Vitamin B12 deficiency and hyperhomocysteinemia in rural and urban Indians.
Vitamin B12 deficiency and hyperhomocysteinemia in rural and urban Indians.
复制标题
印度农村和城市居民维生素 B12 缺乏症和高同型半胱氨酸血症。
DOI：
--
复制
发表时间：
2006
期刊：
影响因子：
--
通讯作者：
JS Yudkin
中科院分区：
文献类型：
--
作者：
CS Yajnik;S. Deshpande;H. Lubree;SS Naik;DS Bhat;Bhagyashree S Uradey;J. Deshpande;S. Rege;H. Refsum;JS Yudkin
背景
南亚印度人的维生素B12浓度低是常见的，但确切的患病率尚不清楚。
目的
调查生活在马哈拉施特拉邦浦那及其周边地区的印度农村和城市男性维生素B12浓度低和高同型半胱氨酸血症的患病率和相关性。
方法
我们研究了441名中年男性（149名农村，142名贫民窟和150名城市中产阶级居民，平均年龄39岁）。获得了生活方式、社会经济状况、营养和病史的数据。测量了维生素B12、叶酸、铁蛋白、总同型半胱氨酸（tHcy）的循环浓度、血液学指标和心血管风险变量。
结果
中位血浆B12浓度较低（110 pmol/L）：总体而言，67%的男性维生素B12浓度较低（<150 pmol/L），58%的男性患有高同型半胱氨酸血症（>15 μ mol/L）。在城市中产阶级中，81%的人维生素B12浓度低，79%的人患有高同型半胱氨酸血症。低维生素B12浓度对高同型半胱氨酸血症风险（人群归因风险）的贡献率为28%，而低红细胞叶酸的贡献率为2%。与经常吃非素食的人相比，素食者维生素B12浓度低的风险高4.4倍（95%CI 2.1，9.4），高同型半胱氨酸血症的风险高3.0倍（95%CI 1.4，6.5）。城市中产阶级是高同型半胱氨酸血症的另一个独立危险因素（与农村男性相比，比值比为7.6（95%CI 2.5，22.6））。低维生素B12浓度与较低的血红蛋白浓度和较高的平均红细胞体积有关，但大红细胞性贫血是罕见的。
结论
低维生素B12浓度和高同型半胱氨酸血症在印度男性中很常见，特别是素食者和城市中产阶级居民。需要进一步的研究来证实印度其他地区的这些发现。
BACKGROUND
Low vitamin B12 concentration in South Asian Indians is common, but the exact prevalence is not known.
AIM
To investigate prevalence and associations of low vitamin B12 concentration and hyperhomocysteinemia in rural and urban Indian men living in and around Pune, Maharashtra.
METHOD
We studied 441 middle-aged men (149 rural, 142 slum and 150 urban middle-class residents, mean age 39 y). Data on lifestyle, socio-economic status, nutrition and medical history were obtained. Circulating concentrations of vitamin B12, folate, ferritin, total homocysteine (tHcy), and haematological indices, and cardiovascular risk variables were measured.
RESULTS
Median plasma B12 concentration was low (110 pmol/L): Overall, 67% of men had low vitamin B12 concentration (<150 pmol/L) and 58% had hyperhomocysteinemia (>15 micromol/L). Of the urban middle class, 81% had low vitamin B12 concentration and 79% had hyperhomocysteinemia. Low vitamin B12 concentration contributed 28% to the risk of hyperhomocysteinemia (population attributable risk) while low red cell folate contributed 2%. Vegetarians had 4.4 times (95% CI 2.1, 9.4) higher risk of low vitamin B12 concentrations and 3.0 times (95% CI 1.4, 6.5) higher risk of hyperhomocysteinemia compared to those who ate non-vegetarian foods frequently. Urban middle-class residence was an additional independent risk factor of hyperhomocysteinemia (odds ratio 7.6 (95% CI 2.5, 22.6), compared to rural men). Low vitamin B12 concentration was related to lower blood haemoglobin concentration and higher mean corpuscular volume, but macrocytic anemia was rare.
CONCLUSION
Low vitamin B12 concentration and hyperhomocysteinemia are common in Indian men, particularly in vegetarians and urban middle class residents. Further studies are needed to confirm these findings in other parts of India.