Vitamin B12 screening in older inpatients without known risk factors: why do clinicians measure it?

Abstract. Vitamin B12 deficiency may have indirect cardiovascular effects in addition to hematological and neuropsychiatric symptoms. It was shown that the monocyte count-to-high density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel cardiovascular marker. In this study, the aim was to evaluate whether MHR was high in patients with vitamin B12 deficiency and its relationship with cardiometabolic risk factors. The study included 128 patients diagnosed with vitamin B12 deficiency and 93 healthy controls. Patients with vitamin B12 deficiency had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), MHR, C-reactive protein (CRP) and uric acid levels compared with the controls (median 139 vs 115 mmHg, p < 0.001; 80 vs 70 mmHg, p < 0.001; 14.2 vs 9.5, p < 0.001; 10.2 vs 4 mg/dl p < 0.001; 6.68 vs 4.8 mg/dl, p < 0.001 respectively). The prevalence of left ventricular hypertrophy was higher in vitamin B12 deficiency group (43.8%) than the control group (8.6%) (p < 0.001). In vitamin B12 deficiency group, a positive correlation was detected between MHR and SBP, CRP and uric acid (p < 0.001 r:0.34, p < 0.001 r:0.30, p < 0.001 r:0.5, respectively) and a significant negative correlation was detected between MHR and T-CHOL, LDL, HDL and B12 (p < 0.001 r: −0.39, p < 0.001 r: −0.34, p < 0.001 r: −0.57, p < 0.04 r: −0.17, respectively). MHR was high in vitamin B12 deficiency group, and correlated with the cardiometabolic risk factors in this group, which were SBP, CRP, uric acid and HDL. In conclusion, MRH, which can be easily calculated in clinical practice, can be a useful marker to assess cardiovascular risk in patients with vitamin B12 deficiency.

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The role of Vitamin B12 and genetic risk factors in the etiology of neural tube defects: A systematic review

International Journal of Developmental Neuroscience ◽

10.1002/jdn.10113 ◽

2021 ◽

Author(s):

Farah Wahbeh ◽

Mange Manyama

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Vitamin B12 ◽

Neural Tube ◽

Neural Tube Defects ◽

Genetic Risk ◽

Genetic Risk Factors

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Incidence and risk factors of micronutrient deficiency in patients with IBD and intestinal Behçet’s disease: folate, vitamin B12, 25-OH-vitamin D, and ferritin

BMC Gastroenterology ◽

10.1186/s12876-021-01609-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yong Eun Park ◽

Soo Jung Park ◽

Jae Jun Park ◽

Jae Hee Cheon ◽

TaeIl Kim ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin B12 ◽

Behcet’S Disease ◽

Micronutrient Deficiency ◽

Intestinal Behçet’S Disease ◽

Intestinal Behcet’S Disease ◽

25 Oh Vitamin D ◽

Deficiency Group ◽

Intestinal Behçet's Disease

Abstract Background Patients with inflammatory bowel disease (IBD) and intestinal Behçet’s disease (BD) are vulnerable to micronutrient deficiencies due to diarrhea-related gastrointestinal loss and poor dietary intake caused by disease-related anorexia. However, few studies have investigated the incidence and risk factors for micronutrient deficiency. Methods We retrospectively analyzed 205 patients with IBD who underwent micronutrient examination, including folate, vitamin B12, 25-OH-vitamin D, and/or ferritin level quantification, with follow-up blood tests conducted 6 months later. Results Eighty patients (39.0%), who were deficient in any of the four micronutrients, were classified as the deficiency group, and the remaining 125 (61.0%) were classified as the non-deficient group. Compared to those in the non-deficiency group, patients in the deficiency group were much younger, had more Crohn's disease (CD) patients, more patients with a history of bowel operation, and significantly less 5-amino salicylic acid usage. Multivariate analysis revealed that CD and bowel operation were significant independent factors associated with micronutrient deficiency. Conclusions The incidence of micronutrient deficiency was high (39.0%). Factors including CD, bowel operation, and younger ages were found to be associated with higher risks of deficiency. Therefore, patients with IBD, especially young patients with CD who have undergone bowel resection surgery, need more attention paid to micronutrition.

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Vertigo and Cytotoxic Lesions of the Corpus Callosum: Report with Review of the Literature

Case Reports in Neurological Medicine ◽

10.1155/2021/5573822 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

John Rolshoven ◽

Katelyn Fellows ◽

Rolando Ania ◽

Burton J. Tabaac

Keyword(s):

Risk Factors ◽

Corpus Callosum ◽

Vitamin B12 ◽

Head And Neck ◽

Vitamin B12 Deficiency ◽

Radiographic Features ◽

Mri Brain ◽

Ct Angiogram ◽

Imaging Results ◽

B12 Deficiency

Background. The term cytotoxic lesions of the corpus callosum (CLOCCs) encompasses the entity reversible splenial lesion syndrome (RESLES). RESLES typically presents with altered levels of consciousness, seizures, and delirium and is distinguished radiographically by reversible focal lesions of the splenium of the corpus callosum. This disease pathology is associated with withdrawal of antiepileptic medications, infections, metabolic disturbance, or high-altitude cerebral edema. Methods. We presented an otherwise healthy 72-year-old female that was consulted for an episode of isolated vertigo lasting four hours. Initial workup included CT head without contrast, CT angiogram head and neck, and MRI brain with and without contrast. The patient experienced recurrent episodes of vertigo at one and four months after initial presentation. An extensive workup at one month included a wide spectrum of laboratory tests and repeat imaging. Results. Noncontrast CT of the head and CT angiogram of the head and neck were reassuring. MRI brain with and without contrast demonstrated hyperintensity in the splenium of the corpus callosum on FLAIR sequencing. A follow-up visit at one month revealed vitamin B12 deficiency and unchanged hyperintensity of the splenium of the corpus callosum. History and workup were negative for typical risk factors associated with RESLES. Conclusion. An otherwise healthy patient who presented with an isolated episode of vertigo was discovered to demonstrate radiographic features consistent with RESLES but lacked the common risk factors and typical presentation of RESLES. This case expands the possible clinical presentation of RESLES and highlights the possible relationship between vitamin B12 deficiency and radiographic features of RESLES.

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An overview of vitamin B12 and iron deficiencies as a risk factors in children with febrile seizure etiology

Experimental Biomedical Research ◽

10.30714/j-ebr.2021267979 ◽

2021 ◽

Vol 4 (2) ◽

pp. 154-163

Author(s):

Sevim Turay ◽

Fatma Hanci ◽

Sukriye Ozde

Keyword(s):

Risk Factors ◽

Vitamin B12 ◽

Febrile Seizure

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Folic Acid and Vitamin B12 Administration in CKD, Why Not?

Nutrients ◽

10.3390/nu11020383 ◽

2019 ◽

Vol 11 (2) ◽

pp. 383 ◽

Cited By ~ 17

Author(s):

Irene Capelli ◽

Giuseppe Cianciolo ◽

Lorenzo Gasperoni ◽

Fulvia Zappulo ◽

Francesco Tondolo ◽

...

Keyword(s):

Risk Factors ◽

Folic Acid ◽

Cardiovascular Risk ◽

Vitamin B12 ◽

Therapeutic Target ◽

Direct Action ◽

Blood Levels ◽

Traditional Risk Factors ◽

Stage Renal Disease ◽

End Stage

Patients affected by chronic kidney disease (CKD) or end-stage renal disease (ESRD) experience a huge cardiovascular risk and cardiovascular events represent the leading causes of death. Since traditional risk factors cannot fully explain such increased cardiovascular risk, interest in non-traditional risk factors, such as hyperhomocysteinemia and folic acid and vitamin B12 metabolism impairment, is growing. Although elevated homocysteine blood levels are often seen in patients with CKD and ESRD, whether hyperhomocysteinemia represents a reliable cardiovascular and mortality risk marker or a therapeutic target in this population is still unclear. In addition, folic acid and vitamin B12 could not only be mere cofactors in the homocysteine metabolism; they may have a direct action in determining tissue damage and cardiovascular risk. The purpose of this review was to highlight homocysteine, folic acid and vitamin B12 metabolism impairment in CKD and ESRD and to summarize available evidences on hyperhomocysteinemia, folic acid and vitamin B12 as cardiovascular risk markers, therapeutic target and risk factors for CKD progression.

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Logistic LASSO Regression for Dietary Intakes and Breast Cancer

Nutrients ◽

10.3390/nu12092652 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2652

Author(s):

Archana J. McEligot ◽

Valerie Poynor ◽

Rishabh Sharma ◽

Anand Panangadan

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Vitamin B12 ◽

Dietary Factors ◽

Dietary Intakes ◽

Lasso Regression ◽

Cancer Risk Factors ◽

Breast Cancer Risk Factors

A multitude of dietary factors from dietary fat to macro and micronutrients intakes have been associated with breast cancer, yet data are still equivocal. Therefore, utilizing data from the large, multi-year, cross-sectional National Health and Nutrition Examination Survey (NHANES), we applied a novel, modern statistical shrinkage technique, logistic least absolute shrinkage and selection operator (LASSO) regression, to examine the association between dietary intakes in women, ≥50 years, with self-reported breast cancer (n = 286) compared with women without self-reported breast cancer (1144) from the 1999–2010 NHANES cycle. Logistic LASSO regression was used to examine the relationship between twenty-nine variables, including dietary variables from food, as well as well-established/known breast cancer risk factors, and to subsequently identify the most relevant variables associated with self-reported breast cancer. We observed that as the penalty factor (λ) increased in the logistic LASSO regression, well-established breast cancer risk factors, including age (β = 0.83) and parity (β = −0.05) remained in the model. For dietary macro and micronutrient intakes, only vitamin B12 (β = 0.07) was positively associated with self-reported breast cancer. Caffeine (β = −0.01) and alcohol (β = 0.03) use also continued to remain in the model. These data suggest that a diet high in vitamin B12, as well as alcohol use may be associated with self-reported breast cancer. Nonetheless, additional prospective studies should apply more recent statistical techniques to dietary data and cancer outcomes to replicate and confirm the present findings.

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