical neuropathy (DN4 ≥ 4) was present in 33.6% of the cohort. Neuropathy was much more common in vitamin B12-deficient (81.2%) and normal vitamin B12 level patients (12.6%). Serum vitamin B12 levels had a significant inverse correlation with the VAS pain scores (rs= - 0.527, p &lt; 0.001). Multivariable regression confirmed that lower levels of vitamin B12 were an independent predictor of lower neuropathic pain levels. Conclusion: Vitamin B12 deficiency is seen in high percentages of metformin-treated patients with T2DM and is highly correlated with a greater level of neuropathic pain. Routine monitoring and supplementation may help to decrease neuropathic complications.

Premature graying of hair (PGH) is a significant concern for individuals, as it is frequently perceived as an indicator of advancing age and reduced vitality, and can lead to lower self-esteem and psychological distress. Deficiencies of vitamin B12, vitamin D3 and ferritin may be related to PGH. Nevertheless, data on the specific risk factors and biochemical parameters for PGH in India are relatively limited. This study was conducted to examine the various demographic and potential risk factors, along with biochemical variables linked to PGH. An analytical case-control study was conducted on patients attending the skin outpatient department with PGH. The control group comprised age- and gender-matched patients and attendants with other dermatoses. Various demographic factors and potential risk factors were documented and compared with control groups. Measurement of serum ferritin, calcium, hemoglobin, vitamin D3, vitamin B12, lipid profile, and thyroid profile was done and analyzed between the cases and controls. Males outnumbered females with a male-to-female ratio of 1.5:1. Most of the cases of PGH belonged to the age group of 15-25 years (71.5%). On binary multivariate regression analysis, statistically significant differences in family history, smoking and hair plucking compared to controls were noted. Additionally, the cases had considerably lower levels of serum ferritin (P = 0.020), vitamin B12 (P = 0.012), and vitamin D3 (P = 0.043). This study was done at a single center. We plan to conduct a multicentric study in the future. Recall bias may also be a limitation in the study. The patients were not followed-up after correction to assess it's effect. Identifying modifiable risk factors and correcting biochemical abnormalities may help in preventing and better managing patients with PGH.

Background Specific learning disorder (SLD) is frequently characterized by weaknesses in working memory and processing speed; however, its biological correlates remain unclear. In this study, we investigate whether inexpensive, blood count–derived inflammation composites and micronutrients are related to cognitive variation in SLD. Methods In this cross-sectional study, participants in the SLD group underwent Wechsler Intelligence Scale for Children–Fourth Edition assessment to characterize their cognitive profile, yielding a Full-Scale IQ (FSIQ) and four index scores: Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. Fasting blood samples were obtained from all participants for routine hematology/biochemistry, vitamin B12 and folate, C-reactive protein (CRP), and the composite indices, the systemic immune-inflammation index (SII), the systemic inflammation response index (SIRI), and the pan-immune-inflammation value (PIV). Results We enrolled 52 children/adolescents with SLD and 56 age-matched healthy controls (HC). The groups were similar in terms of age and sex. Compared with the HC group, the SLD group had a lower vitamin B12 ( p = 0.008) and a higher PIV ( p = 0.025), whereas CRP, SII, SIRI, and folate levels did not differ significantly. Within the SLD group, higher cell-based inflammatory indices correlated with poorer cognitive performance, most consistently for the PIV in relation to processing speed and working memory, while vitamin B12 correlated positively with FSIQ, working memory, and processing speed. In the adjusted analyses of the full case–control sample, a higher PIV was independently associated with an increased likelihood of SLD, whereas a higher vitamin B12 level was independently associated with a decreased likelihood of SLD. SII and SIRI exhibited positive trend-level associations, whereas folate showed no association with group membership. Conclusions In this case–control study, SLD was associated with lower vitamin B12 levels and higher PIV values than healthy controls. Within the SLD group, higher inflammatory composite indices and lower vitamin B12 levels were associated with poorer cognitive performance, particularly in processing speed and working memory. These findings should be interpreted as associations within a case–control framework and warrant further longitudinal and mechanistic studies.

Status of Vitamin B12 levels in sickle cell anemia patients of the tribal population of Dadra and Nagar Haveli: A comprehensive analytical study

This study aimed to examine the impact of metabolic and bariatric surgery (MBS) on key micronutrients in patients with obesity over 10 years. A retrospective chart review was carried out for individuals who had MBS from February 2013 to May 2022 at 11 centres. The micronutrient (iron, Vitamin B12, Vitamin D3 and calcium) levels were collected before surgery and up to 10 years afterwards. The data from 1675 individuals with a mean age of 43.09 ± 11.93 years were analysed. The study population comprised 34.81% of males and 65.19% of females. There was an increase in the serum iron levels over 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.2175), 7 years (P < 0.01) and 10 years (P = 0.0998) after surgery. Similar results were observed for Vitamin B12 levels at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.3083), 7 years (P = 0.2817) and 10 years (P = 0.2645). Vitamin D3 levels increased at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P < 0.01), 7 years (P = 0.0069) and 10 years (P = 0.8179). However, calcium levels exhibited a downwards trend at 5 years (P = 0.0008) post-surgery. A high prevalence of micronutrient deficiency was observed amongst patients preoperatively, which improved following MBS.

There is an increasing concern on the risks of cardiovascular diseases in migrant workers in China. In the Zhoushan Archipelago, an urbanized area comprising 103 inhabited islands, migrant workers represent a growing population at risk of ischemic stroke, while the clinical characteristics of migrant workers with stroke remain understudied. This study aimed to identify the clinical characteristics of ischemic stroke in migrant workers compared with local residents in the Zhoushan Archipelago. A total of 1,006 patients with ischemic stroke were included (452 migrant workers and 554 local residents). Clinical and radiological data were collected and compared between groups. Continuous and categorical variables were compared using t tests (or non-parametric tests) and chi-square tests, respectively. Binary logistic regression analyses were used to investigate differences between groups. Statistical significance was defined as p < 0.05. In these patients, compared with local residents, migrant workers had a higher body mass index but lower rates of diabetes and atrial fibrillation, and lower levels of lymphocyte, uric acid, folate, and vitamin B12, with higher ratios of overweight and obese cases (p < 0.05 for all). There was no significant difference between the two groups in etiological classification of stroke. Regarding the ischemic regions, migrant workers showed a higher incidence of basal ganglia infarctions (p < 0.05). Ischemic stroke in migrant workers showed a distinct clinical profile compared with local residents, underscoring the need for targeted preventive healthcare interventions for migrant workers in urbanized archipelago setting.

Risk stratification of gastric neuroendocrine tumors (G-NETs) arising in the context of autoimmune gastritis (AIG) remains a significant clinical challenge, as current approaches based on isolated biomarkers or endoscopic findings fail to fully account for the multifactorial nature of tumor development. Li et al [13 ] recently published a study in World Journal of Gastroenterology , and this article synthesizes existing evidence on the pathophysiological mechanisms linking AIG to G-NETs, and systematically evaluates the development and validation of integrated clinical-endoscopic models, demonstrating the enhanced performance of machine learning techniques in identifying robust predictors such as age, Helicobacter pylori status, vitamin B12 levels, severity of corpus atrophy, and serum gastrin concentration for accurate risk stratification. The clinical implications of these models are examined across several domains: Enabling risk-adapted endoscopic surveillance schedules, guiding chemopreventive interventions including vitamin B12 supplementation, improving prognostic precision through incorporation of proliferative indices, and enhancing diagnostic consistency across diverse healthcare settings. Although current models show promising discriminative ability (area under the curve: 0.830), they are constrained by reliance on single-center cohorts and limited integration of molecular data. Future efforts should prioritize multicenter validation, incorporation of genomic markers, and the creation of multimodal frameworks that integrate endoscopic imaging with serological and genetic profiles to support personalized management of AIG-induced G-NETs.

BackgroundProper feeding is a priority in early childhood, specifically below the age of 3 years. Eating disorders are increasingly common in pediatric populations. Inadequate energy and nutrient intake affects children’s health and development. Prolonged feeding problems can lead to nutrient deficiencies.Material/MethodsThis study included children under 3 years of age with feeding disorders and their families. A 3-day food diary and a questionnaire were used for data collection. Participants (n=40) were divided by age into 2 groups: 6 months (from infant feeding) to 1 year, and 1 year to 3 years. Data analysis was performed using NutriComp 5.0 SPORT software, IBM SPSS Statistics 22, with 1-sample and 2-sample t tests.ResultsThe average daily energy intake was below the recommended value in both age groups. Energy intake was 62.5%, within the insufficient intake range. The average energy intake from carbohydrates was above the recommended intake level for both age groups. Energy from added sugar was within the recommended amount. Protein intake was on average at the lower end of the recommended intake level, while energy from fat was below the recommended intake level. Among micronutrients, vitamin B6, vitamin D, calcium, magnesium, iron, and zinc intake levels were insufficient, while vitamin K intake was excessive.ConclusionsChildren under 3 years of age with feeding disorders were characterized by inadequate intake of nutrients in terms of quantity and quality.

Epidemiologic studies suggest that patients with Parkinson disease (PD) may have lower levels of vitamin B12 compared with healthy controls, and it was proposed that patients with PD could benefit from vitamin B12 supplementation. Functional studies have shown that B12 could modify LRRK2 activity and may directly interact with alpha-synuclein. The aim of this study was to investigate the role of common and rare variants in genes related to B12 metabolism and assess the potential causal relationships between B12 levels and PD risk, age at onset, and motor/cognitive progression. We investigated the association between common and rare variants in genes involved in vitamin B12 metabolism. Rare variants (minor allele frequency <0.01) were analyzed using the optimal sequence kernel association test in 4,815 patients with PD and 65,607 controls from 2 independent cohorts. We constructed pathway-specific polygenic risk scores (PRSs) for genes essential to B12 metabolism and for genes identified in previous genome-wide association studies (GWASs) on B12 metabolism. Mendelian randomization and genetic correlation analyses were applied to explore the relationship between vitamin B12 levels and PD risk, age at onset, and disease progression. Our analysis showed no associations between common variants of genes crucial in B12 metabolism and PD. Pathway PRSs identified nominal association between B12-related genes and PD (odds ratio [OR] = 1.061, 95% CI 1.004-1.121, p = 0.038), which did not survive Bonferroni correction. In the rare-variant analysis, we identified a significant association between variants with high Combined Annotation Dependent Depletion scores in the CUBN gene (p = 6.07E-05; Pfdr = 0.005) in the Accelerating Medicines Partnership-PD cohort, driven by the benign variant p.G3114S (OR = 3.3; p = 3.56E-05); however, this was not validated in the meta-analysis. We did not identify a potentially causal relationship between vitamin B12 levels and the risk, age at onset, or progression of PD. In addition, no genetic correlation was observed between vitamin B12 and PD risk or age-at-onset GWASs. Overall, our analyses indicate lack of genetic link between B12 levels or metabolism and PD.

Bariatric surgery offers sustained weight loss for adolescents with severe obesity, but long-term data on its effectiveness is limited. Our objective was to compare outcomes in adolescents who underwent bariatric surgery versus those who received nutritional intervention. We conducted a retrospective cohort study of individuals under 18 who underwent bariatric surgery within < institution name> between 2011 and 2021. A comparison group included adolescents with class II obesity or higher and who had ≥ 3 dietitian visits. Anthropometric measures and blood test results (hemoglobin, TSH, vitamin D, folic acid, B12) were collected over five years. Multivariate linear mixed models assessed group differences over time. The cohort included 278 adolescents: 152 in the surgery group and 126 in the nutritional group. Over five years, BMI decreased from 44 to 32 in the surgery group but remained largely unchanged in the nutritional group (45.5 to 44), p < 0.001. At year 5, the surgery group had lower hemoglobin (12.45 vs. 13.46, p < 0.001) and declining B12 levels (p < 0.001). TSH levels decreased modestly in both groups, more so in the surgery group (p = 0.04). Bariatric surgery in adolescents led to significant, sustained BMI reductions but was associated with declines in some nutritional markers, highlighting the need for ongoing monitoring. • Bariatric surgery in adolescents with severe obesity proved effective in reducing weight and BMI, compared to nutritional intervention. • In the five-year period after bariatric surgery, adolescents had markedly lower levels of hemoglobin, vitamin B12, and TSH. • Micronutrient deficiencies are a potential risk of bariatric surgeries, requiring long-term monitoring and supplementation.

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical records. Predictors of fasting were identified using Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression with 5-fold cross-validation, followed by Poisson regression with robust standard errors. Among 1087 women with available data, 581 (53·4 %; 95 % CI 50·4 %, 56·4 %) reported fasting during pregnancy (19·5 % in the first trimester, 25·1 % in the second and 10·1 % in the third). Women who fasted had significantly lower levels of ferritin (P = 0·048), vitamin B12 (P = 0·001), erythrocytes folate (P < 0·001), 25-hydroxyvitamin D (P = 0·002) and vitamin D binding protein (P = 0·011), but higher parathyroid hormone (P = 0·011). Predictive models based on sociodemographic and clinical factors showed limited predictive ability. This study indicates that fasting during pregnancy is a common practice among women in Kuwait and is associated with lower levels of key nutrients such as vitamin D, RBC folate and vitamin B12. Fasting during pregnancy appears to be driven more by personal, religious and cultural influences than by identifiable clinical or sociodemographic characteristics.

A 3-year-old boy presented with dark-colored urine for 4months. His history was negative for infections, but he was taking oral methylcobalamin treatment for a persistent deficiency. His parents were first-degree cousins, and a female cousin had proteinuria of unknown etiology. A physical examination and laboratory examination revealed no abnormalities except for non-orthostatic nephritic proteinuria and low levels of vitamin B12. Albumin was the main protein in the urine. Kidney biopsy showed nonspecific changes. Genetic analysis identified a homozygous pathogenic AMN mutation, confirming Imerslund-Grâsbeck syndrome (IGS). Angiotensin-converting enzyme inhibitor was prescribed but discontinued due to stable protein levels. After 4years, kidney function remained stable. Imerslund-Grâsbeck syndrome is a rare autosomal recessive disorder that affects vitamin B12 and protein, particularly albumin absorption. While typically presenting with megaloblastic anemia, AMN mutations show variable phenotypes. Proteinuria is resistant to ACE inhibitors, and currently, there is no specific treatment.

Cobalt ion-enhanced chemiluminescence of boron-nitrogen co-doped carbon dots for sensitive detection of cobalt ions and vitamin B12.

Background: Infantile Tremor Syndrome (ITS) is a rare yet clinically significant nutrition-related neurological disorder that is observed in most infants and young children in developing nations. Tremors, neurodevelopmental delay or deterioration, anemia, pigmented skin, and shaggy hair are characteristic feature. Increasing evidence suggests a strong association with vitamin B12 deficiency, particularly in exclusively breastfed infants born to nutritionally deficient mothers. We report a case of a 10-month-old female infant exhibited typical features of Infantile Tremor Syndrome with markedly low vitamin B12 levels despite normal growth, and showed significant clinical improvement after treatment. ITS should be considered in infants with tremors and developmental delay even with normal anthropometry, as early detection and vitamin B12 supplementation can prevent long-term neurodevelopmental complications. Keywords: Infantile tremor syndrome; Vitamin B12 deficiency; Nutritional rehabilitation; Neurodevelopmental delay.