High prevalence of vitamin B-12 insufficiency in patients with Crohn's disease

• Published in: Asia Pacific Journal of Clinical Nutrition Vol. 26; no. 6; pp. 1076 - 1081
• Main Authors: Ao, Misora, Tsuji, Hidemi, Shide, Kenichiro, Kosaka, Yuki, Noda, Akari, Inagaki, Nobuya, Nakase, Hiroshi, Tanaka, Kiyoshi
• Format: Journal Article
• Language: English
• Published: Australia HEC Press 01.01.2017
• Subjects: Acids; Adult; Area Under Curve; Cardiovascular disease; Crohn Disease - blood; Crohn Disease - complications; Crohn's disease; Crohns disease; Eating; Female; Folic Acid - blood; Health risk assessment; Homocysteine; Homocysteine - blood; Humans; Hyperglycemia; Inflammatory bowel disease; Inflammatory bowel diseases; Male; Maternal & child health; Metabolism; Metabolites; Middle Aged; Prevalence; ROC Curve; Small intestine; Vitamin B; Vitamin B 12 - blood; Vitamin B 12 - metabolism; Vitamin B 12 - pharmacokinetics; Vitamin B 12 Deficiency - blood; Vitamin B 12 Deficiency - etiology; Vitamin B12 deficiency; Vitamin deficiency; homocysteine; malabsorption; vitamin B-12; Crohn’s disease; vitamin insufficiency
• DOI: 10.6133/apjcn.022017.13
• ISSN: 0964-7058

Background and Objectives: In Crohn's disease (CD), belonging to inflammatory bowel disease, the small intestine is involved in most cases. Most frequently affected is the distal ileum, where vitamin B-12 is specifically absorbed. Therefore, malabsorption of vitamin B-12 is quite likely to occur in patients with CD. In this study, we have studied the vitamin B-12 status in CD patients. Methods and Study Design: Forty eight patients with CD were evaluated for their food intake, and circulating concentrations of vitamin B-12, folic acid, and homocysteine (Hcy) as a sensitive marker for the insufficiency of these vitamins and a risk factor of atherosclerosis. Results: Plasma Hcy concentration was significantly correlated with serum vitamin B-12 concentration alone, and 60.4 % of the subjects had hyperhomocysteinemia. Receiver Operating Characteristics (ROC) analysis showed that serum concentration of vitamin B-12, but not folic acid, predicted hyperhomocysteinemia. Their intake of vitamin B-12 was much higher than the Japanese RDA, but not correlated with blood concentrations of vitamin B-12 or Hcy, probably due to malabsorption. Conclusions: Vitamin B-12 insufficiency and hyperhomocysteinemia were highly prevalent in CD patients. Recently, the significance of extra-intestinal complications of CD has been increasingly recognized, and our finding is likely to be of clinical importance.