Kalkan Çağdaş, Karakaya Fatih, Tüzün Ali, Gençtürk Zeynep Bıyıklı, Soykan Irfan
Department of Gastroenterology, Ibni Sina Hospital, Ankara University Faculty of Medicine, Ankara, Turkey.
Department of Biostatistics, Ibni Sina Hospital, Ankara University Faculty of Medicine, Ankara, Turkey.
Geriatr Gerontol Int. 2016 Jun;16(6):686-92. doi: 10.1111/ggi.12537. Epub 2015 Jun 4.
Vitamin B12 deficiency is frequent in older patients, and the main reason is pernicious anemia. However, vitamin B12 deficiency can occur in patients who do not have atrophic gastritis. The aim of the present study was to investigate factors affecting serum vitamin B12 levels in older patients with non-atrophic gastritis.
A total of 1256 out of 1607 patients aged over 60 years who had undergone upper gastrointestinal endoscopy for various reasons, and who had serum vitamin B12 value and were diagnosed as having "non-atrophic gastritis" were analyzed by means of factors affecting low serum vitamin B12 levels.
Non-atrophic gastritis patients were divided into two groups: patients with normal serum vitamin B12 (group I, n = 759) and patients with low serum vitamin B12 (group II, n = 497). The median serum vitamin B12 was 339 pg/mL (range 201-987 pg/mL) in group I and 180 pg/mL (range 50-200 pg/mL) in group II. Helicobacter pylori (n = 154 vs 325, P < 0.001), neutrophil activity (n = 176 vs 367, P < 0.001), intestinal metaplasia (n = 35 vs 14, P < 0.001) and inflammation (n = 230 vs 386, P < 0.001) were present significantly more often in group II compared with group I. A total of 785 patients were both negative for Helicobacter pylori and atrophy. Of these 785 patients, neutrophil activity (n = 56, [32.6%] vs 25, [4.4%], P < 0.001) and inflammation (n = 69, [40.1%] vs 82, [13.4%], P < 0.001) scores were present significantly more often in group II compared with group I.
Helicobacter pylori was present significantly more often in older patients whose serum vitamin B12 levels were ≤200 pg/mL, and Helicobacter pylori density was inversely correlated with serum B12 level. Upper gastrointestinal endoscopic examination should be suggested for elderly patients with serum vitamin B12 level ≤200 pg/mL. Geriatr Gerontol Int 2015; ●●: ●●-●●.
维生素B12缺乏在老年患者中很常见，主要原因是恶性贫血。然而，维生素B12缺乏也可能发生在没有萎缩性胃炎的患者中。本研究的目的是调查影响非萎缩性胃炎老年患者血清维生素B12水平的因素。
在1607例因各种原因接受上消化道内镜检查、有血清维生素B12值且被诊断为“非萎缩性胃炎”的60岁以上患者中，共1256例患者被纳入分析影响血清维生素B12水平降低的因素。
非萎缩性胃炎患者分为两组：血清维生素B12正常组（I组，n = 759）和血清维生素B12降低组（II组，n = 497）。I组血清维生素B12中位数为339 pg/mL（范围201 - 987 pg/mL），II组为180 pg/mL（范围50 - 200 pg/mL）。与I组相比，II组幽门螺杆菌（n = 154 vs 325，P < 0.001）、中性粒细胞活性（n = 176 vs 367，P < 0.001）、肠化生（n = 35 vs 14，P < 0.001）和炎症（n = 230 vs 386，P < 0.001）的发生率明显更高。共有785例患者幽门螺杆菌和萎缩均为阴性。在这785例患者中，与I组相比，II组中性粒细胞活性（n = 56，[32.6%] vs 25，[4.4%]，P < 0.001）和炎症（n = 69，[40.1%] vs 82，[13.4%]，P < 0.001）评分的发生率明显更高。
血清维生素B12水平≤200 pg/mL的老年患者中幽门螺杆菌感染明显更常见，且幽门螺杆菌密度与血清B12水平呈负相关。对于血清维生素B12水平≤200 pg/mL的老年患者，建议进行上消化道内镜检查。《老年医学与老年病学国际杂志》2015年；●●：●● - ●●。
