High prevalence of vitamin B-12 insufficiency in patients with Crohn's disease
High prevalence of vitamin B-12 insufficiency in patients with Crohn's disease
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DOI：
10.6133/apjcn.022017.13
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发表时间：
2017-01-01
影响因子：
1.3
通讯作者：
Tanaka, Kiyoshi
中科院分区：
文献类型：
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作者：
Ao, Misora;Tsuji, Hidemi;Tanaka, Kiyoshi
背景与目的：克罗恩病（Crohn’s disease，CD）是一种以小肠受累为主的炎症性肠病。最常受影响的是回肠末端，维生素B-12在此处被特异性吸收。因此，CD患者很可能发生维生素B-12吸收不良。在这项研究中，我们研究了CD患者的维生素B-12状况。方法和研究设计：对48例CD患者的食物摄入量和维生素B-12、叶酸和同型半胱氨酸（Hcy）的循环浓度进行了评价，作为这些维生素不足和动脉粥样硬化危险因素的敏感标志物。结果如下：血浆Hcy浓度与血清维生素B-12单独浓度显著相关，60. 4%的受试者有高同型半胱氨酸血症。受试者工作特征（ROC）分析表明，血清维生素B-12浓度，而不是叶酸，预测高同型半胱氨酸血症。他们的维生素B-12摄入量远高于日本RDA，但与维生素B-12或Hcy的血液浓度无关，可能是由于吸收不良。结论：CD患者中维生素B-12不足和高同型半胱氨酸血症的发生率较高。最近，CD肠外并发症的重要性已越来越多地被认识到，我们的发现可能具有临床意义。
Background and Objectives: In Crohn's disease (CD), belonging to inflammatory bowel disease, the small intestine is involved in most cases. Most frequently affected is the distal ileum, where vitamin B-12 is specifically absorbed. Therefore, malabsorption of vitamin B-12 is quite likely to occur in patients with CD. In this study, we have studied the vitamin B-12 status in CD patients. Methods and Study Design: Forty eight patients with CD were evaluated for their food intake, and circulating concentrations of vitamin B-12, folic acid, and homocysteine (Hcy) as a sensitive marker for the insufficiency of these vitamins and a risk factor of atherosclerosis. Results: Plasma Hcy concentration was significantly correlated with serum vitamin B-12 concentration alone, and 60.4 % of the subjects had hyperhomocysteinemia. Receiver Operating Characteristics (ROC) analysis showed that serum concentration of vitamin B-12, but not folic acid, predicted hyperhomocysteinemia. Their intake of vitamin B-12 was much higher than the Japanese RDA, but not correlated with blood concentrations of vitamin B-12 or Hcy, probably due to malabsorption. Conclusions: Vitamin B-12 insufficiency and hyperhomocysteinemia were highly prevalent in CD patients. Recently, the significance of extra-intestinal complications of CD has been increasingly recognized, and our finding is likely to be of clinical importance.