Rogers Lisa M, Boy Erick, Miller Joshua W, Green Ralph, Rodriguez Monica, Chew Francisco, Allen Lindsay H
Department of Nutrition, Program in International Nutrition, University of California, Davis, California 95616-8669, USA.
J Pediatr Gastroenterol Nutr. 2003 Jan;36(1):27-36. doi: 10.1097/00005176-200301000-00008.
The authors investigated whether low vitamin B12 intake, impaired gastric function, infection, and bacterial overgrowth were risk factors for the high prevalence of cobalamin deficiency observed in Guatemalan children.
The plasma cobalamin concentration of 556 school children was measured and classified as low, marginal, or adequate. In 60 children from each of these three groups, concentrations of serum methylmalonic acid (MMA), plasma homocysteine, and plasma holotranscobalamin II were measured, and usual dietary B12 intake was estimated. Serum gastrin and pepsinogen I concentrations were measured, and and bacterial overgrowth were diagnosed using C-urea and C-xylose breath tests, respectively.
infection was present in 83% (144 of 174) of children, and bacterial overgrowth was found in 25% (28 of 113). Children with infection had higher serum gastrin and pepsinogen I. There were no significant differences among the plasma cobalamin groups in the prevalence of infection, bacterial overgrowth, serum gastrin, or pepsinogen I concentrations. However, there was a significant positive correlation between serum MMA and gastrin concentrations. The average daily consumption of dietary B12 was 5.5 +/- 5.2 microg/day, but intakes for 23% of children were <1.8 micro g/day. B12 intake from fortified snacks added an additional 0.3 +/- 0.2 microg/day. B12 intake was not significantly different among the plasma cobalamin groups, but it was significantly correlated with plasma cobalamin.
The specific cause of cobalamin deficiency in this population remains unclear, but these results suggest that low dietary B12 intake is a risk factor and alterations in gastric secretions may also play a role.
作者研究了维生素B12摄入量低、胃功能受损、感染和细菌过度生长是否是危地马拉儿童中观察到的高钴胺素缺乏患病率的危险因素。
测量了556名学童的血浆钴胺素浓度，并将其分类为低、边缘或充足。在这三组中的每组60名儿童中，测量了血清甲基丙二酸（MMA）、血浆同型半胱氨酸和血浆全转钴胺素II的浓度，并估计了日常饮食中B12的摄入量。测量了血清胃泌素和胃蛋白酶原I的浓度，并分别使用C-尿素呼气试验和C-木糖呼气试验诊断细菌过度生长。
83%（174名中的144名）儿童存在感染，25%（113名中的28名）发现细菌过度生长。感染儿童的血清胃泌素和胃蛋白酶原I较高。血浆钴胺素组在感染患病率、细菌过度生长、血清胃泌素或胃蛋白酶原I浓度方面没有显著差异。然而血清MMA和胃泌素浓度之间存在显著正相关。饮食中B12的平均每日摄入量为5.5±5.2微克/天，但23%的儿童摄入量<1.8微克/天。强化零食中的B12摄入量额外增加了0.3±0.2微克/天。血浆钴胺素组之间的B12摄入量没有显著差异，但与血浆钴胺素显著相关。
该人群中钴胺素缺乏的具体原因仍不清楚，但这些结果表明饮食中B12摄入量低是一个危险因素，胃分泌物的改变也可能起作用。
