Department of Pulmonary Medicine, Stavanger University Hospital, P.O. Box 8100, 4068 Stavanger, Norway.
Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway.
Nutrients. 2022 May 5;14(9):1941. doi: 10.3390/nu14091941.
People with severe substance use disorder (SUD) have a higher burden of micronutrient deficiency compared with the general population. The aim of this study was to investigate vitamin B12 status and risk factors of deficiency related to substance use, opioid agonist therapy (OAT), as well as hepatitis C infection and liver fibrosis. In this prospective cohort study, participants were recruited from outpatient OAT and SUD clinics in western Norway, and assessed annually with a clinical interview and exam, including venous blood sampling. Data were collected between March 2016 and June 2020, and a total of 2451 serum vitamin B12 measurements from 672 participants were included. The median serum vitamin B12 concentration was 396 (standard deviation 198) pmol/L at baseline, 22% of the population had suboptimal levels (<300 pmol/L) and 1.2% were deficient at baseline (<175 pmol/L). No clear associations were seen with substance use patterns, but liver disease and younger age were associated with higher vitamin B12 levels. Although the majority of participants had satisfactory vitamin B12 levels, about a fifth had suboptimal levels that might or might not be adequate for metabolic needs. Future studies could investigate potential gains in interventions among patients with suboptimal but non-deficient levels.
患有严重物质使用障碍（SUD）的人比一般人群有更高的微量营养素缺乏负担。本研究旨在调查与物质使用、阿片类激动剂治疗（OAT）以及丙型肝炎感染和肝纤维化相关的维生素 B12 状况和缺乏风险因素。在这项前瞻性队列研究中，参与者从挪威西部的门诊 OAT 和 SUD 诊所招募，并每年通过临床访谈和检查进行评估，包括静脉采血。数据收集于 2016 年 3 月至 2020 年 6 月之间，共纳入了 672 名参与者的 2451 项血清维生素 B12 测量值。基线时血清维生素 B12 浓度中位数为 396（标准差 198）pmol/L，人群中有 22%的人存在亚临床缺乏（<300 pmol/L），1.2%的人存在临床缺乏（<175 pmol/L）。未发现与物质使用模式有明显关联，但肝病和年龄较小与较高的维生素 B12 水平有关。尽管大多数参与者的维生素 B12 水平令人满意，但约五分之一的人存在亚临床缺乏，其水平可能足以满足代谢需求，也可能不足。未来的研究可以探讨在亚临床但非缺乏水平的患者中进行干预的潜在获益。
