不同肌肉注射维生素B补充方案的比较：一项回顾性匹配队列研究。

Comparison Between Different Intramuscular Vitamin B Supplementation Regimes: a Retrospective Matched Cohort Study.

作者信息

Smelt H J M, Pouwels S, Said M, Berghuis K A, Boer A K, Smulders J F

机构信息

Department of Dietetics, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands.

Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.

出版信息

Obes Surg. 2016 Dec;26(12):2873-2879. doi: 10.1007/s11695-016-2207-z.

DOI:10.1007/s11695-016-2207-z

PMID:27146501

Abstract

BACKGROUND

The incidence of vitamin B deficiency after bariatric surgery can range from 26 to 70 %. There is no consensus on optimal vitamin B supplementation in postbariatric patients. The objective of this study was to compare three different regimes.

METHODS

In this retrospective matched cohort study, we included 63 patients with methylmalonic acid (MMA) levels ≥300 nmol/L. Group A (n = 21) received 6 intramuscular (im) vitamin B injections including a loading dose, group B (n = 21) received 3 im vitamin B injections without loading dose and group C (n = 21) received no im vitamin B injections.

RESULTS

The total post-bariatric patient population consisted of 14 males (22.2 %) and 49 women (77.8 %) with a mean current body mass index of 30.6 ± 8.0 kg/m. There was no significant difference in vitamin B and MMA levels between 3 groups at baseline. There was a significant difference in follow-up vitamin B levels of group A compared to group B (p = 0.02) and group A compared to group C (p = 0.03). In the follow-up results, there is also a significant decrease in MMA levels of group A compared to group B (p = 0.02), group A compared to group C (p < 0.001), and group B compared to group C (p < 0.01).

CONCLUSIONS

In this study, a shorter injection regime is probably not sufficient to treat a vitamin B deficiency. An injection regime with 6 injections recovered all vitamin B deficiencies biochemically. MMA levels cannot recover spontaneously over time without additional im injection regime.

摘要

背景

减肥手术后维生素B缺乏的发生率在26%至70%之间。对于减肥术后患者最佳维生素B补充方案尚无共识。本研究的目的是比较三种不同方案。

方法

在这项回顾性匹配队列研究中，我们纳入了63名甲基丙二酸（MMA）水平≥300 nmol/L的患者。A组（n = 21）接受6次肌肉注射维生素B，包括一次负荷剂量；B组（n = 21）接受3次肌肉注射维生素B，无负荷剂量；C组（n = 21）未接受肌肉注射维生素B。

结果

减肥术后患者总体包括14名男性（22.2%）和49名女性（77.8%），当前平均体重指数为30.6±8.0 kg/m²。三组在基线时维生素B和MMA水平无显著差异。A组随访时的维生素B水平与B组相比有显著差异（p = 0.02），A组与C组相比有显著差异（p = 0.03）。在随访结果中，A组的MMA水平与B组相比也有显著下降（p = 0.02），A组与C组相比（p < 0.001），B组与C组相比（p < 0.01）。