Sun Andy, Chang Julia Y-F, Wang Yi-Ping, Cheng Shih-Jung, Chen Hsin-Ming, Chiang Chun-Pin
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Oral Pathol Med. 2016 Jan;45(1):23-7. doi: 10.1111/jop.12330. Epub 2015 May 18.
Vitamin B12 deficiency may result in pernicious anemia (PA). This study evaluated whether all the patients with vitamin B12 deficiency had PA.
The blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine concentrations and mean corpuscular volume (MCV) in 90 vitamin B12-deficient patients were measured and compared with the corresponding data in 180 age- and sex-matched healthy control subjects. PA was defined by World Health Organization (WHO) as having an Hb concentration <13 g/dl for men and <12 g/dl for women, an MCV ≧ 100 fl, a serum vitamin B12 level <200 pg/ml, and serum gastric parietal cell antibody (GPCA) positivity.
We found that 35 (38.9%) and 20 (22.2%) patients with vitamin B12 deficiency had deficiencies of Hb (men <13 g/dl, women <12 g/dl) and iron (<60 μg/dl), respectively. Moreover, 65 (72.2%) and 37 (41.1%) patients with vitamin B12 deficiency had abnormally high blood homocysteine level (>12.7 μM) and high MCV (≧100 fl), respectively. In addition, 43 (47.8%) vitamin B12-deficient patients with had GPCA positivity. Patients with vitamin B12 deficiency had a significantly higher frequency of Hb or iron deficiency, of abnormally elevated blood homocysteine level or high MCV, and of GPCA positivity than healthy control subjects (all P-values < 0.001). However, only 17 (18.9%) of 90 vitamin B12-deficient patients were diagnosed as having PA by the WHO definition.
Only 18.9% of patients with vitamin B12 deficiency are discovered to have PA by the WHO definition.
维生素B12缺乏可能导致恶性贫血（PA）。本研究评估了所有维生素B12缺乏患者是否患有PA。
测量了90例维生素B12缺乏患者的血红蛋白（Hb）、铁、维生素B12、叶酸和同型半胱氨酸浓度以及平均红细胞体积（MCV），并与180例年龄和性别匹配的健康对照者的相应数据进行比较。世界卫生组织（WHO）将PA定义为男性Hb浓度<13 g/dl、女性Hb浓度<12 g/dl、MCV≧100 fl、血清维生素B12水平<200 pg/ml以及血清胃壁细胞抗体（GPCA）呈阳性。
我们发现，分别有35例（38.9%）和20例（22.2%）维生素B12缺乏患者存在Hb缺乏（男性<13 g/dl，女性<12 g/dl）和铁缺乏（<60 μg/dl）。此外，分别有65例（72.2%）和37例（41.1%）维生素B12缺乏患者血同型半胱氨酸水平异常升高（>12.7 μM）和MCV升高（≧100 fl）。另外，43例（47.8%）维生素B12缺乏患者GPCA呈阳性。维生素B12缺乏患者Hb或铁缺乏、血同型半胱氨酸水平异常升高或MCV升高以及GPCA阳性的频率显著高于健康对照者（所有P值<0.001）。然而，按照WHO的定义，90例维生素B12缺乏患者中只有17例（18.9%）被诊断为患有PA。
按照WHO的定义，只有18.9%的维生素B12缺乏患者被发现患有PA。
