B-Vitamine in der Geriatrie – was bestimmen, was ersetzen?

2021 ◽  
Vol 46 (05) ◽  
pp. 312-316
Author(s):  
Marija Djukic ◽  
Christine A. F. von Arnim
Keyword(s):  
Vitamin B12 ◽  
Barthel Index ◽  
Vitamin B6 ◽  
Vitamin B1 ◽  
Geriatrische Patienten ◽  
Klinische Diagnose ◽  
Neurologische Symptome ◽  
Diagnostische Zuverlässigkeit

ZusammenfassungEin Vitamin-B1-Mangel kann sich als Wernicke-Enzephalopathie oder als Beriberi manifestieren. Geriatrische Patienten mit den Diagnosen Demenz oder Delir haben niedrigere Vitamin-B1-Spiegel als solche ohne diese Diagnosen. Ebenso zeigen sich bei geriatrischen Patienten mit höherem Vitamin-B1-Spiegel bessere Ergebnisse in der Funktionalität (Barthel-Index) bei Entlassung. Vitamin B6 ist an über 100 Reaktionen als Koenzym beteiligt und ein Mangel kann daher mit vielen Symptomen einhergehen. Klinische Manifestationen des Vitamin-B12-Mangels reichen von frühen neuropsychiatrischen bis zu hämatologischen Symptomen, wobei die makrozytäre Anämie als später Indikator eines Vitamin-B12-Mangels gilt. Neurologische Symptome treten sehr häufig schon vor oder ohne hämatologische Manifestationen auf. Die Bestimmung des Vitamin-B1-Spiegels im Blut ist wenig aussagekräftig. Die Wernicke-Enzephalopathie ist eine klinische Diagnose. Zur Diagnose eines Vitamin-B6-Mangels wird die Bestimmung von Pyridoxin (Pyridoxal-5′-Phosphat) im Plasma empfohlen. Ein erniedrigter Holo-TC-Spiegel im Serum gilt als frühester Marker eines Vitamin-B12-Mangels. Eine kombinierte Bestimmung von Vitamin B12, Holo-TC, MMA und Homozystein scheint die diagnostische Zuverlässigkeit bei Vitamin-B12-Mangel zu erhöhen. Für Empfehlungen zur Substitutionstherapie bei allen B-Vitaminen liegen kaum bzw. keine evidenzbasierten Daten vor. Durch die Substitution von 0,8 mg Folsäure, 0,5 mg Vitamin B12 und 20 mg Vitamin B6 konnte in einer randomisierten kontrollierten Studie bei Patienten mit einer leichten kognitiven Störung eine Verlangsamung der Hirnatrophie bewirkt werden.

B-Vitamine in der Geriatrie – was bestimmen, was ersetzen?

2021 ◽  
Vol 146 (03) ◽  
pp. 152-156
Author(s):  
Marija Djukic ◽  
Christine A.F. von Arnim
Keyword(s):  
Vitamin B12 ◽  
Barthel Index ◽  
Vitamin B6 ◽  
Vitamin B1 ◽  
Geriatrische Patienten ◽  
Klinische Diagnose ◽  
Neurologische Symptome ◽  
Diagnostische Zuverlässigkeit ◽  
B Vitamin ◽  
Klinische Manifestation

Was ist neu? Klinische Manifestation eines B-Vitamin-Mangels Ein Vitamin-B1-Mangel kann sich als Wernicke-Enzephalopathie oder als Beriberi manifestieren. Geriatrische Patienten mit den Diagnosen Demenz oder Delir haben niedrigere Vitamin-B1-Spiegel als solche ohne diese Diagnosen. Ebenso zeigen sich bei geriatrischen Patienten mit höherem Vitamin-B1-Spiegel bessere Ergebnisse in der Funktionalität (Barthel-Index) bei Entlassung. Vitamin B6 ist an über 100 Reaktionen als Koenzym beteiligt und ein Mangel kann daher mit vielen Symptomen einhergehen. Klinische Manifestationen des Vitamin-B12-Mangels reichen von frühen neuropsychiatrischen bis zu hämatologischen Symptomen, wobei die makrozytäre Anämie als später Indikator eines Vitamin-B12-Mangels gilt. Neurologische Symptome treten sehr häufig schon vor oder ohne hämatologische Manifestationen auf. Diagnostik von B-Vitamin-Mangelzuständen Die Bestimmung des Vitamin-B1-Spiegels im Blut ist wenig aussagekräftig. Die Wernicke-Enzephalopathie ist eine klinische Diagnose. Zur Diagnose eines Vitamin-B6-Mangels wird die Bestimmung von Pyridoxin (Pyridoxal-5′-Phosphat) im Plasma empfohlen. Ein erniedrigter Holo-TC-Spiegel im Serum gilt als frühester Marker eines Vitamin-B12-Mangels. Eine kombinierte Bestimmung von Vitamin B12, Holo-TC, MMA und Homozystein scheint die diagnostische Zuverlässigkeit bei Vitamin-B12-Mangel zu erhöhen. Therapie Für Empfehlungen zur Substitutionstherapie bei allen B-Vitaminen liegen kaum bzw. keine evidenzbasierten Daten vor. Durch die Substitution von 0,8 mg Folsäure, 0,5 mg Vitamin B12 und 20 mg Vitamin B6 konnte in einer randomisierten kontrollierten Studie bei Patienten mit einer leichten kognitiven Störung eine Verlangsamung der Hirnatrophie bewirkt werden.

PERBAIKAN KADAR ALBUMIN PASIEN POST AMPUTASI ET CAUSA LUKA BAKAR LISTRIK 25% DERAJAT III DAN STATUS GIZI KURANG DENGAN PEMBERIAN ASUPAN TINGGI PROTEIN

2018 ◽  
Vol 1 (1) ◽  
pp. 18-25
Author(s):  
Diane Paparang ◽  
Nurpudji A. Taslim ◽  
Haerani Rasyid ◽  
A. Yasmin Syauki
Keyword(s):  
Vitamin A ◽  
Vitamin C ◽  
Vitamin B12 ◽  
Vitamin B6 ◽  
Vitamin B1

Pendahuluan Proses penyembuhan luka post amputasi dan luka bakar dengan luas 25% dan kedalaman derajat III serta hipoalbuminemia sedang (albumin 2,6g/dL) dan status gizi kurang memerlukan terapi gizi spesifik tinggi protein. Laporan Kasus Tn.I, laki-laki, 28 tahun dikonsul oleh bagian bedah dengan luka post amputasi dan  luka bakar listrik derajat III luas 25%. Keluhan utama asupan makan kurang sejak 16 hari terakhir karena nafsu makan kurang akibat nyeri pada luka post amputasi dan luka bakar. Ada nyeri ulu hati dan demam menggigil. Asupan 24 jam 1000kkal. Pasien didiagnosis dengan status gizi kurang (LLA=80,7%), status metabolik anemia normositik normokrom (Hb 9.7 g/dl), deplesi sedang sistem imun (TLC 940/µL), hipoalbuminemia (albumin 2,6g/dL) dan status gastrointestinal fungsional. Terapi nutrisi dengan energi 2500 kkal, protein 2 gr/kgBBI/hari (23%), karbohidrat 57% dan lemak 20 %, melalui oral berupa makanan biasa 1250 kkal, ONS glutamine 2.5g/hari, suplementasi 6 butir putih telur (protein 31,5g/hari), vitamin C 1g/24jam, vitamin A 6.000IU/12jam, vitamin B1-100mg, vitamin B6-200mg, vitamin B12-200mg, Zinc 50mg/24jam, selenium 55µg, Curcuma 400mg/8jam dan ekstrak ikan gabus 2 kapsul/8 jam. Setelah perawatan 30 hari, terjadi perbaikan dalam penyembuhan luka, peningkatan LLA menjadi 23,5cm, peningkatan hemoglobin 9.3g/dl, peningkatan sistem imun (TLC 2064/µL), peningkatan albumin 3.9g/dL. Kesimpulan Terapi nutrisi spesifik dengan protein 2 gr/kgBBI dapat meningkatkan kadar albumin dan mempercepat penyembuhan luka pada pasien luka bakar.

scholarly journals The Role of Neurotropic B Vitamins in Nerve Regeneration

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Simone Baltrusch
Keyword(s):  
Vitamin B12 ◽  
Vitamin B6 ◽  
Vitamin B1 ◽  
B Vitamins ◽  
Nerve Degeneration ◽  
Antioxidant Vitamin ◽  
Neuronal Viability ◽  
Cell Structures ◽  
A Site

Damage and regeneration naturally occur in the peripheral nervous system. The neurotropic B vitamins thiamine (B1), pyridoxine (B6), and cobalamin (B12) are key players, which maintain the neuronal viability in different ways. Firstly, they constantly protect nerves against damaging environmental influences. While vitamin B1 acts as a site-directed antioxidant, vitamin B6 balances nerve metabolism, and vitamin B12 maintains myelin sheaths. However, nerve injury occurs at times, because of an imbalance between protective factors and accumulating stress and noxae. This will result in the so-called Wallerian degeneration process. The presence of vitamins B1, B6, and B12 paves the way out to the following important regeneration by supporting the development of new cell structures. Furthermore, vitamin B1 facilitates the usage of carbohydrates for energy production, whereas vitamin B12 promotes nerve cell survival and remyelination. Absence of these vitamins will favor permanent nerve degeneration and pain, eventually leading to peripheral neuropathy.

scholarly journals Các Vitamin cần thiết như thế nào đối với bệnh nhân đái tháo đường typ 2

2020 ◽  
pp. 16-22
Author(s):  
Trung Vinh Hoàng
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Vitamin B12 ◽  
Vitamin K ◽  
Vitamin B6 ◽  
Vitamin B1

Bài tổng quan sau đây nói về mối liên quan giữa đái tháo đường typ 2 (ĐTĐT2) với từng loại vitamin nói chung cũng như vitamin tổng hợp. Nồng độ các vitamin có tác dụng chống gốc tự do như vitamin A, C và E đều giảm ở BN ĐTĐ làm gia tăng các stress oxi hóa, góp phần gây bất thường chuyển hóa glucose. Mặt khác các protein mang retinol (vitamin A) còn có tác dụng điều biến tương tự như các adipokin. Mặc dù cơ chế gây giảm nồng độ các vitamin nhóm B như thiamin (vitamin B1), vitamin B6 và biotin là hoàn toàn chưa rõ song nếu bổ sung các loại đó lại có tác dụng cải thiện kiểm soát chuyển hóa ở BN ĐTĐ. Hấp thu acid folic và vitamin B12 sẽ bị giảm đi nếu sử dụng merformin kéo dài trong khi đó đây lại là thuốc lựa chọn hàng đầu để điều trị ĐTĐ chưa có biến chứng. Chính vì vậy nồng độ hai loại này bị thiếu hụt, rất cần bổ sung thường xuyên. Vitamin D đóng vai trò như là yếu tố nguy cơ (YTNC) gây biến chứng ở BN trong đó có biến chứng tim mạch. Cũng có ý kiến cho rằng vitamin K có liên quan đến chuyển hóa glucose song cần phải có thêm bằng chứng trong nghiên cứu. Việc sử dụng vitamin tổng hợp cho hiệu quả chưa rõ rệt. Tuy vậy hiện nay vẫn chưa có một chỉ định thống nhất nào về bồi phụ vitamin thiếu hụt ngoại trừ sử dụng acid folic và vitamin B12 nếu điều trị bằng metformin kéo dài.

scholarly journals Nutritionally Enhanced Probioticated Whole Pineapple Juice

Fermentation ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 178
Author(s):  
Wilawan Palachum ◽  
Wanna Choorit ◽  
Yusuf Chisti
Keyword(s):  
Vitamin B12 ◽  
Vitamin B6 ◽  
Vitamin B1 ◽  
Calorific Value ◽  
Probiotic Bacterium ◽  
Live Cells ◽  
Pineapple Juice ◽  
C Storage ◽  
Lactic Acid Content ◽  
Pineapple Pulp

Nutritionally enhanced probioticated whole pineapple juice (WPJ, comprising juice of pineapple pulp and peel) beverages were produced by fermentation of WPJ with the probiotic bacterium Lactobacillus plantarum WU-P19. The 12 h fermented juice contained between 2.1 × 109 and 3.7 × 109 live cells of the probiotic per milliliter, depending on the beverage formulation. The beverage had a pH of around 4.1 and a lactic acid content of ~12.8 g L−1. It had a total sugar (glucose, sucrose, fructose, maltose) content of ~100.2 g L−1. During fermentation, some of the initial glucose and fructose were consumed by the probiotic, but sucrose and maltose were not consumed. The original WPJ was free of vitamin B12, but fermentation enhanced vitamin B12 content (~19.5 mg L−1). In addition, fermentation enhanced the concentrations of vitamins B2, B3, and B6, but the bacterium consumed some of the vitamin B1 originally present. From a nutritional perspective, the final probioticated beverage was a good source of vitamin B12, vitamin C and vitamin B6. In addition, it contained nutritionally useful levels of vitamins B1, B2, and B3. The calorific value of the final beverage was 56.94 kcal per 100 mL. The product was stable during 21-day refrigerated (4 °C) storage.

Association Between Homocysteine and Vitamin Levels in Demented Patients

2021 ◽  
pp. 1-12
Author(s):  
Jessica Hoffmann ◽  
Stefan Busse ◽  
Franz von Hoff ◽  
Katrin Borucki ◽  
Thomas Frodl ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Vitamin B6 ◽  
Homocysteine Level ◽  
Vitamin B1 ◽  
Lewy Body Dementia ◽  
Serum Levels ◽  
Elderly Persons ◽  
Total Homocysteine ◽  
Folate And Vitamin B12 ◽  
Elderly Control

Background: Although it is known that the nutritional status among elderly persons and, in particular, patients with dementia, is compromised, malnutrition that results in insufficient uptake of several vitamins is often not diagnosed. Objective: An elevated homocysteine level is a known strong risk factor for vascular dementia (VaD) and Alzheimer’s disease (AD). Several B vitamins are involved in the metabolism of homocysteine. Therefore, we investigated the serum levels of vitamin B1, vitamin B6, folate, and vitamin B12 in 97 patients with mild cognitive impairment (MCI) or different forms of dementia and 54 elderly control persons without dementia. Results: Compared to aged non-demented people, vitamins B1, B6, B12, and folate were decreased in serum of patients with AD, and patients with Lewy body dementia had reduced vitamin B12 level. Vitamin B6 was diminished in VaD. Patients with frontotemporal dementia showed no alterations in vitamin levels. Age was identified as an important factor contributing to the concentrations of vitamin B1 and B6 in serum, but not vitamin B12 and folate. Increased levels of total homocysteine were detected especially in MCI and AD. Homocysteine correlated negatively with levels of vitamins B6, B12, and folate and positively with Q Albumin. Conclusion: Our data suggest that despite increased homocysteine already present in MCI, vitamin levels are decreased only in dementia. We propose to determine the vitamin levels in patients with cognitive decline, but also elderly people in general, and recommend supplementing these nutrients if needed.

PENGARUH GIZI TERHADAP RESPON TERAPI PASIEN CHRONIC MYELOCYSTIC LEUKIMIA (CML)

2018 ◽  
Vol 1 (1) ◽  
pp. 57-66
Author(s):  
Asrini Safitri ◽  
Haerani Rasyid ◽  
Agussalim Bukhari ◽  
Mardiana Madjid
Keyword(s):  
Vitamin C ◽  
Vitamin B12 ◽  
Vitamin B6 ◽  
Vitamin B1 ◽  
Optimal Monitoring

Latar Belakang Penyakit kanker darah atau yang sering disebut dengan leukemia adalah salah satu penyakit yang mematikan. Penyakit ini merupakan kurangnya sel darah merah pada system produksi darah di tubuh manusia dan memproduksi sel darah putih dengan jumlah yang berlebihan. Laporan Kasus Tn I, Laki-laki, 37 tahun dikonsul oleh bagian Interna dengan Chronic Myelocystic Leukimia. Keluhan utama Asupan makan berkurang dialami sejak 5 bulan yang lalu dan memberat dalam 2 bulan terakhir karena nafsu makan menurun, mual  , tidak muntah, riwayat muntah ada, Ada gangguan menelan  ,rasa cepat kenyang , ada demam ,ada riwayat demam , batuk, tidak  sesak, penurunan berat badan ada tetapi besarnya tidak diketahui. Asupan 24 jam 550 Kkal. Pasien didiagnosis dengan status gizi buruk ( LLA = 59,32%), status metabolik anemia normositik normokrom (Hb 7,9 g/dl ),  Hipoalbuminemia  ( Albumin 2,9 gr/dl ), Hipoglikemia ( GDS 67 mg/dl ), leukositosis ( 53.550 /uL ) , dan status gastrointestinal fungsional. Penatalaksanaan Nutrisi dengan pemberian Energi 1600 Kkal yang diberikan secara bertahap sesuai toleransi pasien dan manajemen peningkatan berat badan dilakukan bertahap jika kebutuhan energi telah tercapai. Protein diberikan 1,5 gram/KgBBI/ hari ( 19%), Karbohidrat 50% dan lemak 31%. Pemberian asupan via oral berupa makanan lunak, formula peptisol, buah, dan putih telur 3 butir / hari. Suplementasi diberikan berupa zinc 20 mg/24 jam, Curcuma 40 mg/8 jam, ekstrak ikan gabus 2 kapsul/8 jam, Vitamin B1 100 mg, Vitamin B6 200 mg, Vitamin B12 200 mg, Vitamin C 100 mg/24 jam. Setelah perawatan selama 16 hari, terjadi peningkatan LLA dari 17,5 cm menjadi 19 cm, Hb 7,9 gr/dl menjadi 11,9 gr/dl dengan transfusi PRC 3 kantong. Kadar sel darah putih saat masuk rumah sakit adalah 53.550/uL dan saat dipulangkan 29.000/uL . Pada saat awal di rawat, kadar albumin pasien adalah 2,9 g/dL. Kemudian turun menjadi 2.5 g/dL. Pada saat albumin turun menjadi 2.5 g/dL, pasien di anjurkan untuk mengkonsumsi makanan yang tinggi protein, memberikan formula tinggi protein dan pemberian ekstra putih telur dan setelahnya kadar albumin pasien naik menjadi 3.2 g/dL sebelum dipulangkan untuk rawat jalan. Kesimpulan Malnutrisi pada penderita kanker secara negatif berpengaruh terhadap respon terapi, komplikasi, kualitas hidup dan survival penderita. Intervensi nutrisi yang optimal, monitoring serta edukasi gizi menunjukkan perbaikan status gizi serta perbaikan status metabolik.

Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yanjun Wu ◽  
Liming Zhang ◽  
Suyun Li ◽  
Dongfeng Zhang
Keyword(s):  
Systematic Review ◽  
Vitamin B12 ◽  
Vitamin B6 ◽  
Fixed Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Vitamin B1 ◽  
Dietary Vitamin ◽  
Vitamin B2 ◽  
Fixed Effects Model

Abstract Context The results from epidemiologic studies on the intake of dietary vitamin B1, B2, B6, and B12 and association with risk of developing depression have been inconsistent. Objective The purpose of this systematic review and meta-analysis was to summarize the existing evidence and synthesize the results. Data Sources The databases of Web of Science and PubMed were searched for relevant articles published in English until September 2020. Study Selection Observational studies that evaluated the associations between depression and dietary vitamin B1, B2, B6, and B12 were included in this study. Data Extraction The job of data extraction was undertaken by 2 authors, and the pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed-effects model. Results Thirteen articles related to 18 studies were eligible for inclusion in this systematic review and meta-analysis. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B1, B2, B6, and B12 was 0.69 (0.55–0.87), 0.77 (0.67–0.89), 0.81 (0.71–0.93), and 0.86 (0.75–0.99), respectively. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B2 was 0.80 (0.64–0.99) in females and 0.83 (0.67–1.02) in males, for dietary vitamin B6 was 0.71 (0.59–0.86) in females and 0.92 (0.76–1.12) in males, and for dietary vitamin B12 was 0.79 (0.65–0.97) in females and 0.94 (0.77–1.15) in males. Conclusion This study suggested that the intake of dietary vitamin B1, B2, B6, and B12 may be inversely associated with the risk of depression; the inverse associations observed between depression and intake of dietary vitamin B2, B6, and B12 were significant in females, but not in males. Further studies are needed to confirm these results.

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