Demirci Büşra, Konuksever Dilek, Gülsoy Gülşah Efeoğlu, Yücel Sevinç Püren
Department of Pediatrics, Ankara Bilkent City Hospital, Ankara, Turkey.
Department of Biostatistics, Cukurova University, Adana, Turkey.
J Paediatr Child Health. 2025 Jul;61(7):1030-1038. doi: 10.1111/jpc.70065. Epub 2025 Apr 22.
Vitamin B12 is a vital vitamin essential for DNA synthesis, central nervous system myelination and erythropoiesis. Its deficiency, particularly during the rapid growth phase of infancy, can lead to neurological and haematological complications. This study aimed to investigate the relationship between vitamin B12 deficiency, hemogram parameters, and thyroid hormones in children under 36 months of age.
MATERIALS & METHODS: Conducted at Bilkent Children's Hospital between 2020 and 2024, the study evaluated 10 268 children, grouped based on their B12 levels (≤ 200 pg/mL: deficient, 200-800 pg/mL: normal).
Vitamin B12 deficiency was identified in 7.8% of the participants, with the highest prevalence (12.3%) in the 0-12 months age group. In the deficiency group, WBC, NEU, NEU/LYM ratio, HGB and TSH levels were found to be lower, while PLT levels were higher. Neutropenia was found to be significantly more frequent in the low B12 group (p < 0.001). No significant difference was found in the prevalence of lymphopenia and leukopenia between the groups. Regarding thyroid hormone levels, fT4 levels were similar across groups, but TSH levels were lower in the B12-deficient group. A positive correlation was observed between TSH and HGB levels, while a negative correlation was noted with the NEU/LYM ratio.
In conclusion, B12 deficiency during infancy can cause significant changes in hemogram parameters. During this period, when physiological anaemia is common, MCV may remain normal. Neutropenia and a lower Neu/Lym ratio appear to be the most striking hemogram parameters associated with vitamin B12 deficiency in infants undergoing routine check-ups. Decreased TSH levels may be related to B12 deficiency, and the NEU/LYM ratio could serve as a predictor of thyroid dysfunction. This study stands out as a large-scale study demonstrating the effects of B12 deficiency on haematological and thyroid parameters.
维生素B12是一种对DNA合成、中枢神经系统髓鞘形成和红细胞生成至关重要的维生素。其缺乏,尤其是在婴儿快速生长阶段,可导致神经和血液学并发症。本研究旨在调查36个月以下儿童维生素B12缺乏、血常规参数和甲状腺激素之间的关系。
该研究于2020年至2024年在比尔肯特儿童医院进行,评估了10268名儿童,根据其B12水平分组(≤200 pg/mL:缺乏,200 - 800 pg/mL:正常)。
7.8%的参与者被确定为维生素B12缺乏,在0 - 12个月年龄组中患病率最高(12.3%)。在缺乏组中,白细胞(WBC)、中性粒细胞(NEU)、中性粒细胞/淋巴细胞比值(NEU/LYM ratio)、血红蛋白(HGB)和促甲状腺激素(TSH)水平较低,而血小板(PLT)水平较高。发现低B12组中性粒细胞减少症明显更常见(p < 0.001)。两组之间淋巴细胞减少症和白细胞减少症的患病率无显著差异。关于甲状腺激素水平,各组之间游离甲状腺素(fT4)水平相似,但B12缺乏组的TSH水平较低。观察到TSH与HGB水平呈正相关,而与NEU/LYM比值呈负相关。
总之,婴儿期维生素B12缺乏可导致血常规参数发生显著变化。在此期间,生理性贫血很常见,平均红细胞体积(MCV)可能保持正常。中性粒细胞减少症和较低的中性粒细胞/淋巴细胞比值似乎是常规检查中与婴儿维生素B12缺乏相关的最显著血常规参数。TSH水平降低可能与维生素B12缺乏有关,且中性粒细胞/淋巴细胞比值可作为甲状腺功能障碍的预测指标。本研究作为一项大规模研究,证明了维生素B12缺乏对血液学和甲状腺参数的影响。