should not be the only criteria to order vitamin B 12 for anemia under evaluation (original) (raw)
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M.C.V. should not be the only criteria to order vitamin B12 for anemia under evaluation
Open Journal of Gastroenterology, 2012
Introduction: A strict vegetarian diet has been associated with increased risk of cobalamin deficiency therefore; one would expect a high prevalence of Cobalamin deficiency in India. Erythrocyte indices have been used in the initial evaluation of anemic patients; high Mean corpuscular volume (MCV) is a traditional criterion for folate and vitamin B12 deficiencies. There is no large study of the prevalence of B12 deficiency among patients with normocytosis or microcytosis. Method: We retrospectively analyzed the records of serum vitamin B12 and MCV of both inpatients and outpatients at Santokba Durlabhji Memorial Hospital & Research Institute, Jaipur (Rajasthan) during the period from August 2010-April 2011. The study was aimed at identifying the correlation between vitamin B12 level and MCV; and prevalence of vitamin B12 deficiency in this region. Result & Conclusion: Every third person is vitamin B12 deficient in the region. There is no correlation between vitamin B12 levels and MCV in majority of the cases. MCV should not be the only criteria for ordering vitamin B12 for patients with anemia under evaluation.
National Journal of Community Medicine, 2018
Introduction: Vitamin B12 deficiency is gaining increasing importance as a public health issue as subclinical deficiency is reported to exist in India in more than 30% of adults and children. Thus the present study was done to find the burden of vitamin B12 deficiency in the symptomatic patients in the tertiary care centre and to analyze its association with demographic profile, dietary habits and severity of presenting symptoms. Method: A 3 months long cross-sectional study was done in 235 symptomatic patients who were biochemically tested for serum Vitamin B12 levels. Results: Almost 25.1% patients with symptoms were found deficient in Vitamin B12 at the study centre. Deficiency is higher in males i.e. 29.6%. Higher deficiency levels were found in urban population i.e. 30.6% and vegetarians (27.7%). Maximum deficiency was seen in females when they presented with late neurological deficit like dementia or seizures (42.8%). Conclusion: Approximately 1/4th of the symptomatic population was found Vitamin B12 deficient suggesting the clinical deficiency showing the tip of the iceberg. Study findings suggest public health issue, thus further community based studies are required to evaluate it in India with large sample size and compelling IEC activities regarding dietary habits and early reporting of the symptoms and prompt treatment.
Vitamin-B12 and folate deficiency, major contributing factors for anemia: A population based study
2014
Background and aims: More than 60% people in India suffer from anemia. Supplementation of iron as a state policy for decades has not brought about significant decline in its incidence. India also harbors high malnutrition rates hence it is imperative that additional nutritional components as risk factors for anemia are to be examined in Indian population. This study explores the possible association of vit-B12 and folate deficiency with the prevalence of anemia in an Indian cohort. Methods: Hematological profile of 1290 individuals from eastern Indian states were correlated with their Homocysteine, vitamin-B12 and folate levels. Results: Vitamin-B12 and folate deficiency were significantly associated with anemia in the studied cohort, suggesting them as vital risk factors in Indian population. Most of the macrocytic and greater than 50% of subjects with microcytic and normocytic anemia showed vit-B12 deficiency, indicating the plausible coexistence of iron and vit-B12 deficiency in the studied cohort. Conclusions: Vitamin B12 deficiency is a compounding factor in the metabolic etiology of anemia along with folate, and this may be one of the plausible reasons for ineffectiveness of iron supplementation in reducing the incidence of anemia in Indian population. We therefore believe that there is a compelling reason to include vit-B12 & folate in the supplement regimen to alleviate the disease burden of anemia in Indian population.
Identification of vitamin B12 deficiency in vegetarian Indians
British Journal of Nutrition, 2018
The prevalence of a sub-clinical vitamin B12 deficiency in the vegetarians is high. Total serum vitamin B12 concentration alone does not reliably reflect vitamin B12 status. Holotranscobalamin (holo-TC) II is a bioactive B12 fraction promoting specific uptake of B12 by cells and the circulating concentration reflects the intake of B12, whereas total homocysteine (tHcy) indicates the metabolic ability. In this study, we investigated the diagnostic value of circulating holo-TC, B12, folate and homocysteine in vegetarians who were at risk of B12 deficiency. B12-related biomarkers were measured in 119 young, healthy graduate vegetarians. None was folate deficient. As per reported definition, half were B12 deficient; 70 % of males and 50 % of females had low plasma holo-TC concentrations; and 92 % of males and half of females had hyperhomocysteinaemia. None had any clinical signs of B12 deficiency. Receiver operating characteristic curve analysis demonstrated similar AUC at the B12 conce...
Vitamin-B12 and Folate deficiency, major contributing factors for anaemia: A population based study
s u m m a r y Background and aims: More than 60% people in India suffer from anemia. Supplementation of iron as a state policy for decades has not brought about significant decline in its incidence. India also harbors high malnutrition rates hence it is imperative that additional nutritional components as risk factors for anemia are to be examined in Indian population. This study explores the possible association of vit-B12 and folate deficiency with the prevalence of anemia in an Indian cohort. Methods: Hematological profile of 1290 individuals from eastern Indian states were correlated with their Homocysteine, vitamin-B12 and folate levels. Results: Vitamin-B12 and folate deficiency were significantly associated with anemia in the studied cohort, suggesting them as vital risk factors in Indian population. Most of the macrocytic and greater than 50% of subjects with microcytic and normocytic anemia showed vit-B12 deficiency, indicating the plausible coexistence of iron and vit-B12 deficiency in the studied cohort. Conclusions: Vitamin B12 deficiency is a compounding factor in the metabolic etiology of anemia along with folate, and this may be one of the plausible reasons for ineffectiveness of iron supplementation in reducing the incidence of anemia in Indian population. We therefore believe that there is a compelling reason to include vit-B12 & folate in the supplement regimen to alleviate the disease burden of anemia in Indian population.
The Egyptian Journal of Internal Medicine, 2022
In India, approximately 75% of population that is over 650 million people have B12 deficiency majority of which is caused by variation in demography, diet, and religion. Conditions such as smoking, alcohol, and antacid use are certain causes for incidence of vitamin B12 deficiency. Looking at various adverse health effects of drinking demineralized water, there is possibility that it may also be one of the newly associated factors for increasing incidence and prevalence of vitamin B12 deficiency. To assess the risk factors associated with vitamin B12 deficiency. A case control study was conducted at SSG Hospital in Vadodara, Gujarat, wherein all the patients visiting the hospital from November 2017 to June 2018 with symptoms suggestive of B12 deficiency and serum B12 level below 200pg/mL were included in the study. Information regarding the vitamin B12 deficiency was obtained from the patients. Controls were selected and matched with cases as per age group to minimize confounding. O...
Status of Vitamin B12 among Healthy Adult and Elderly Population in India: A Review
Journal of Nutritional Science and Vitaminology
Vitamin B12 is a water soluble micronutrient found in animal foods. Its deficiency is not uncommon in India owing to vegetarianism but often unrecognized due to diverse clinical manifestations. This review aims to collate the current data on vitamin B12 status in healthy Indian adult and elderly population. Online database Pubmed was searched for articles published in English between 2000 and 2019. Inclusion criteria consisted of original studies conducted on apparently healthy adult and elderly Indian population reporting serum/plasma vitamin B12 levels. Comprehensive literature search identified 14 studies eligible for inclusion. The deficiency prevalence reached 78.5% and 61.7% among adults and elderly, respectively, based on varying cut offs. Higher vitamin B12 levels were reported in women than men. Hyperhomocysteinemia (Hcy .15 mmol/L) was lower in females as compared to males (60% vs 90%, 14.9% vs 57.4% and 3.6% vs 20.9% respectively in three studies). Vitamin B12 deficiency was higher in vegetarians. The results indicate that inadequate vitamin B12 status is a wide spread problem in the Indian population. However, variety of laboratory methods and cutoffs of vitamin B12 deficiency and the heterogeneity in results pose challenges to draw clear conclusions on the extent of vitamin B12 deficiency in India. This review, therefore, highlights the need for more evidence based research to define age and sex specific cut offs for defining vitamin B12 deficiency.
Vitamin Cobalamin deficiency in macrocytic anemia reporting at a Tertiary Care Hospital
The Professional Medical Journal, 2021
Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subje...
VITAMIN B12 STATUS IN A TERTIARY CARE CENTER IN CENTRAL GUJARAT
National Journal of Community Medicine, 2012
Introduction: Vitamin B12 deficiency usually presents with pernicious anemia or various neuropsychiatric manifestations such as neuropathy, myelopathy, dementia, cerebellar ataxia, optic atrophy, pscyhosis and mood disorders. Hence vitamin B12 deficiency should be identified. The local population in our area mainly comprises of vegetarians, this study was initiated with a view to assess their B12 status early, to rule out its deficiency and help to prevent further complications. Methodology: We analyzed serum B12 levels in 396 cases by competitive chemiluminescent immunometric method using Immulite instrument. Result: It was found that B12 levels were significantly low in 260(65.6%) patients (P<0.000). Majority 225 (86.5%) of the deficient patients were vegetarians and the deficiency was found less in non vegetarians (P<0.000). The B12 deficiency was evident more in patients below 50years (199 out of 396 i.e. 76.5%) of age as compared to those who are above 51 years of age (60 out of 396 i.e. 23.4%), with a P value <0.000. The deficiency was prevalent more in females 179 (68.8%) in comparison to males 81(31.1%) and the P<0.000. Our study found that B12 deficiency is quiet prevalent in local population (65.6%), the condition being worse in females. And it was also noticed that deficiency was relatively more in vegetarians. Conclusion: The early detection of B12 deficiency could help in warding off the resultant complications.
IP Innovative Publication Pvt. Ltd., 2018
Aim: To determine the prevalence of vitamin B12 deficiency in subjects with anaemia and elevated mean corpuscular volume. Materials and Methods: Blood samples from 119 subjects were selected for the study based on the inclusion and exclusion criteria laid down. Blood samples were analysed on sysmex KX 21 haematology analyser. Morphological evaluation of blood cells was done on peripheral blood smear. Serum vitamin B 12 assays were done. Qualitative and quantitative variables were analysed by statistical methods. Results: Out of 119 subjects taken for study 70 (58.8 %) were male and 49 (41.2 %) were female with mean age ± SD 40.5± 18. Vitamin B 12 deficiency was noted in 82 (69 %) of which 12 (10.1%) were in Borderline levels of deficiency, 31 (26.1%) were in deficient levels and 39 (32.8%) were in severely deficient group. Red blood cell indices were categorized as per different groups of vitamin B 12 levels. Pancytopenia was noted in 67.1% (54) of B 12 deficient individuals. Significant negative correlation was found between vitamin B 12 levels and mean corpuscular volume (r = - 0.215 .p = 0.019). A positive correlation was found between vitamin B12 and platelet count. (p= < 0.001) and also with leukocyte counts (p value < 0.001) These correlations were found to be statistically significant. Peripheral blood film examination shows macrocytosis in 76 (64%) smears and hypersegmented neutrophils in 66 (56%) smears. Keywords: Vitamin B 12 deficiency, prevalence, Megaloblastic anaemia, Pancytopenia, Mean corpuscular volume.