Cattan D, Belaiche J, Zittoun J, Yvart J
Ann Nutr Metab. 1982;26(6):367-73. doi: 10.1159/000176587.
In three different groups of patients presenting severe folate deficiency (purely nutritional folate deficiency, chronic alcoholism or various intestinal diseases), vitamin B12 absorption has been tested by Schilling test in order to investigate the possible effect of folate deficiency on B12 absorption. Following this study, it appears that folate deficiency in itself, even severe, cannot induce vitamin B12 malabsorption, since in the first group, consisting of malnourished old people, the Schilling test was always normal even in those who presented a lowered B12 serum level; in the group of patients with intestinal disease, the Schilling test was abnormal as expected in some patients; 3 alcoholics out of 12 presented a malabsorption of B12 on the Schilling test; the follow-up of 2 of them exhibited complete correction after normal diet and alcohol suppression. Consequently, folate deficiency does not seem responsible for a secondary B12 malabsorption unless another etiological factor is present, such as alcohol or ileopathy.
在三组患有严重叶酸缺乏症的患者（单纯营养性叶酸缺乏、慢性酒精中毒或各种肠道疾病）中，通过希林试验检测了维生素B12的吸收情况，以研究叶酸缺乏对B12吸收可能产生的影响。经过这项研究发现，叶酸缺乏本身，即使是严重缺乏，也不会导致维生素B12吸收不良，因为在第一组由营养不良的老年人组成的患者中，即使那些血清B12水平降低的患者，希林试验结果也始终正常；在肠道疾病患者组中，正如预期的那样，一些患者的希林试验结果异常；12名酗酒者中有3人在希林试验中表现出B12吸收不良；对其中2人进行随访发现，在正常饮食和戒酒之后，吸收不良情况完全得到纠正。因此，除非存在其他病因，如酒精或回肠疾病，否则叶酸缺乏似乎不是继发性B12吸收不良的原因。
