Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Am J Med Sci. 2022 Dec;364(6):746-751. doi: 10.1016/j.amjms.2022.07.006. Epub 2022 Jul 24.
Previous studies have demonstrated an association between proton pump inhibitors (PPI) use and vitamin B12 deficiency. However, data regarding PPI use and elevated serum homocysteine level, an important marker of vitamin B12 deficiency, are scant.
Data were collected from medical records of subjects examined at a screening center in Israel. Cross sectional analysis was conducted on 25,953 subjects. Levels of vitamin B12 and homocysteine were compared between subjects who consumed PPI medications and those who did not.
The mean age of the study population was 45 years and 33% were females. Subjects who received PPI medications had a minor higher vitamin B12 levels (320 pmol/L vs 300 pmol/L, p=0.024). Levels of vitamin B12 remained higher in females receiving PPI medications after performing a stratified analysis according to subjects' gender. Homocysteine levels were higher in subjects receiving PPI medications as compared to those who did not (12.0 μmol/L vs 11.6 0 μmol/L, p<0.001). Levels remained higher in female subjects after performing a stratified analysis according to subjects' sex. There was no statistically significant difference in the prevalence of vitamin B12 deficiency (according to two cutoffs: vitamin B12≤200 or ≤140 pmol/L) as well as the prevalence of hyperhomocysteinemia (defined as homocysteine >15.0 μmol/L) between the two groups.
According to our study, no association was found between PPI medication use and vitamin B12 deficiency or hyperhomocysteinemia. Patients receiving PPI medications had slightly higher levels of vitamin B12 and homocysteine, however these differences were too small to have any clinical relevance.
先前的研究表明质子泵抑制剂（PPI）的使用与维生素 B12 缺乏之间存在关联。然而，关于 PPI 使用与升高的血清同型半胱氨酸水平（维生素 B12 缺乏的一个重要标志物）之间的关系的数据却很少。
数据来自以色列筛查中心检查的受试者的病历中收集。对 25953 名受试者进行了横断面分析。比较了服用 PPI 药物的受试者和未服用 PPI 药物的受试者的维生素 B12 和同型半胱氨酸水平。
研究人群的平均年龄为 45 岁，其中 33%为女性。服用 PPI 药物的受试者的维生素 B12 水平略高（320 pmol/L 比 300 pmol/L，p=0.024）。根据受试者的性别进行分层分析后，女性服用 PPI 药物的维生素 B12 水平仍较高。与未服用 PPI 药物的受试者相比，服用 PPI 药物的受试者的同型半胱氨酸水平更高（12.0 μmol/L 比 11.6 0 μmol/L，p<0.001）。根据受试者的性别进行分层分析后，女性受试者的水平仍较高。在两种截值（维生素 B12≤200 或≤140 pmol/L）下，维生素 B12 缺乏症（定义为维生素 B12≤200 或≤140 pmol/L）以及高同型半胱氨酸血症（定义为同型半胱氨酸>15.0 μmol/L）的患病率在两组之间无统计学显著差异。
根据我们的研究，未发现 PPI 药物使用与维生素 B12 缺乏或高同型半胱氨酸血症之间存在关联。服用 PPI 药物的患者的维生素 B12 和同型半胱氨酸水平略高，但这些差异太小，没有任何临床意义。
