Choudhury Arup, Jena Anuraag, Jearth Vaneet, Dutta Amit K, Makharia Govind, Dutta Usha, Goenka Mahesh, Kochhar Rakesh, Sharma Vishal
Department of Medicine, Nagaon Medical College and Hospital, Nagaon, Assam, India.
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Expert Rev Gastroenterol Hepatol. 2023 May;17(5):479-487. doi: 10.1080/17474124.2023.2204229. Epub 2023 Apr 19.
Proton pump inhibitors (PPI) may impact the absorption of vitamin B12. We performed a systematic review to ascertain if PPI use increases risk of vitamin B12 deficiency.
Electronic databases (PubMed, Embase, Scopus) were searched on first of September 2022. We selected studies that compared the frequency of vitamin B12 deficiency in PPI users and non-users. Pooled Odds Ratio (OR) was calculated for the occurrence of vitamin B12 deficiency in PPI users compared to non-users. The risk of bias was assessed using the Newcastle Ottawa scale.
Twenty-five studies were included. The pooled OR of vitamin B12 deficiency among PPI users (2852 participants) was higher than non-users (28070 participants) (OR 1.42, 95% CI: 1.16-1.73; I = 54%). Overall risk of PPI use among vitamin B12 deficient individuals was higher than those without deficiency (OR 1.49, 1.20-1.85; I = 68%). Most studies found no difference between serum vitamin B12 levels among PPI users compared to non-users.
Although the pooled OR of vitamin B12 deficiency was slightly increased in PPI users, but there was significant heterogeneity, and the pooled OR was too low to imply an association clearly. Better-designed prospective studies in long-term users may clarify the issue.
This study was not registered on PROSPERO.
质子泵抑制剂（PPI）可能会影响维生素B12的吸收。我们进行了一项系统评价，以确定使用PPI是否会增加维生素B12缺乏的风险。
于2022年9月1日检索电子数据库（PubMed、Embase、Scopus）。我们选择了比较PPI使用者和非使用者中维生素B12缺乏频率的研究。计算了PPI使用者与非使用者相比维生素B12缺乏发生的合并比值比（OR）。使用纽卡斯尔渥太华量表评估偏倚风险。
纳入25项研究。PPI使用者（2852名参与者）中维生素B12缺乏的合并OR高于非使用者（28070名参与者）（OR 1.42，95%CI：1.16 - 1.73；I² = 54%）。维生素B12缺乏个体中使用PPI的总体风险高于无缺乏者（OR 1.49，1.20 - 1.85；I² = 68%）。大多数研究发现，PPI使用者与非使用者的血清维生素B12水平无差异。
尽管PPI使用者中维生素B12缺乏的合并OR略有升高，但存在显著异质性，且合并OR过低，无法明确表明存在关联。针对长期使用者开展设计更优的前瞻性研究可能会阐明这一问题。
本研究未在PROSPERO上注册。
