vitamin-b-12 and Chronic-Disease

Vitamin B deficiency causes cardiac hypertrophy, reduced cardiac contractility, and arrhythmias.The purpose of this study is to perform a network meta-analysis of randomized controlled trials of vitamin B supplements in a group of 150 patients who meet the eligibility criteria.The study also aims to describe the effect of synthetic multivitamins (pyridoxine, folic acid, and cyanocobalamin) on the laboratory findings reflecting the severity of chronic heart failure (cholesterol, glucose, and fibrinogen).. The experiment involved a group of people (150 individuals) diagnosed with chronic heart failure with reduced left ventricular ejection fraction. The study compared serum levels of B vitamins measured after the therapy and at baseline. The second part of the study focused on the assessment of the laboratory findings reflecting the severity of cardiovascular pathology and indicating an increased risk of vascular catastrophes.. Clinical trials among patients diagnosed with chronic heart failure showed that the intake of synthetic forms of pyridoxine, folic acid, and cyanocobalamin slightly increases systolic, diastolic and central venous pressure while decreasing the heart rate and increasing LVEF. Thiamine acts as a vasodilator. It reduces the cardiac afterload and improves heart function.. The results obtained can be useful in terms of improving the comprehensive treatment strategy for chronic heart failure and further investigation of the effects produced by the intake of B vitamins.

Topics: Chronic Disease; Folic Acid; Heart Failure; Humans; Pyridoxine; Stroke Volume; Ventricular Function, Left; Vitamin B 12; Vitamin B Complex

Chronic migraine is a particular classification of a headache that is typically unilateral and pulsatile and lasts for at least 3 months. Owing to its high prevalence and detrimental impact on personal, social, and economic aspects of patient lives, much desire has gone into fully understanding the pathogenesis of migraine, and to search for therapeutic agents. In addition to current therapeutics such as triptans, ergotamine, and monoclonal antibodies targeting calcitonin gene-related peptide receptors, vitamin B12 has been investigated for its possible use as a prophylactic agent for migraines. Specifically, the observed effects of vitamin B12 on nitric oxide and homocysteine prompt further investigation of its underlying mechanisms in migraine pathophysiology. In this comprehensive review, we provide a brief overview of migraines and current therapies while focusing on the promising role of vitamin B12 as a possible treatment option for chronic migraine management.

Topics: Chronic Disease; Homocysteine; Humans; Migraine Disorders; Nitric Oxide; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

This review brings together human and animal studies and reviews that examine the possible role of maternal vitamin B12 (B12) on fetal growth and its programming for susceptibility to chronic disease. A selective literature review was undertaken to identify studies and reviews that investigate these issues, particularly in the context of a vegetarian diet that may be low in B12 and protein and high in carbohydrate. Evidence is accumulating that maternal B12 status influences fetal growth and development. Low maternal vitamin B12 status and protein intake are associated with increased risk of neural tube defect, low lean mass and excess adiposity, increased insulin resistance, impaired neurodevelopment and altered risk of cancer in the offspring. Vitamin B12 is a key nutrient associated with one carbon metabolic pathways related to substrate metabolism, synthesis and stability of nucleic acids and methylation of DNA which regulates gene expression. Understanding of factors regulating maternal-fetal one carbon metabolism and its role in fetal programming of non communicable diseases could help design effective interventions, starting with maternal nutrition before conception.

Topics: Animals; Biomarkers; Chronic Disease; Diet, Vegetarian; DNA Methylation; Female; Fetal Development; Humans; Insulin Resistance; Lipogenesis; Maternal Nutritional Physiological Phenomena; Metabolic Networks and Pathways; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Biomarkers; Chronic Disease; Erythropoietin; Evidence-Based Medicine; Folic Acid; Hematinics; Hemoglobins; Humans; Iron; Kidney Diseases; Recombinant Proteins; Treatment Outcome; Vitamin B 12

As for any chronic disease, adherence to osteoporosis treatment is low. Folates and vitamin B12 decrease hip fracture risk in elderly Japanese with stroke. Raloxifene (Evista) decreases the incidence of positive estrogen receptor breast cancer and could prevent cardiovascular events in patients at high risk. Strontium ranelate (Protélos) prevents hip fracture in elderly women. The action of alendronate (Fosamax) on bone mineral density and markers of bone remodelling is of higher amplitude than that of risedronate (Actonel). Once monthly ibandronate (Bonviva) increases bone mineral density in post menopausal women with osteoporosis. Excessive suppression of bone remodelling and osteonecrosis of the yaws could be related to bisphosphonate intake.

Topics: Bone Density; Bone Density Conservation Agents; Bone Resorption; Chronic Disease; Folic Acid; Fractures, Bone; Humans; Osteonecrosis; Osteoporosis; Vitamin B 12

This paper evaluates the possible reasons for consistent vitamin B12 deficiency in chronic toxigenic mold exposures and the synergistic relationships with the possible mycotoxic effects on one-carbon metabolism that lead to the manifestations of clinical neuropathological symptomology. Vitamins are first defined in general and the nutritional sources of vitamin B12 are evaluated in particular. Since patients with chronic exposures to toxigenic molds manifest vitamin B12 deficiencies, the role of mycotoxins in vitamin B12 metabolism is assessed, and since vitamin B12 plays important biochemical roles in one-carbon metabolism, the synergistic effects with mycotoxins on humans are reviewed. An outline of the proposed mechanism by which mycotoxins disrupt or interfere with the normal functions of vitamin B12 on one-carbon metabolism is proposed. The overall functions of vitamin B12 as a source of coenzymes, in intracellular recycling of methionine, in methionine synthase reaction, in the prevention of chromosome breakage, in methylation, and in maintaining a one-carbon metabolic balance are reviewed. Signs, symptoms, and clinical neurological indications of vitamin B12 deficiency are also cited. By implication and derivation, it is likely that the interruption of the structure and function of vitamin B12 would in turn interfere with the one-carbon metabolism leading to the neurological manifestations. This review is an attempt to formulate a basis for an ongoing research investigation on the subject.

Topics: Animals; Chronic Disease; Environmental Exposure; Fungi; Humans; Intracellular Space; Mycotoxins; Nervous System Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aldehyde Reductase; Chronic Disease; Diabetic Neuropathies; Diagnosis, Differential; Enzyme Inhibitors; Fludrocortisone; Humans; Hypoglycemic Agents; Mexiletine; Nerve Growth Factor; Platelet Aggregation Inhibitors; Recombinant Proteins; Severity of Illness Index; Vasodilator Agents; Vitamin B 12

Although vitamin deficiency is encountered infrequently in developed countries, inadequate intake of several vitamins is associated with chronic disease.. To review the clinically important vitamins with regard to their biological effects, food sources, deficiency syndromes, potential for toxicity, and relationship to chronic disease.. We searched MEDLINE for English-language articles about vitamins in relation to chronic diseases and their references published from 1966 through January 11, 2002.. We reviewed articles jointly for the most clinically important information, emphasizing randomized trials where available.. Our review of 9 vitamins showed that elderly people, vegans, alcohol-dependent individuals, and patients with malabsorption are at higher risk of inadequate intake or absorption of several vitamins. Excessive doses of vitamin A during early pregnancy and fat-soluble vitamins taken anytime may result in adverse outcomes. Inadequate folate status is associated with neural tube defect and some cancers. Folate and vitamins B(6) and B(12) are required for homocysteine metabolism and are associated with coronary heart disease risk. Vitamin E and lycopene may decrease the risk of prostate cancer. Vitamin D is associated with decreased occurrence of fractures when taken with calcium.. Some groups of patients are at higher risk for vitamin deficiency and suboptimal vitamin status. Many physicians may be unaware of common food sources of vitamins or unsure which vitamins they should recommend for their patients. Vitamin excess is possible with supplementation, particularly for fat-soluble vitamins. Inadequate intake of several vitamins has been linked to chronic diseases, including coronary heart disease, cancer, and osteoporosis

Topics: Ascorbic Acid; Avitaminosis; Blood Coagulation; Breast Neoplasms; Carotenoids; Chronic Disease; Colorectal Neoplasms; Coronary Disease; Dietary Supplements; Female; Folic Acid; Fractures, Bone; Humans; Lung Neoplasms; Male; Neoplasms; Neural Tube Defects; Prostatic Neoplasms; Risk Factors; Vitamin A; Vitamin B 12; Vitamin B 6; Vitamin D; Vitamin E; Vitamin K; Vitamins

A 69-year-old woman reported marked restriction of voluntary movements of the hands in the preceding 6 months. She had also experienced loss of motivation, memory and concentration. Her skin was pale yellow, and scratches on her skin indicated marked pruritus.. Neurological examination revealed decreased vibratory sense in both legs. Haemoglobin concentration was 8.3 g/dl, mean corpuscular volume 114 fl, vitamin B12 level < 100 ng/l, folic acid level normal. Antibody titre against parietal cells was increased, vitamin B12 resorption diminished. Gastroscopy revealed small raised lesions, made up of hyperplastic cells which stained with chromogranin, indicating a diagnosis of microcarcinoid of the gastric mucosa.. On administration of cobalamine (1,000 micrograms i.m. daily for 2 weeks, twice weekly for 6 weeks, then once per week for the last 7 months) the blood picture returned to normal, but the microcarcinoids, the psychological symptoms and the apraxia of the hands were unchanged.

Topics: Aged; Carcinoid Tumor; Chronic Disease; Female; Gastritis, Atrophic; Hematinics; Humans; Memory Disorders; Nervous System Diseases; Psychopathology; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Hair loss in otherwise healthy women presents several challenges for the clinician. The first is to identify the cause, which may be complicated by two or more secondary factors; the second is to find effective treatments; and the third is to establish requirements for long-term management. An optimal hair growth potential is considered to exist when specific parameters for biochemical variables are operating. These include red blood cell and serum folate concentrations within the normal range, serum vitamin B12 levels between 300 and 1000 ng/L, hemoglobin levels greater than 13.0 g/dL, and serum ferritin concentrations of 70 ng/mL or greater. The two predominant disturbances, diffuse androgen-dependent alopecia and chronic telogen effluvium, both require months of treatment before the benefits can be seen. During this time several follow-up investigations and reassuring consultations must occur. Current systemic antiandrogen regimens are highly effective, but the prospect of long-term therapy, possibly for life, is daunting. For some patients there is no systemic choice and topical treatment is the only option. Minoxidil is the only topical preparation currently licensed, but with no quantitative long-term data available, assessing its value in the long-term treatment of androgen-dependent alopecia is difficult.

Topics: Administration, Cutaneous; Alopecia; Androgen Antagonists; Androgens; Chronic Disease; Female; Ferritins; Humans; Iron; Iron Deficiencies; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Anemia, Hemolytic, Congenital; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Megaloblastic; Anemia, Sideroblastic; Chronic Disease; Diagnosis, Differential; Humans; Malabsorption Syndromes; Thalassemia; Vitamin B 12

Topics: Animals; Calcium; Chronic Disease; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Pancreatectomy; Pancreatic Diseases; Pancreatic Juice; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adrenal Cortex Hormones; Anabolic Agents; Chronic Disease; Diagnosis, Differential; Diet Therapy; Dietary Fats; Dietary Proteins; Diuretics; Hepatitis; Humans; Immunosuppressive Agents; Lactulose; Liver Cirrhosis; Liver Diseases; Long-Term Care; Penicillamine; Rest; Vitamin B 12

This contribution deals with the occurrence of cyanide and its biological pathways in the body. Especially possibilities of detoxification are pointed out. Intoxications are caused by acute and chronical cyanide uptake. Tobacco amblyopia, retrobulbar neuritis in pernicious anaemia, Leber's optic atrophy, Nigerian nutritional neuropathy, and sterility in female heavy smokers are attributed to cyanide intoxication. Various methods for treating acute and chronic cyanide intoxication are discussed.

Topics: Acute Disease; Amblyopia; Anemia, Pernicious; Animals; Antidotes; Chronic Disease; Cyanides; Female; Humans; Inactivation, Metabolic; Infertility, Female; Manihot; Nigeria; Optic Atrophy; Optic Neuritis; Plants, Edible; Scotoma; Smoking; Syndrome; Thiocyanates; Thiosulfate Sulfurtransferase; Vitamin B 12

Topics: Animals; Chronic Disease; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Intestinal Secretions; Intestine, Small; Intrinsic Factor; Pancreas; Pancreatic Diseases; Pancreatic Juice; Rats; Vitamin B 12

Topics: Achlorhydria; Alcoholism; Avitaminosis; Bone Marrow; Bone Marrow Cells; Carbohydrate Metabolism; Chronic Disease; Ethanol; Humans; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Iron; Vitamin B 12

Topics: Adrenal Cortex Hormones; Anemia, Pernicious; Animals; Antibodies; Autoantibodies; Biopsy; Chronic Disease; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intrinsic Factor; Schilling Test; Stomach; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Antigens, Bacterial; Antilymphocyte Serum; Bile Acids and Salts; Celiac Disease; Chronic Disease; Colectomy; Colitis, Ulcerative; Crohn Disease; Cytotoxicity Tests, Immunologic; Diarrhea; Digestive System; Escherichia coli; Gastrointestinal Hemorrhage; Glutens; Humans; Ileostomy; Immune Sera; Lymphocytes; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: ABO Blood-Group System; Celiac Disease; Chronic Disease; Colitis, Ulcerative; Crohn Disease; Drainage; Esophageal Diseases; Female; Folic Acid; Gastrectomy; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Heavy Chain Disease; Hepatitis, Viral, Human; Humans; Hypersplenism; Intestinal Diseases; Iron; Liver Diseases; Middle Aged; Pancreatic Diseases; Vagotomy; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Pernicious; Antigens; Autoantibodies; Biopsy; Chronic Disease; Cytoplasm; Digestive System; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immunologic Deficiency Syndromes; Intrinsic Factor; Lipoproteins; Microsomes; Schilling Test; Stomach; Vitamin B 12

Topics: Antibodies; Autoradiography; Chronic Disease; Depression, Chemical; Duodenal Ulcer; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methods; Protein Binding; Radioisotopes; Stimulation, Chemical; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Hemoglobinometry; Hemolysis; Humans; Liver; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Adolescent; Adult; Allografts; Chronic Disease; Disease-Free Survival; Female; Graft vs Host Disease; Guillain-Barre Syndrome; Hematopoietic Stem Cell Transplantation; Humans; Immunologic Factors; Incidence; Male; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating; Risk Factors; Survival Rate; Thiamine; Vitamin B 12

Chronic, nonspecific low back pain is a difficult ailment to treat and poses an economic burden in terms of medical expenses and productivity loss. The aim of this study was to determine the efficacy and safety of intramuscular metylcobalamin in the treatment of chronic nonspecific low back pain.. This was a double-blinded, randomised, controlled experimental study. 60 patients were assigned to either the methylcobalamin group or the placebo group. The former received intramuscular injections of 500 mcg parenteral methylcobalamin in 1 ml solution three times a week for two weeks, and the placebo group received 1 ml normal saline. Patients were assessed with Oswestry Disability Index questionnaire Version 2.0 and Visual Analogue Scale pain score. They were scored before commencement of the injections and at two months interval.. Of the 60 patients, 27 received the placebo injections and 33 were given methylcobalamin injections. A total of 58 patients were available for review at two months (placebo: n is 26; methylcobalamin: n is 32). There was a significant improvement in the Oswestry Disability Index and Visual Analogue Scale pain scores in the methylcobalamin group as compared with the placebo group (p-value less than 0.05). Only minor adverse reactions such as pain and haematoma at the injection sites were reported by some patients.. Intramuscular methylcobalamin is both an effective and safe method of treatment for patients with nonspecific low back pain, both singly or in combination with other forms of treatment.

Topics: Adult; Aged; Chronic Disease; Disability Evaluation; Double-Blind Method; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Low Back Pain; Male; Middle Aged; Pain Measurement; Placebos; Software; Surveys and Questionnaires; Vitamin B 12

Chronic kidney disease (CKD) is associated with an increased incidence of cardiovascular disease (CVD). The Anti-oxidant Therapy In Chronic Renal Insufficiency (ATIC) Study showed that a multistep treatment strategy improved carotid intima-media thickness, endothelial function, and microalbuminuria in patients with stages 2 to 4 CKD. Increased plasma concentrations of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, have been linked to greater CVD risk in patients with CKD. The aim of this study is to assess effects of the multistep intervention on plasma ADMA concentrations in the ATIC Study.. Secondary analysis of a randomized double-blind placebo-controlled trial.. 93 patients with creatinine clearance of 15 to 70 mL/min/1.73 m(2) (according to the Cockcroft-Gault equation) from 7 outpatient clinics in Amsterdam, The Netherlands.. The treatment group received sequential treatment consisting of pravastatin, 40 mg/d. After 6 months, vitamin E, 300 mg/d, was added, and after another 6 months, homocysteine-lowering therapy (folic acid, 5 mg/d; pyridoxine, 100 mg/d; and vitamin B(12), 1 mg/d, all in 1 tablet) were added and continued for another year. The control group received matching placebos.. Plasma ADMA levels.. 36 participants (77%) in the treatment group and 38 (83%) in the placebo group completed the study. Mean ADMA and symmetric dimethylarginine concentrations in the total study population were 0.53 +/- 0.07 (SD) and 1.14 +/- 0.46 mumol/L, respectively. After 24 months, there was no overall effect of the treatment strategy on ADMA concentrations (beta = -0.006; P = 0.27). Analysis of separate treatment effects suggested that vitamin E significantly decreased ADMA levels by 4% in the treatment group compared with the placebo group (multiple adjusted P = 0.02).. The study was a secondary analysis, power calculation was based on the primary end point of carotid intima-media thickness, mean plasma ADMA levels were relatively low.. Overall, a multistep treatment strategy consisting of pravastatin, vitamin E, and B vitamins had no effect on plasma ADMA levels in a stage 2 to 4 CKD population. This suggests that the beneficial effects of the intervention were not mediated by changes in ADMA levels. Possible ADMA-lowering effects of vitamin E deserve further attention.

Topics: Adult; Aged; Anticholesteremic Agents; Arginine; Carotid Arteries; Chronic Disease; Creatinine; Double-Blind Method; Female; Folic Acid; Homocysteine; Humans; Kidney Diseases; Lipoproteins, LDL; Male; Middle Aged; Pravastatin; Vitamin B 12; Vitamin B 6; Vitamin E

An elevated homocysteine level is reported to be a risk factor for several diseases, including Alzheimer's and cerebrovascular disease. Recently, several studies have reported that homocysteine levels are elevated in many schizophrenic patients. Homocysteine levels can be lowered by oral folic acid, B-12, and pyridoxine.. Forty-two schizophrenic patients with plasma homocysteine levels >15 micromol/L were treated with these vitamins for 3 months and placebo for 3 months in a study with a randomized, double-blind, placebo-controlled, crossover design.. Homocysteine levels declined with vitamin therapy compared with placebo in all patients except for one noncompliant subject. Clinical symptoms of schizophrenia as measured by the Positive and Negative Syndrome Scale declined significantly with active treatment compared with placebo. Neuropsychological test results overall, and Wisconsin Card Sort (Categories Completed) test results in particular, were significantly better after vitamin treatment than after placebo.. A subgroup of schizophrenic patients with hyperhomocysteinemia might benefit from the simple addition of B vitamins.

Topics: Adult; Chronic Disease; Cross-Over Studies; Double-Blind Method; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Neuropsychological Tests; Psychiatric Status Rating Scales; Pyridoxine; Schizophrenia; Schizophrenic Psychology; Time Factors; Vitamin B 12; Vitamin B Complex

Hyperhomocysteinemia is considered to be a risk factor for vascular diseases including ischemic stroke. It has been shown that plasma homocysteine level can be lowered by folic acid supplementation. Vitamin B(12) may be also beneficial when included in the supplement regimen with folic acid. We have examined in Japanese patients with ischemic stroke the homocysteine-lowering potential of a combination therapy with folic acid and vitamin B(12). Patients with ischemic stroke were randomized into three groups and each group received vitamin B(12) (1500 microg/day, n = 63), folic acid (5 mg/day, n = 64), or both vitamin B(12) and folic acid (n = 64) for 8 weeks. Plasma levels of homocysteine and these vitamins were followed. Significant reduction in plasma homocysteine was observed in all three groups, and the combination therapy yielded the most remarkable result, i.e., plasma total homocysteine was reduced by 38.5% and this was significantly larger than the reduction in other two groups (22.4% and 10.9% in the groups received folic acid and vitamin B(12), respectively). Vitamin B(12) synergizes with folic acid in reducing plasma homocysteine in Japanese patients with ischemic stroke and the combined therapy may be particularly effective in the secondary prevention.

Topics: Aged; Chronic Disease; Drug Synergism; Drug Therapy, Combination; Female; Folic Acid; Hematinics; Homocystine; Humans; Hyperhomocysteinemia; Japan; Male; Middle Aged; Stroke; Treatment Outcome; Vitamin B 12

In a randomized, placebo-controlled double-blind trial a combination of lofepramine, phenylalanine and vitamin B(12) was found to be effective in relieving the symptoms of multiple sclerosis (MS). The effect occurred within 2-4 weeks, and improved all types of symptoms in all types of MS. The combination was also effective in relieving symptoms in patients with chronic pain and chronic fatigue. We hypothesize that the action of this combined therapy may relate to activation of the noradrenergic locus coeruleus/lateral tegmentum (LC/LT) system which has the potential to influence the functioning of large areas of the brain and spinal cord.

Topics: Adrenergic Fibers; Adrenergic Uptake Inhibitors; Antidepressive Agents; Chronic Disease; Double-Blind Method; Drug Therapy, Combination; Fatigue Syndrome, Chronic; Humans; Locus Coeruleus; Lofepramine; Methylation; Multiple Sclerosis; Norepinephrine; Pain; Phenylalanine; Severity of Illness Index; Stroke; Stroke Rehabilitation; Tegmentum Mesencephali; Treatment Outcome; Vitamin B 12

High-flux haemodialysis (HD) has recently been vigorously promoted as a novel standard, and it can indeed efficiently reduce the occurrence of most uraemic symptoms due to middle molecular toxins and/or underdialysis. However, some symptoms remain problematical, particularly peripheral polyneuropathy (PPN). One of the possible reasons for this is that the patients may have low concentrations of some nutrients, e.g. vitamin B(6), necessary for normal peripheral neuron function.. Predialysis serum pyridoxal-5'-phosphate (P5P) level was determined in 36 chronic HD patients who were undergoing high-flux HD and receiving human recombinant erythropoietin. Among them, 26 patients suffered from PPN. Prior to supplementation, these 26 patients were examined and their neurological symptoms were ranked according to our PPN symptom score. Vitamin B(6) (60 mg/day) was randomly prescribed to 14 of them, and vitamin B(12) (500 microg/day) was prescribed to the others. After 4 weeks, all the patients were re-examined.. We found that predialysis serum P5P levels of HD patients with PPN were not significantly lower than those of matched HD patients without PPN. Nonetheless, it was demonstrated that supplementation with vitamin B(6) for 4 weeks significantly increased the predialysis level of P5P and dramatically attenuated PPN symptoms compared with initial symptoms. No improvement was observed in response to vitamin B(12) supplementation.. This result suggests that although vitamin B(6) deficiency could not be demonstrated in patients with chronic renal failure on high-flux HD, vitamin B(6) supplementation was effective in improving PPN symptoms of various aetiologies, possibly because of vitamin B(6) resistance to PPN in these patients.

Topics: Chronic Disease; Diabetic Neuropathies; Erythropoietin; Female; Glomerulonephritis; Humans; Kidney Failure, Chronic; Male; Middle Aged; Polyneuropathies; Pyridoxal Phosphate; Pyridoxine; Recombinant Proteins; Renal Dialysis; Vitamin B 12

We tested the effects of an uncooked vegan diet, rich in lactobacilli, in rheumatoid patients randomized into diet and control groups. The intervention group experienced subjective relief of rheumatic symptoms during intervention. A return to an omnivorous diet aggravated symptoms. Half of the patients experienced adverse effects (nausea, diarrhoea) during the diet and stopped the experiment prematurely. Indicators of rheumatic disease activity did not differ statistically between groups. The positive subjective effect experienced by the patients was not discernible in the more objective measures of disease activity (Health Assessment Questionnaire, duration of morning stiffness, pain at rest and pain on movement). However, a composite index showed a higher number of patients with 3-5 improved disease activity measures in the intervention group. Stepwise regression analysis associated a decrease in the disease activity (measured as change in the Disease Activity Score, DAS) with lactobacilli-rich and chlorophyll-rich drinks, increase in fibre intake, and no need for gold, methotrexate or steroid medication (R2=0.48, P=0.02). The results showed that an uncooked vegan diet, rich in lactobacilli, decreased subjective symptoms of rheumatoid arthritis. Large amounts of living lactobacilli consumed daily may also have positive effects on objective measures of rheumatoid arthritis.

Topics: Adult; Alanine Transaminase; Alkaline Phosphatase; Arthritis, Rheumatoid; Blood Sedimentation; C-Reactive Protein; Chronic Disease; Cooking; Diet, Vegetarian; Female; Health Status Indicators; Hemoglobins; Humans; Lactobacillus; Male; Middle Aged; Patient Satisfaction; Platelet Count; Sodium; Vitamin B 12

A controlled clinical trial comparing 2-Mercapto-Priopionyl-Glycine (2-MPG) plus B12 vitamin with B12 vitamin alone in chronic liver disease has been conducted in seven hospitals in Italy. Patients were divided into two groups on the basis of liver histology; group I included 26 patients showing histological evidence for chronic persistent hepatitis (C.P.H.) (according to De Groote et al.) whereas group II consisted of 54 patients with chronic aggressive hepatitis (C.A.H.) or compensated liver cirrhosis. Patients of each group were randomly allocated to 2-MPG plus B12 vitamin, or to placebo plus B12 vitamin, in a double-blind way. The drug (or placebo) was diluted in 500 ml of 10% Levulose, and administered intravenously; 1000 gamma of B12 vitamin were added to each bottle. Patients in the 2-MPG group received 2.5 gms of the drug daily; the treatment lasted for 30 days. The following parameters were checked in all patients on admission, and repeated at the end of treatment: Serum bilirubin, serum Cholesterol, A.P., BSP retention, Prothrombin time, S-GOT, S-GPT, Gamma-GT, Total serum Protein, serum electrophoresis, Immunoglobulins. Patients given 2-MPG showed significant decreases of serum transaminases, and improvement of BSP retention.

Topics: Amino Acids, Sulfur; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Tiopronin; Vitamin B 12

Six oral administrations per day of 30 mg S-adenosylmethionine (SAMe) for 30 days, in addition to 6000 gamma/day of Vitamine B12 induced marked improvements of biochemical parameters in 20 patients with hepatic cirrhosis or various chronic hepatites. Particularly, the protidemia, bilirubinemia and radial immunodiffusion have shown the highest favorable drug responses. These improvements were still lasting and even further increasing 30 days after the end of therapy. In another group of patients with similar diagnosis and under clinical conditions comparable to the previous group of twenty, the administration of Vitamine B12 alone, in the same doses as above, has not induced any alteration in the biochemical parameters.

Topics: Chronic Disease; Clinical Trials as Topic; Hepatitis; Humans; Liver Cirrhosis; Liver Function Tests; S-Adenosylmethionine; Vitamin B 12

Topics: Chronic Disease; Drug Combinations; Drug Compounding; Humans; Joint Diseases; Phenylbutazone; Spinal Diseases; Vitamin B 12; Vitamin B Complex

Topics: Bilirubin; Choline; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Female; Homocysteine; Humans; Lactones; Liver; Liver Diseases; Liver Function Tests; Lung Diseases; Male; Peritonitis; Pleurisy; Silicotuberculosis; Transaminases; Tuberculosis, Pulmonary; Vitamin B 12

Topics: Adult; Aged; Choline; Chronic Disease; Drug Combinations; Evaluation Studies as Topic; Female; Homocysteine; Humans; Lactones; Liver Diseases; Liver Function Tests; Male; Middle Aged; Phosphoric Acids; Vitamin B 12

Topics: Acute Disease; Adrenocorticotropic Hormone; Adult; Chronic Disease; Evoked Potentials; Extremities; Female; Folic Acid; Humans; Male; Methods; Motor Activity; Multiple Sclerosis; Neural Conduction; Peripheral Nerves; Vitamin B 12

Topics: Chronic Disease; Humans; Liver Diseases; Liver Extracts; Placebos; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Chronic Disease; Humans; Liver Diseases; Liver Extracts; Placebos; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Aldosterone; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Nandrolone; Prednisone; Pyridoxine; Tolbutamide; Vitamin B 12

Irradiation of food at 50-55 kGy results in a profound, chronic demyelinating-remyelinating disease of the entire central nervous system (CNS) in cats, named Feline Irradiated Diet-Induced Demyelination (FIDID). This study examines the early stages of demyelination and long-term consequences of demyelination and remyelination on axon survival or loss. Myelin vacuolation is the primary defect leading to myelin breakdown, demyelination then prompt remyelination in the spinal cord and brain. There is no evidence of oligodendrocyte death. The spinal cord dorsal column is initially spared yet eventually becomes severely demyelinated with subsequent loss of axons in the core and then surface of the fasciculus gracilis. However remyelination of the sub-pial axons in the dorsal column results in their protection. While there was a lack of biochemical evidence of Vitamin B12 deficiency, the pathological similarities of FIDID with sub-acute combined degeneration (SCD) led us to explore treatment with Vitamin B12. Treatment led to recovery or improvement in some cats and neurologic relapse on cessation of B12 therapy. While the reason that irradiated food is myelinotoxic in the cat remains unresolved, nonetheless the neuropathological changes match exactly what is seen in SCD and its models and provide an ideal model to study the cellular and molecular basis of remyelination.

Topics: Acute Disease; Animals; Axons; Cats; Chronic Disease; Demyelinating Diseases; Diet; Disease Models, Animal; Female; Macrophages; Male; Metabolome; Microglia; Myelin Sheath; Nerve Degeneration; Neuropathology; Radiation; Remyelination; Spinal Cord; Time Factors; Vitamin B 12

Anemia of chronic diseases is a condition that accompanies a specific underlying disease, in which there is a decrease in hemoglobin, hematocrit and erythrocyte counts due to a complex process, usually initiated by cellular immunity mechanisms and pro-inflammatory cytokines and hepcidin. This is the second most common type of anemia after iron deficiency anemia in the world. Its severity generally correlates with the severity of the underlying disease. This disease most often coexists with chronic inflammation, autoimmune diseases, cancer, and kidney failure. Before starting treatment, one should undertake in-depth diagnostics, which includes not only assessment of complete blood count and biochemical parameters, but also severity of the underlying disease. The differential diagnosis of anemia of chronic diseases is primarily based on the exclusion of other types of anemia, in particular iron deficiency. The main features of anemia of chronic diseases include mild to moderate lowering of hemoglobin level, decreased percentage of reticulocyte count, low iron and transferrin concentration, but increased ferritin. Due to the increasingly better knowledge of the pathomechanism of chronic diseases and cancer biology, the diagnosis of this anemia is constantly expanding with new biochemical indicators. These include: the concentration of other hematopoietic factors (folic acid, vitamin B

Topics: Anemia; Anemia, Iron-Deficiency; Chronic Disease; Diagnosis, Differential; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Reticulocyte Count; Transferrin; Vitamin B 12

Deficits of vitamin resources constitute a significant public health problem, especially among the elderly population. The aim of the research was to determine the level of vitamin 25 (OH) D and vitamins from group B in the chronically ill elderly in domiciliary care, depending on functional capacity and coexisting diseases.. The pilot study included 137 patients staying in long-term domiciliary care. Samples of the participants' venous blood was obtained for laboratory tests. Centrifuged serum was used to determine the level of the following biochemical parameters: vitamin 25 (OH)D, B12, folic acid and total protein, albumin, triglycerides, total cholesterol and HDL cholesterol. Assessment of the functional status of patients was made by using the Barthel scale.. More than ¾ of the patients with functional deficit (according to Barthel's score 0-85 points) were deficient in vitamin 25 (OH)D, while folic acid values were below the reference values in more than half of the patients. Respondents with lower functional efficiency were characterised by a reduced average value of vitamin 25 (OH)D and folic acid.. The studied group of the chronically ill elderly was characterised by a deficiency of vitamin D3 and folic acid. Subjects with a functional impairment deficit show a reduced mean value of vitamin 25 (OH)D and folic acid in the blood serum, compared to the group of patients with higher mobility.

Topics: Aged; Aged, 80 and over; Aging; Chronic Disease; Female; Folic Acid; Home Care Services; Humans; Locomotion; Male; Motor Activity; Pilot Projects; Triglycerides; Vitamin B 12; Vitamin D

Topics: Chronic Disease; Folic Acid; Homocysteine; Humans; Psoriasis; Vitamin B 12

Helicobacter pylori (H. pylori) is closely associated with pre-neoplastic lesions such as atrophic gastritis (AG) and gastric intestinal metaplasia (GIM). The relationshionship between inflammation, hyperhomocysteinemia and arterial stiffness is of pathophysiological relevance for the development of cardiovascular disease. This study aimed to investigate the relationship between vitamin B12, folic acid, homocysteine (Hcy) and pulse wave velocity (PWV) levels in patients with GIM, AG and non-atrophic non-metaplastic chronic gastritis.. ninety-seven patients with GIM, 67 patients with AG and 69 patients with chronic gastritis were included in the study. Glucose, creatinine, total cholesterol, triglyceride, low-density lipoprotein, cholesterol, high-density lipoprotein cholesterol, vitamin B12, folic acid and Hcy levels were measured by biochemical methods. PWV and other vascular parameters were measured using the Phsyio-port AS device.. PWV was higher in patients with GIM and AG than in controls (p < 0.05 and p < 0.05, respectively). Vitamin B12 levels were significantly lower in patients with GIM and AG than in controls (p < 0.01 and p < 0.01, respectively). Folic acid levels were significantly lower in patients with GIM than in controls (p < 0.05). Hcy levels were significantly higher in patients with GIM and AG than in controls (p < 0.001 and p < 0.05, respectively). A logistic regression analysis showed that GIM, AG and vitamin B12 deficiency were predictors for arterial stiffness.. PWV values increased in patients with GIM and AG compared to non-atrophic non-metaplastic chronic gastritis, without different conventional cardiovascular risk factors.

Topics: Adult; Aged; Chronic Disease; Female; Folic Acid; Gastritis; Gastritis, Atrophic; Homocysteine; Humans; Intestines; Male; Metaplasia; Middle Aged; Pulse Wave Analysis; Stomach; Vascular Stiffness; Vitamin B 12

The aim of this study was to evaluate the prevalence of anemia and other vitamin deficiencies among elderly home care patients and to evaluate the causes of anemia and effect of malnutrition as a contributing factor.. Anemia was defined according to the World Health Organization. Hemogram, serum iron, iron binding capacity, ferritin and transferrin saturation values, serum vitamin B12, folic acid and vitamin D levels were evaluated. It was tried to differentiate as absolute iron deficiency anemia, anemia of chronic disease, anemia of unknown cause and vitamin B12 deficiency anemia. Malnutrition was evaluated by Mini Nutritional Assessment test.. Total of 472 patients (mean age 81,4±7,4 years) were included in the study. Anemia was detected in 179 (%37,9) patients, 22,7% of males and 45,5 % of female. Prevalence of iron deficiency anemia, vitamin B12, folic acid and vitamin D deficiencies were found 43%, 46%, 19% and 91% respectively. 22,8% of all patients were malnourished, 17,5% were under malnutrition risk. In patients with anemia 16,2% chronic disease anemia and 37,4% unknown anemia were detected.. With or without malnutrition, iron deficiency anemia, vitamin B12 deficiency and vitamin D deficiency were common in the home care elderly patients.

Topics: Aged; Anemia; Anemia, Iron-Deficiency; Chronic Disease; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Home Care Services; Homes for the Aged; Humans; Male; Malnutrition; Nutrition Assessment; Nutritional Status; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

Topics: Antacids; Biological Availability; Chronic Disease; Dietary Supplements; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypoglycemic Agents; Micronutrients; Middle Aged; Nutritional Requirements; Nutritional Status; Vitamin B 12

Chronic autoimmune atrophic gastritis (CAAG) is an autoimmune disease characterized by hypo/achlorhydria. A role of CAAG in the pathogenesis of nutritional deficiencies has been reported, therefore we hypothesized a possible association between CAAG and 25-OH-Vitamin D [25(OH)D] deficiency. Aim of the present study is to evaluate the prevalence of 25(OH)D deficiency in CAAG patients.. 87 CAAG patients (71 females; mean age 63.5 ± 12.8 years) followed at our Centre from January 2012 to July 2015 were consecutively evaluated. 25(OH)D, vitamin B. Data from the present study showed a significant reduction of 25(OH)D levels in CAAG patients and a possible impairment of vitamin D absorption in CAAG may be postulated. Any implication to the genesis of gastric carcinoids remains to be elucidated.

Topics: 25-Hydroxyvitamin D 2; Aged; Autoimmune Diseases; Calcium; Chronic Disease; Female; Gastritis, Atrophic; Humans; Intestinal Absorption; Male; Middle Aged; Parathyroid Hormone; Prospective Studies; Vitamin B 12; Vitamin D Deficiency

Lymphocytic gastritis is an idiopathic disease, characterized by intraepithelial infiltration of large numbers of T lymphocytes and often described in association with coeliac disease and Helicobacter pylori infection. Although usually associated with iron deficiency anaemia, there is no description on the association between lymphocytic gastritis and secondary vitamin B

Topics: Aged; Anemia; Chronic Disease; Ferrous Compounds; Gastritis; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Male; Recurrence; T-Lymphocytes; Vitamin B 12; Vitamin B 12 Deficiency

Lower serum vitamin B12 concentrations have been observed in patients with chronic spontaneous urticaria (CSU). It is known that vitamin B12 deficiency is closely related to hyperhomocysteinaemia, which is associated with a proinflammatory state.. To assess the relationship between vitamin B12 status and concentrations of homocysteine (Hcy) with acute phase response in patients with CSU.. Circulating concentrations of vitamin B12, Hcy and C-reactive protein (CRP) were measured in 42 patients with CSU of varying severity, and compared with 19 healthy controls (HCs).. Significantly lower concentrations of vitamin B12 and higher concentrations of CRP were observed in the serum of the patients with CSU compared with HCs (P < 0.01 and P < 0.001, respectively). However, there were no significant differences in plasma Hcy concentrations between the investigated groups. In addition, no correlations were found between the concentrations of vitamin B12, Hcy and CRP.. Lower values of vitamin B12 concentration in patients with CSU were not associated with higher Hcy concentrations, suggesting that such patients do not have functional vitamin B12 deficiency.

Topics: Adult; Atherosclerosis; Biomarkers; C-Reactive Protein; Chronic Disease; Female; Follow-Up Studies; Homocysteine; Humans; Hyperhomocysteinemia; Immunoturbidimetry; Luminescent Measurements; Male; Severity of Illness Index; Time Factors; Urticaria; Vitamin B 12

Chronic diarrhea poses a significant threat to the health of NHP research colonies, and its primary etiology remains unclear. In macaques, the clinical presentation of intractable diarrhea and weight loss that are accompanied by inflammatory infiltrates within the gastrointestinal tract closely resembles inflammatory bowel disease of humans, dogs, and cats, in which low serum and tissue cobalamin (vitamin B12) levels are due to intestinal malabsorption. We therefore hypothesized that macaques with chronic idiopathic diarrhea (CID) have lower serum cobalamin concentrations than do healthy macaques. Here we measured serum cobalamin concentrations in both rhesus and pigtailed macaques with CID and compared them with those of healthy controls. Serum cobalamin levels were 2.5-fold lower in pigtailed macaques with CID than control animals but did not differ between rhesus macaques with CID and their controls. This finding supports the use of serum cobalamin concentration as an adjunct diagnostic tool in pigtailed macaques that present with clinical symptoms of chronic gastrointestinal disease. This use of serum vitamin B12 levels has implications for the future use of parenteral cobalamin supplementation to improve clinical outcomes in this species.

Topics: Animals; Case-Control Studies; Chronic Disease; Diarrhea; Female; Humans; Inflammatory Bowel Diseases; Macaca mulatta; Macaca nemestrina; Male; Monkey Diseases; Reference Values; Species Specificity; Vitamin B 12

To determine the prevalence, clinical correlates and the effects on outcome of vitamin B12 and folic acid levels in patients with chronic heart failure (HF).. We studied an international pooled cohort comprising 610 patients with chronic HF. The main outcome measure was all-cause mortality.. Mean age of the patients was 68±12 years and median serum N-terminal prohormone brain natriuretic peptide level was 1801 pg/mL (IQR 705-4335). Thirteen per cent of the patients had an LVEF >45%. Vitamin B12 deficiency (serum level <200 pg/mL), folate deficiency (serum level <4.0 ng/mL) and iron deficiency (serum ferritin level <100 µg/L, or 100-299 µg/L with a transferrin saturation <20%) were present in 5%, 4% and 58% of the patients, respectively. No significant correlation between mean corpuscular volume and vitamin B12, folic acid or ferritin levels was observed. Lower folate levels were associated with an impaired health-related quality of life (p=0.029). During a median follow-up of 2.10 years (1.31-3.60 years), 254 subjects died. In multivariable proportional hazard models, vitamin B12 and folic acid levels were not associated with prognosis.. Vitamin B12 and folate deficiency are relatively rare in patients with chronic HF. Since no significant association was observed between mean corpuscular volume and neither vitamin B12 nor folic acid levels, this cellular index should be used with caution in the differential diagnosis of anaemia in patients with chronic HF. In contrast to iron deficiency, vitamin B12 and folic acid levels were not related to prognosis.

Topics: Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Biomarkers; Chronic Disease; Erythrocyte Indices; Europe; Female; Ferritins; Folic Acid Deficiency; Heart Failure; Humans; Iron; Kaplan-Meier Estimate; Linear Models; Male; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Prevalence; Proportional Hazards Models; Quality of Life; Risk Factors; Stroke Volume; Time Factors; Transferrin; Treatment Outcome; Ventricular Function, Left; Vitamin B 12; Vitamin B 12 Deficiency

Patient Blood Management (PBM) is the design of a personalized, multimodal multidisciplinary plan for minimizing transfusion and simultaneously achieving a positive impact on patient outcomes. The first pillar of PBM consists of optimizing the erythrocyte mass. The best chance for this step is offered by preoperative preparation. In most cases, a detailed medical history, physical examination and laboratory tests will identify the cause of anemia. A correct evaluation of parameters that assess the state and function of iron, such as ferritin levels, and the parameters that measure functional iron, such as transferrin saturation and soluble transferrin receptor levels, provide us with essential information for guiding the treatment with iron. The new blood count analyzers that measure hypochromia (% of hypochromic red blood cells and reticulocyte hemoglobin concentrations) provide us useful information for the diagnosis and follow-up of the response to iron treatment. Measuring serum folic acid and vitamin B12 levels is essential for treating deficiencies and thereby achieving better hemoglobin optimization.

Topics: Anemia; Avitaminosis; Biomarkers; Blood Banks; Blood Transfusion; Chronic Disease; Contraindications; Elective Surgical Procedures; Erythrocyte Indices; Ferritins; Folic Acid; Hematinics; Hemoglobinometry; Hemoglobins; Humans; Iron; Perioperative Care; Receptors, Transferrin; Transferrin; Vitamin B 12

Folate-mediated one-carbon metabolism is essential for DNA synthesis, repair, and methylation. Perturbations in one-carbon metabolism have been implicated in increased risk of some cancers and may also affect inflammatory processes. We investigated these interrelated pathways to understand their relation. The objective was to explore associations between inflammation and biomarkers of nutritional status and one-carbon metabolism. In a cross-sectional study in 1976 women selected from the Women's Health Initiative Observational Study, plasma vitamin B-6 [pyridoxal-5'-phosphate (PLP)], plasma vitamin B-12, plasma folate, and RBC folate were measured as nutritional biomarkers; serum C-reactive protein (CRP) and serum amyloid A (SAA) were measured as biomarkers of inflammation; and homocysteine and cysteine were measured as integrated biomarkers of one-carbon metabolism. Student's t, chi-square, and Spearman rank correlations, along with multiple linear regressions, were used to explore relations between biomarkers; additionally, we tested stratification by folic acid fortification period and multivitamin use. With the use of univariate analysis, plasma PLP was the only nutritional biomarker that was modestly significantly correlated with serum CRP and SAA (ρ = -0.22 and -0.12, respectively; P < 0.0001). Homocysteine (μmol/L) showed significant inverse correlations with all nutritional biomarkers (ranging from ρ = -0.30 to ρ = -0.46; all P < 0.0001). With the use of multiple linear regression, plasma PLP, RBC folate, homocysteine, and cysteine were identified as independent predictors of CRP; and PLP, vitamin B-12, RBC folate, and homocysteine were identified as predictors of SAA. When stratified by folic acid fortification period, nutrition-homocysteine correlations were generally weaker in the postfortification period, whereas associations between plasma PLP and serum CRP increased. Biomarkers of inflammation are associated with PLP, RBC folate, and homocysteine in women. The connection between the pathways needs to be further investigated and causality established. The trial is registered at clinicaltrials.gov as NCT00000611.

Topics: Aged; Biomarkers; C-Reactive Protein; Carbon; Chronic Disease; Cross-Sectional Studies; Cysteine; Erythrocytes; Female; Folic Acid; Homocysteine; Humans; Inflammation; Linear Models; Middle Aged; Nutritional Status; Risk Factors; Serum Amyloid A Protein; Vitamin B 12; Vitamin B 6

The vitamin B12 (B12)-binding protein haptocorrin (HC) has proven to be a potentially useful biomarker in patients with fibrolamellar hepatocellular carcinoma (HCC). Little is known concerning the level of HC and other B12-related proteins in patients with HCC as compared to patients with other chronic liver diseases (CLDs) and healthy controls. We hypothesized that HC could be a biomarker of HCC.. To investigate levels of HC and B12-related proteins in HCC compared to CLDs and healthy controls.. We investigated two patient populations: A cross-sectional cohort of HCC patients (n = 130), CLD patients (n = 102) and healthy controls (n = 46) and a cohort of 38 HCC patients studied at baseline and 1, 4, and 12 weeks following ablative treatment. Patients were evaluated by standard biochemistry, Child-Pugh-score and Barcelona Clinic Liver Cancer (BCLC) classification. We analyzed total B12 by routine methods and HC, transcobalamin (TC), B12 saturated TC (holoTC), and the soluble cell surface receptor for holoTC (sCD320) by in-house enzyme-linked immunosorbent assay.. HC showed higher median (range) levels for both HCC (590 [290-5860]) and CLD patients (620 [310-4010]) compared to controls (460 [250-2020]) (p < 0.01). Total B12, TC, holoTC, and sCD320 showed elevated levels in both HCC and CLD compared to controls. Only holoTC changed following treatment, without a concurrent change in TC.. B12 and B12-related proteins (total B12, HC, TC, holoTC, and sCD320) show elevations in both HCC and CLD patients compared to controls, suggesting a relation to CLD in general rather than to primary liver cancer. Thus, HC is not useful as a biomarker for HCC.

Topics: Adult; Aged; Aged, 80 and over; Antigens, CD; Biomarkers, Tumor; Carcinoma, Hepatocellular; Case-Control Studies; Catheter Ablation; Chemoembolization, Therapeutic; Chronic Disease; Cross-Sectional Studies; Female; Humans; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Receptors, Cell Surface; Transcobalamins; Vitamin B 12

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, which includes a spectrum of hepatic pathology such as simple steatosis, steatohepatitis, fibrosis and cirrhosis. The increased serum levels of homocysteine (Hcy) may be associated with hepatic fat accumulation. Genetic mutations in the folate route may only mildly impair Hcy metabolism. The aim of this study was to investigate the relation between liver steatosis with plasma homocysteine level and MTHFR C677T and A1298C polymorphisms in Brazilian patients with NAFLD.. Thirty-five patients diagnosed with NAFLD by liver biopsy and forty-five healthy controls neither age nor sex matched were genotyped for C677T and A1298C MTHFR polymorphisms using PCR-RFLP and PCR-ASA, respectively, and Hcy was determined by HPLC. All patients were negative for markers of Wilson's, hemochromatosis and autoimmune diseases. Their daily alcohol intake was less than 100 g/week. A set of metabolic and serum lipid markers were also measured at the time of liver biopsies.. The plasma Hcy level was higher in NAFLD patients compared to the control group (p = 0.0341). No statistical difference for genotypes 677C/T (p = 0.110) and 1298A/C (p = 0.343) in patients with NAFLD and control subjects was observed. The genotypes distribution was in Hardy-Weinberg equilibrium (677C/T p = 0.694 and 1298 A/C p = 0.188). The group of patients and controls showed a statistically significant difference (p < 0.001) for BMI and HOMA_IR, similarly to HDL cholesterol levels (p < 0,006), AST, ALT, γGT, AP and triglycerides levels (p < 0.001). A negative correlation was observed between levels of vitamin B12 and Hcy concentration (p = 0.005).. Our results indicate that plasma Hcy was higher in NAFLD than controls. The MTHFR C677T and A1298C polymorphisms did not differ significantly between groups, despite the 677TT homozygous frequency was higher in patients (17.14%) than in controls (677TT = 4.44%) (p > 0.05). The suggested genetic susceptibility to the MTHFR C677T and A1298C should be confirmed in large population based studies.

Topics: Adult; Biomarkers; Brazil; Cholesterol; Chronic Disease; Fatty Liver; Female; Folic Acid; Gene Frequency; Genetic Predisposition to Disease; Genotype; Homocysteine; Humans; Leukocytes, Mononuclear; Liver; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Mutation; Non-alcoholic Fatty Liver Disease; Polymorphism, Genetic; Triglycerides; Vitamin B 12

The burden of chronic noncommunicable diseases (NCDs) such as diabetes, obesity and cardiovascular disease is shifting rapidly to low- and middle-income countries. It calls for a review of the classic 'dogma' of genetic predisposition, precipitated by adult lifestyle. The paradigm of early life origins of chronic disease has focused attention on maternal health and nutrition as major determinants of the health of the offspring. India has high burden of maternal ill health and also of diabetes and cardiovascular disease, offering unique opportunities to study the links between the two. Pune studies showed that the Indian babies were thin but fat (more adipose) compared to European babies, and that maternal micronutrient status during pregnancy was a determinant of offspring size and body composition. Two thirds of the mothers had low vitamin B12 concentrations, while folate deficiency was rare. Higher circulating concentrations of homocysteine predicted smaller baby size. Follow-up studies revealed that higher maternal folate in pregnancy predicted higher adiposity and insulin resistance in the child at 6 years of age, and that low maternal vitamin B12 exaggerated the risk of insulin resistance. Low maternal vitamin B12 status is also associated with increased risk of neural tube defects and poor offspring cognitive functions. Our results suggest an important role for maternal one-carbon metabolism in offspring growth and programming of NCD risk. These ideas are supported by animal studies. Improvement of adolescent nutrition could effect intergenerational prevention of chronic diseases.

Topics: Adiposity; Adolescent; Adult; Animals; Body Weight; Carbon; Cardiovascular Diseases; Child; Chronic Disease; Diabetes Mellitus; Female; Folic Acid; Folic Acid Deficiency; Growth; Homocysteine; Humans; India; Infant; Infant, Newborn; Insulin Resistance; Maternal Nutritional Physiological Phenomena; Neural Tube Defects; Nutritional Status; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10·4 nmol/l; women, 10·7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north-south gradient. Vitamin B₂ concentrations were highest in Northern Europe (men, 22·2 nmol/l; women, 26·0 nmol/l) and decreased towards Southern Europe (P trend< 0·001). Vitamin B(6) concentrations were highest in Central Europe in men (77·3 nmol/l) and highest in the North among women (70·4 nmol/l), with decreasing concentrations towards Southern Europe in women (P trend< 0·001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.

Topics: Adult; Aged; Alcohol Drinking; Chronic Disease; Ethnicity; Europe; Female; Folic Acid; Glycine; Health Behavior; Humans; Life Style; Male; Middle Aged; Prospective Studies; Sarcosine; Serine; Sex Factors; Smoking; Vitamin B 12

To determine the prevalence of hypocobalaminemia or methylmalonic acidemia (or both) in dogs with chronic gastrointestinal disease.. Serum samples from 56 dogs with chronic gastrointestinal disease and 43 control dogs.. Serum cobalamin and methylmalonic acid (MMA) concentrations were measured in all samples and compared between groups. A correlation between serum cobalamin and MMA concentrations and the canine chronic enteropathy clinical activity index was evaluated via the Spearman rank correlation.. 20 of 56 (36%) dogs with gastrointestinal disease had hypocobalaminemia. Serum cobalamin concentrations were significantly lower in dogs with gastrointestinal disease than in control dogs. Five of 56 (9%) dogs with chronic gastrointestinal disease and 5 of 20 (25%) hypocobalaminemic dogs had increased MMA concentrations. There was a significant negative correlation (Spearman r = -0.450) between serum cobalamin and MMA concentrations in dogs with gastrointestinal disease. No correlation was found between the canine chronic enteropathy clinical activity index and serum cobalamin or MMA concentrations.. These data indicated the prevalence of hypocobalaminemia in dogs with chronic gastrointestinal disease was 20 of 56 (36%). Five of 20 (25%) hypocobalaminemic dogs had increased serum MMA concentrations, which indicated that although hypocobalaminemia was common in these dogs, it did not always appear to be associated with a deficiency of cobalamin on a cellular level. Hypocobalaminemia is a risk factor for negative outcome in dogs with chronic gastrointestinal disease and should be considered in every patient with corresponding clinical signs.

Topics: Amino Acid Metabolism, Inborn Errors; Animals; Chronic Disease; Dog Diseases; Dogs; Female; Gas Chromatography-Mass Spectrometry; Gastrointestinal Diseases; Luminescent Measurements; Male; Methylmalonic Acid; Prevalence; Prospective Studies; Texas; Vitamin B 12; Vitamin B 12 Deficiency

Anemia has been associated with increased physical and financial costs and occurs more frequently in older individuals. Therefore, the primary objectives of this study were to examine the prevalence and possible predictors of anemia in the very old.. Hemoglobin was used to identify those with anemia in a group of centenarians and near centenarians (98+, n = 185) and octogenarians (n = 69), who were recruited as part of the population-based multidisciplinary Georgia Centenarian Study. Blood markers, including ferritin, vitamin B12, red blood cell folate, methylmalonic acid, creatinine, and C-reactive protein, demographic variables, and medication and/or supplement usage were used to determine possible predictors of anemia.. The prevalence of anemia was 26.2% in octogenarians and 52.1% in centenarians. Low serum albumin (<3.6 g/dL) and decreased estimated glomerular filtration rate (<45 mL/min/m(2)) were predictors of anemia in centenarians.. Anemia is a major health issue, particularly as people age. Because of the high prevalence of anemia in older individuals, awareness of the predictors associated with anemia becomes increasingly important so as to reduce the negative consequences associated with it and allow for the identification of steps that can be taken to correct anemia, including managing chronic disease.

Topics: Aged, 80 and over; Anemia; C-Reactive Protein; Chronic Disease; Creatinine; Dietary Supplements; Erythrocytes; Female; Ferritins; Folic Acid; Georgia; Glomerular Filtration Rate; Hemoglobins; Humans; Male; Methylmalonic Acid; Prevalence; Serum Albumin; Vitamin B 12

Hyperhomocysteinemia is associated with an increased risk of Alzheimer's disease (AD). Our previous work has demonstrated that combined folate and vitamin B12 (vit-B12) supplementation prevents tau hyperphosphorylation and memory deficits induced by acute administration of homocysteine in young rats. Here, we further investigated whether folate/vit-B12 supplementation is also effective in aged rats with a chronically high level of homocysteine. 18-month-old rats were injected with homocysteine via the vena caudalis with or without a concurrent folate/vit-B12 supplementation for 28 weeks. We found that hyperhomocysteinemia induced tau hyperphosphorylation and accumulation in hippocampus and cortex. Concurrent signaling changes included the activation of glycogen synthase kinases-3β, cyclin-dependent kinase-5, c-Jun N-terminal kinase, extracellular signal-regulated kinase, and p38MAPK, and inhibition of protein phosphatase 2A. Although the ability to learn was not affected, the aged rats exhibited significant memory deficits. Folate/vit-B12 supplementation attenuated these biochemical and behavioral correlates. These data demonstrate that folate/vit-B12 supplementation is also effective in a chronic hyperhomocysteinemia model in reversing the AD-like tau pathologies and memory deficits.

Topics: Aging; Animals; Chronic Disease; Dietary Supplements; Disease Models, Animal; Drug Therapy, Combination; Folic Acid; Hyperhomocysteinemia; Male; Memory Disorders; Phosphorylation; Rats; Rats, Sprague-Dawley; tau Proteins; Vitamin B 12

Homocysteine (Hcys) is a sulphur-containing amino acid that has been widely investigated for its putative role in neuropsychiatric disorders. Elevated plasma homocysteine levels have been associated with schizophrenia. Among other factors, low folate and vitamin B12 levels have been implicated in the increase in homocysteine. The aim of the study was to determine plasma Hcys, folate and vitamin B12, and the frequency and severity of hyperhomocysteinemia in patients with schizophrenia, and to investigate the association between Hcys and clinical features and its relationship with folate and vitamin B12 levels.. This was a case-control study carried out on 61 (54 males and seven females, mean age=33.3 ± 9.2) inpatients with chronic schizophrenia according to DSM-IV criteria and 46 (25 males and 21 females, mean age=45.9 ± 14.2) healthy controls. Most of patients (90.2%) were treated by first generation antipsychotics with a mean daily dosage of 401.6 mg chlorpromazine equivalents. Total homocysteine serum levels were determined quantitatively by fluorescence-polarization immunoassay (FPIA) with an AxSYM analyzer™ (Abbott). Quantitative vitamin B12 and folate serum levels were measured with an Elecsys 2010 analyzer™ (Roche Diagnostics). Differences between patients and controls were examined using a two-way Ancova with gender and diagnosis as independent variables, adjusting for age.. Patients with schizophrenia showed higher plasma Hycs and lower plasma folate than controls (mean=16.1 μmol/L in patients versus 10.9 μmol/L in controls; P=0.028 for Hycs and 4.2 μg/L in patients versus 8.2 μg/L in controls; P<0.001 for folate). Patients and controls did not differ in vitamin B12 levels. Both male and female patients had increased plasma Hcys compared to controls. Hyperhomocysteinemia (Hcys levels>15 μmol/L) was present in 34.4% of the patients versus 15.2% in controls. The prevalence of moderate hyperhomocysteinemia (Hcys levels: 15-29 μmo/L) was 26.2% and that of intermediate hyperhomocysteinemia (Hcys levels: 30-100 μmol/L) was 8.2%. In patients with schizophrenia, plasma Hcys was not correlated with age (r=0.07; P=0.56), duration of illness (r=-0.04; P=0.78) and did not differ with gender and clinical sub-types. Moreover, plasma Hcys was higher in patients without family history of psychiatric disorders (19.2 μmol/L) versus 12.7 μmol/L in patients with family history of psychiatric disorders (P=0.032). Concerning therapeutic features, plasma Hcys did not differ with type of antipsychotic and was not related to daily dosage of antipsychotics. A negative correlation was found between plasma Hcys and vitamin B12 levels (r=-0.26; P=0.04).. These results confirm an increase of Hcys levels in schizophrenic patients and suggest that it is associated with absence of family history of psychiatric disorders and with low vitamin B12 levels. Hyperhomocyteinemia could be related to the pathophysiology of aspects of this illness. Homocysteine should be considered as a factor to consider in monitoring and management of patients with schizophrenia.

Topics: Adult; Case-Control Studies; Chronic Disease; Comorbidity; Cross-Sectional Studies; Female; Fluorescence Polarization Immunoassay; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Reference Values; Schizophrenia; Schizophrenic Psychology; Statistics as Topic; Vitamin B 12

To determine if increased cell turnover in chronic myeloproliferative disorders can lead to hyperhomocysteinemia as a result of folate and/or cobalamin depletion, and contribute to oxidative stress.. The clinical role of oxidative stress was investigated by measuring reactive oxygen species (ROS), total antioxidant capacity (TAC), and total homocysteine (tHcy), folate, cobalamin, and holotranscobalamin (HoloTC) levels in 51 chronic myeloproliferative disorders patients (male-to-female ratio: 1.1; median age: 64 years; range, 40-84 years), including 42 with primary myelofibrosis and 9 with post-polycythemia vera myelofibrosis.. Myelofibrotic patients had higher tHcy (p = 0.0201) and an unbalanced oxidative status (higher ROS and lower TAC levels; p < 0.0001) than controls. Presence of diabetes or another neoplasia was associated with higher ROS levels (p < 0.05), splenomegaly, hepatomegaly, and peripheral blasts with lower HoloTC levels (p < 0.005). The most severe forms of myelofibrosis (2-3) were associated with lower TAC (p = 0.045) and HoloTC levels (p = 0.017). Patients with Janus kinase-2 mutations had lower HoloTC levels (p = 0.0059). HoloTC deficiency was more frequently associated with Janus kinase-2 homozygosity (p < 0.0003).. Our findings suggest that the determination of HoloTC, tHcy, ROS concentrations, and TAC, can identify latent cobalamin deficiency and provide a rational basis for correcting the increased oxidation associated with disease progression.

Topics: Adult; Aged; Aged, 80 and over; Antioxidants; Chronic Disease; Female; Folic Acid; Homocysteine; Humans; Janus Kinase 2; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Mutation; Oxidative Stress; Polycythemia Vera; Polymorphism, Single Nucleotide; Primary Myelofibrosis; Reactive Oxygen Species; Transcobalamins; Vitamin B 12

Elevated blood levels of homocysteine (hCY) have been associated with schizophrenic male patients. However, controversy remains regarding the association between lowered plasma folate and vitamin B12, hyperhomocysteinemia, and schizophrenia. Sixty-six (66) male patients with chronic schizophrenia were investigated to test the hypotheses that alterations in Hcy, folate, and vitamin B12 levels might be related to the antipsychotic drug doses used in treatment.. Serum total homocysteine, folic acid, and vitamin B12 levels were determined by chemiluminescence methods in both patients and control subjects. The patients were grouped according to the antipsychotic drug doses used in their treatment.. Patients had higher homocysteine levels but they did not differ from controls in terms of folate and vitamin B12 levels. On the other hand, only folate levels were negatively correlated in the patient group treated with higher therapeutic doses of chlorpromazine equivalents (> 400 mg/day) compared to the patient group with lower doses (< 400 mg/day).. Our findings show that higher typical antipsychotic drugs may play a role as modifiying factor for folate metabolism in chronic schizoprenic male patients.

Topics: Adolescent; Adult; Antipsychotic Agents; Case-Control Studies; Chlorpromazine; Chronic Disease; Dose-Response Relationship, Drug; Folic Acid; Homocysteine; Humans; Luminescent Measurements; Male; Middle Aged; Schizophrenia; Statistics, Nonparametric; Vitamin B 12

The number of ex-leprosy patients has reduced rapidly who were forced to be admitted under leprosy prevention/segregation law and are staying at national sanatoriums with different disabilities due to different physical and social reasons for long time in Japan. Most of them have been of clinically cured status for decades after effective chemotherapy. Some have still been suffering from acute or chronic neuralgic pains which are supposed to be long standing consequences of nerve damage of leprosy and getting medications for long period. Pharmacy department of National Suruga Sanatorium has studied the amount of prescriptions of some medicines for last 11 years, which were thought to be prescribed for pain including neuralgic pain. There seem to be some tendencies of medications during last decade. VitaminB12 (Mecobalamine) is one of the commonest drugs for neuralgic pain at this sanatorium and the amount of prescription had almost been unchanged through the years. Prescription of non-steroid anti-inflammatory drugs (NSAIDs) increased year by year, which may reflect the increasing age of ex-patients who need more pain killers for their painful joints or back. Loxoprofen is the most popular pain killer here and increased by ten times for last decade. The number of prescription for Pentazocine and Hydroxyzine Hydrochloride injection increased for last several years, which reflects a few patients who were still suffering from severe chronic neuralgia for years. It is desirable that a standard regimen for chronic neuralgic pain as a consequence of nerve impairment in leprosy will be developed as soon as possible.

Topics: Aged; Analgesics; Anti-Inflammatory Agents; Chronic Disease; Drug Utilization; Female; Humans; Japan; Leper Colonies; Leprostatic Agents; Leprosy; Male; Neuralgia; Pentazocine; Phenylpropionates; Prescriptions; Time; Vitamin B 12

Although increased plasma total homocysteine (tHcy) concentrations were reported in psychiatric diseases, currently the reasons of elevated tHcy levels were not clearly understood. In this study we aimed to investigate the contribution of renal clearance of homocysteine on plasma tHcy load in patients with depression and first episode psychosis.. Thirty depression, 14 first episode psychosis patients and 34 healthy individuals (control group) were involved in the study. In patients and control groups, plasma and urine tHcy levels, urine methylmalonic acid (uMMA), serum vitamin B12 and folate concentrations were measured.. Although there was not any difference between depression, psychosis and control groups with respect to mean (SD) values of vitamin B12 (289(131), 230 (72) and 249(79) pg/mL, respectively) and folate (6.4(4.0), 5.3(2.3) and 5.7(2.3) ng/mL, respectively), plasma tHcy levels of depression and psychosis group were higher than the control values (16.3(6.2), 15.5(4.3) and 9.9(2.1) micromol/L, respectively). Urine tHcy values of patient groups were significantly lower than those in the control group (14.5(7.6), 15.8(6.8) and 29.6(16.9) micromol/g creatinine, respectively). There were elevated uMMA levels in depression and psychosis groups compared with control group (4.9(2.4), 6.6(3.2) and 2.8(1.2) mmol/mol creatinine, respectively). There were a significant and negative correlation between urinary tHcy and plasma tHcy levels (r=-0.258 and p=0.011).. In conclusion, reduced urinary tHcy levels in psychiatric patients could be one of the reasons of plasma tHcy elevations with normal folate and vitamin B12 levels. Altered renal handling mechanisms of homocysteine may lead to elevated plasma tHcy levels by reduced clearance of homocysteine via glomerular filtration.

Topics: Acute Disease; Adult; Biomarkers; Chronic Disease; Female; Folic Acid; Homocysteine; Humans; Male; Meta-Analysis as Topic; Middle Aged; Psychotic Disorders; Vitamin B 12

Since studies suggest that both hypoxia and sleep fragmentation are related to cardiovascular alterations induced by obstructive sleep apnea, the present study was designed to evaluate the effects of hypoxia, sleep deprivation, and their combination on biochemical blood parameters in rats. In subchronic experiments (4 days), rats were exposed to intermittent hypoxia (IH) during the light period (2min room air-2min 10% O(2) for 12h/day) and/or paradoxical sleep deprivation (PSD, 24h/day). Consequences of chronic intermittent hypoxia (CIH) exposure were examined after 21 consecutive days of hypoxia protocol from 10:00 to 16:00 followed by a sleep restriction (SR) period of 18h (16:00-10:00). Rats were randomly assigned to seven treatment groups: (1) control (2) IH (3) PSD (4) IH-PSD (5) SR (6) CIH and (7) CIH-SR. PSD reduced triglycerides and very low-density lipoprotein (VLDL) cholesterol concentrations and increased total cholesterol and high-density lipoprotein (HDL) cholesterol. IH did not alter any of these parameters. The combination of IH-PSD did not modify the values of total cholesterol and HDL compared to control group. In the chronic experiment, the animals exposed to CIH displayed a reduction of Vitamin B(6) and an increase of triglycerides and VLDL. Our findings show a duration-dependent effect of hypoxia on triglycerides. Rats in the SR and CIH-SR groups showed a diminished concentration of triglycerides and VLDL. SR rats showed a reduction in the concentration of homocysteine but the animals in the CIH-SR treatment condition did not display any alterations in this parameter. In this latter group, an augmentation of cysteine concentration was observed. These results suggest that sleep deprivation and hypoxia modify biochemical blood parameters in distinct ways.

Topics: Animals; Blood Gas Analysis; Body Weight; Cardiovascular Diseases; Cholesterol; Cholesterol, HDL; Chronic Disease; Cysteine; Folic Acid; Homocysteine; Hypoxia; Male; Rats; Rats, Wistar; Risk Factors; Sleep Apnea Syndromes; Sleep Deprivation; Sleep, REM; Triglycerides; Vitamin B 12

Elevated plasma levels of the amino acid homocysteine have been associated with schizophrenia, particularly in young male patients. Among other factors, low folate and vitamin B12 levels have been implicated in the increase in homocysteine. In order to investigate this association, we determined plasma homocysteine, folate and B12 levels in 97 (67 males and 30 females) inpatients with chronic schizophrenia and 103 (46 males and 57 females) controls. Patients and controls did not differ in folate or B12 levels, after adjusting for age. Patients with schizophrenia had higher plasma homocysteine than controls (mean=15.42 micromol/l in cases versus 11.54 micromol/l in controls: F(1,195)=17.978; p<0.001). This difference persisted after controlling for folate and B12 concentrations. Both male and female patients had increased plasma homocysteine compared to controls [(males: mean=16.61 micromol/l in cases versus mean=13.72 in controls: F(1,110)=5.54; p=0.020) (females: mean=12.78 micromol/l in cases versus mean=9.79 micromol/l in controls: F(1,84)=13.54; p<0.001)]. When dividing our sample into two age groups (age < and > or =50 years), both young and older females and younger males with schizophrenia had increased plasma homocysteine compared to controls. We therefore suggest that homocysteinemia is a general risk factor for schizophrenia. We further suggest that it is not limited to young male patients and is not necessarily associated with low folate or B12 levels.

Topics: Adult; Age Factors; Aged; Analysis of Variance; Chi-Square Distribution; Chronic Disease; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Schizophrenia; Sex Factors; Vitamin B 12

Hyperhomocysteinemia, a risk factor for cardiovascular disease, is present in the majority of patients with chronic kidney disease (CKD). Several studies indicated that the moiety of homocysteine (Hcy) with an unbound -SH group (reduced Hcy [rHcy]) is the atherogenic molecule. This study is designed to examine the relation between different forms of Hcy and other aminothiols in hemodialysis (HD) patients, peritoneal dialysis (PD) patients, and nondialyzed patients with CKD.. rHcy, free Hcy (fHcy), and total Hcy (tHcy), as well as different forms of cysteine, cysteinyl-glycine, and glutathione, were studied by using a high-performance liquid chromatography technique in 19 HD patients, 12 PD patients, 47 patients with CKD, and 15 control subjects.. In PD patients, tHcy levels were 2.8 times greater compared with controls, and in HD patients and those with CKD, 2.1 and 1.9 times greater, respectively. Mean rHcy/tHcy ratios were significantly greater in both HD (P < 0.05) and PD patients (P < 0.01), but did not differ in patients with CKD compared with controls. The decrease in rHcy levels during 1 HD treatment was smaller than that in tHcy and fHcy levels, and rHcy/tHcy ratio increased (before HD, 1.25% +/- 0.44%; after HD, 1.44% +/- 0.66%; P < 0.05).. Levels of rHcy and other aminothiols are markedly increased in patients with impaired renal function. In dialysis patients, rHcy/tHcy ratio is markedly elevated and shows greater variability than in patients with CKD and controls. We conclude that because rHcy is believed to induce endothelial dysfunction and may be part of the accelerated atherogenic process in patients with CKD, plasma rHcy level could be a more relevant marker of cardiovascular disease risk than tHcy level.

Topics: Adult; Aged; Atherosclerosis; Biomarkers; C-Reactive Protein; Chronic Disease; Cysteine; Dipeptides; Female; Folic Acid; Glutathione; Hemodiafiltration; Homocysteine; Humans; Hyperhomocysteinemia; Kidney; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Oxidation-Reduction; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Renal Dialysis; Vitamin B 12

The purpose of this study was to investigate the relationship between cigarette smoking and the serum levels of folic acid, vitamin B(12) and some haematological variables in patients with periodontal disease.. The study base consisted of 88 volunteer patients with periodontal disease, including 45 current smokers in the age range 31-68 years and 43 non-smokers in the range 32-66 years. The clinical parameters included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL). Folic acid, vitamin B(12) and haematological variables were determined from peripheral blood samples.. PI, PD and CAL means were significantly higher in smokers than non-smokers (p<0.05). The serum folic acid concentration of smokers was lower than that of non-smokers (p<0.05), whereas the white blood cell count was higher in smokers than in non-smokers (p<0.05).. The results of this study suggest that among patients with periodontal disease the serum folic acid concentration is lower in smokers compared with non-smokers.

Topics: Adult; Aged; Blood Cell Count; Chronic Disease; Dental Plaque Index; Female; Folic Acid; Gingival Hemorrhage; Gingivitis; Hemoglobins; Humans; Leukocyte Count; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Index; Periodontal Pocket; Smoking; Vitamin B 12

Topics: Aged; Aged, 80 and over; Blood Proteins; Chronic Disease; Creatinine; Female; Hospital Mortality; Humans; Male; Predictive Value of Tests; Reference Values; Risk Assessment; Vitamin B 12

Topics: Adult; Anemia, Hypochromic; Arthroplasty, Replacement, Hip; Chronic Disease; Colitis; Drug Therapy, Combination; Epoetin Alfa; Erythropoietin; Ferric Compounds; Folic Acid; Humans; Intestinal Polyps; Leucovorin; Malabsorption Syndromes; Male; Methotrexate; Osteoarthritis, Hip; Preoperative Care; Recombinant Proteins; Rectal Diseases; Remission Induction; Spondylitis, Ankylosing; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Chronic Disease; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Methylenetetrahydrofolate Reductase (NADPH2); Polymorphism, Genetic; Thromboembolism; Vitamin B 12; Vitamin B 6

Interferon-beta is a mainstay therapy of demyelinating diseases, but its effects are incomplete in human multiple sclerosis and several of its animal models. In this study, we demonstrate dramatic improvements of clinical, histological, and laboratory parameters in in vivo mouse models of demyelinating disease through combination therapy with IFN-beta plus vitamin B(12) cyanocobalamin (B(12)CN) in nonautoimmune primary demyelinating ND4 (DM20) transgenics, and in acute and chronic experimental autoimmune encephalomyelitis in SJL mice. Clinical improvement (p values <0.0001) was paralleled by near normal motor function, reduced astrocytosis, and reduced demyelination. IFN-beta plus B(12)CN enhanced in vivo and in vitro oligodendrocyte maturation. In vivo and in vitro altered expression patterns of reduced Notch-1 and enhanced expression of sonic hedgehog and its receptor were consistent with oligodendrocyte maturation and remyelination. IFN-beta-B(12)CN combination therapy may be promising for the treatment of multiple sclerosis.

Topics: Acute Disease; Animals; Brain; Cell Line; Chronic Disease; Demyelinating Diseases; Drug Synergism; Drug Therapy, Combination; Encephalomyelitis, Autoimmune, Experimental; Female; Hedgehog Proteins; Humans; Interferon-beta; Mice; Mice, Inbred Strains; Mice, Transgenic; Oligodendroglia; Peptide Fragments; Receptor, Notch1; Receptors, Cell Surface; Stem Cells; Trans-Activators; Transcription Factors; Vitamin B 12

Anemia in chronic heart failure (CHF) is common, varying in prevalence between 14.4% and 55%, and is more frequent in patients with more severe heart failure. Patients with CHF who have anemia have a poorer quality of life, higher hospital admission rates, and reduced exercise tolerance. We explored the relation between hematinic levels and hemoglobin (Hb) levels and exercise tolerance in a group of patients with CHF.. We analyzed data from 173 patients with left ventricular systolic dysfunction (LVSD), 123 patients with symptoms of heart failure, but preserved left ventricular (LV) systolic function ("diastolic dysfunction"), and 58 control subjects of similar age. Each underwent echocardiography, a 6-minute walk test, and blood tests for renal function and Hb and hematinic levels (vitamin B12, iron, and folate). We classified patients as having no anemia (Hb level >12.5 g/dL), mild anemia (Hb level from 11.5-12.5 g/dL), or moderate anemia (Hb level <11.5 g/dL).. Of patients with LVSD, 16% had moderate anemia and 19% had mild anemia. Of patients with preserved LV function, 16% had moderate anemia and 17% had mild anemia. Four control subjects had a Hb level <12.5 g/dL. Of all patients, 6% were vitamin B12 deficient, 13% were iron deficient, and 8% were folate deficient. There was no difference between patients with LVSD and the diastolic dysfunction group. In patients with LVSDS, the average Hb level was lower in New York Heart Association class III than classes II and I. The distance walked in 6 minutes correlated with Hb level in both groups of patients with CHF (r = 0.29; P <.0001). Patients with anemia achieved a lower pVO2 (15.0 [2.3] vs 19.5 [4.4], P <.05). Peak oxygen consumption correlated with Hb level (r = 0.21, P <.05) in the patients, but not in the control subjects. In patients with anemia, the mean creatinine level was higher than in patients with a Hb level >12.5 g/dL, but there was no clear relationship with simple regression. Hematocrit level and mean corpuscular volume were not different in the patients with diastolic dysfunction, patients with LV dysfunction, or the control subjects. Hematocrit levels were not influenced by diuretic dose. Patients with anemia were not more likely to be hematinic deficient than patients without anemia.. Patients with symptoms and signs of CHF have a high prevalence of anemia (34%) whether they have LV dysfunction or diastolic dysfunction, but few patients have hematinic deficiency. Hemoglobin levels correlate with subjective and objective measures of severity and renal function.

Topics: Aged; Anemia; Anemia, Iron-Deficiency; Case-Control Studies; Chronic Disease; Creatinine; Exercise Test; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Heart Failure; Humans; Iron; Male; Oxygen Consumption; Ventricular Dysfunction, Left; Vitamin B 12; Vitamin B 12 Deficiency

Recent studies suggest that autoimmune mechanisms may be involved in the etiology of chronic idiopathic urticaria (CIU). There is a higher prevalence of B12 deficiency in autoimmune diseases and possibly in gastric Helicobacter pylori (H. pylori) infection. The frequency of B12 deficiency in CIU is unknown. Our objective in this study was to determine the prevalence of B12 deficiency in patients with CIU and also its relationship to gastric H. pylori infection and serologic markers of autoimmunity in these groups. Thirty-three patients with CIU and 27 healthy controls were included in the study. Serum vitamin B12 levels, H. pylori infection and serological markers of autoimmunity (anti-thyroglobulin, thyroid microsomal, gastric parietal cell and antinuclear autoantibodies) were investigated. H. pylori infection was determined according to serology and gastric biopsy in 19 patients, serology and urea breath test in 4 patients and serology alone in the remaining 10 patients. Serum B12 levels were below the normal reference range in 11/33 (33.3%) patients with CIU. The mean serum B12 levels among patients with CIU and the controls were 281+/-127.5 pg/ml and 465.1+/-140.3 pg/ml (p=0.0001), respectively. Anti-thyroid antibodies were positive in 6 of 11 patients (54.5%) with low B12 levels, but only in 4 of 27 (14.8%) healthy controls (p=0.019). Anti-GPC antibodies were positive in 4 of 11 (36.4%) patients with CIU and low B12 levels, but only in 2 of 27 (7.4%) healthy controls (p=0.047). In CIU patients, there was no difference in the frequency of IgG H. pylori antibodies between those with low B12 levels and normal B12 levels. Among the 19 patients who had been performed gastric endoscopy, 15 patients (78.9%) had chronic antral gastritis, 2 patients (10.5%) had atrophic gastritis and there were normal findings in 2 patients (10.5%). In conclusion, serum B12 levels were found to be below the normal reference range in 33% of the patients with CIU. An association between low B12 levels and H. pylori could not be shown. The higher frequency of antithyroid and anti-GPC antibodies in patients with low B12 levels suggest that low B12 levels in CIU may be autoimmune in nature.

Topics: Adolescent; Adult; Antibodies, Bacterial; Autoantibodies; Chronic Disease; Female; Helicobacter pylori; Humans; Immunoglobulin G; Male; Middle Aged; Parietal Cells, Gastric; Urticaria; Vitamin B 12; Vitamin B 12 Deficiency

Homocysteine metabolism may be impaired in chronic liver disease, possibly contributing to fibrogenesis and disease complications.. The goal was to investigate the prevalence and determinants of basal and postprandial hyperhomocysteinemia in patients with chronic liver disease and after orthotopic liver transplantation (OLT).. This was a cross-sectional study of 323 patients with chronic liver disease (93 with hepatitis, 8 with fatty liver, 168 with cirrhosis, and 54 after OLT) and 25 healthy control subjects. Portohepatovenous gradients of total homocysteine (tHcy) and methionine and postload methionine and tHcy kinetics before and after 10 d of supplementation with folate plus vitamin B-6 were investigated in subgroups.. Basal hyperhomocysteinemia was observed in all patient groups (34% of patients with hepatitis, 50% with fatty liver, 54% with cirrhosis, and 52% after OLT). It was more frequently seen in patients with elevated plasma creatinine concentrations and at advanced stages of liver disease. Mean plasma folate was normal in patients with liver disease, but vitamin B-12 was elevated in cirrhosis and vitamin B-6 was low after OLT. There were significant negative associations between tHcy and folic acid or vitamin B-12 concentrations in control subjects and in patients with hepatitis and after OLT. No systematic association between portohepatovenous differences in tHcy and methionine concentrations was found. Cirrhosis was accompanied by impaired methionine clearance. After vitamin supplementation, the area under the tHcy curve improved in cirrhosis at nearly unchanged basal tHcy concentrations.. Basal hyperhomocysteinemia is seen in approximately 50% of patients with cirrhosis and after OLT. Basal tHcy concentrations do not change significantly after supplementation with folate and vitamin B-6, but postprandial Hcy metabolism improves.

Topics: Adult; Area Under Curve; Case-Control Studies; Chronic Disease; Creatinine; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Liver Diseases; Liver Transplantation; Male; Metabolic Clearance Rate; Methionine; Middle Aged; Vitamin B 12; Vitamin B 6

Hyperhomocysteinaemia has recently been identified as an important risk factor for atherosclerotic vascular disease. Screening for hyperhomocysteinaemia has been recommended, however, the incidence of hyperhomocysteinaemia in vascular patients is not known.. To determine the incidence of hyperhomocysteinaemia in vascular patients, to determine the relation of hyperhomocysteinaemia with folate, vitamin B12 levels and lipid profiles in vascular patients. To examine if there is a relationship between the degree of vascular injury and homocysteine concentration.. New vascular patients at The Queen Elizabeth Hospital were recruited and divided into peripheral, and aneurysmal presentations. Patients demographics were recorded, blood samples were taken for fasting lipid profile, and homocysteine concentration. Samples were also taken for vitamin B12, plasma and red cell folate levels. Sixty age and sex matched controls were included for comparison.. One hundred and twenty-six patients have been recruited, (95 men and 31 women) with a median age of 68 years (61-74 years). The incidence of elevated homocysteine, and cholesterol levels was 33, 47 and 24%. The levels of vitamin B12 and folate were normal in all patients. Homocysteine was elevated in 27% of claudicants, 50% of patients with rest pain and 53% of patients with an aortic aneurysm.. There is a high rate of hyperhomocysteinaemia in vascular patients with a higher incidence in patients with rest pain. There was also a high incidence of elevated homocysteine levels in patients with an abdominal aortic aneurysm. The rate of growth of these aneurysms is currently under review. Low folate or B12 concentrations is not the cause of raised homocysteine levels.

Topics: Aged; Aortic Aneurysm, Abdominal; Chronic Disease; Female; Folic Acid; Humans; Hyperhomocysteinemia; Intermittent Claudication; Ischemia; Leg; Lipids; Male; Middle Aged; Vascular Diseases; Vitamin B 12

To determine whether a colony environment predisposes healthy cats to high bacterial counts, including counts of obligate anaerobes, in the duodenum and whether increased numbers of bacteria could be found in the duodenum of cats with signs of chronic gastrointestinal tract disease.. Prospective study.. 20 healthy control cats (10 from a colony environment and 10 pet cats) and 19 cats with a history of chronic gastrointestinal tract disease.. Undiluted duodenal fluid was quantitatively and qualitatively assessed by bacteriologic culture under aerobic and anaerobic conditions. Serum concentrations of cobalamin and folate were also measured.. Significant differences were not detected in the numbers of bacteria found in the duodenum of cats housed in a colony environment, compared with pet cats fed an identical diet prior to sampling. All healthy cats were, therefore, combined into 1 control group. Compared with healthy cats, cats with clinical signs of gastrointestinal tract disease had significantly lower counts of microaerophilic bacteria, whereas total, anaerobic, and aerobic bacterial counts were not significantly different. None of the cats with disease had total bacterial counts higher than expected from the range established in the control cats. Differences were not detected in regard to serum folate or cobalamin concentrations between diseased and healthy cats.. These findings indicated that healthy colony cats and pet cats have high numbers of bacteria in the duodenum, including high numbers of obligate anaerobes. Our findings also suggest that bacterial overgrowth in the small intestine is not a common clinical syndrome in cats with chronic nonobstructive gastrointestinal tract disease.

Topics: Animals; Animals, Domestic; Bacteria, Anaerobic; Biopsy; Cat Diseases; Cats; Chronic Disease; Colony Count, Microbial; Duodenum; Endoscopy, Digestive System; Female; Folic Acid; Gastrointestinal Diseases; Housing, Animal; Intestinal Mucosa; Male; Microscopy, Electron; Prospective Studies; Statistics, Nonparametric; Vitamin B 12

Conflicting data have been reported concerning the independent association between proteinuria and plasma total homocysteine (tHcy) levels, particularly among chronic renal disease (CRD) patients with a normal range serum creatinine. Studies of this potential relationship have been limited by failure to assess true GFR, failure to assess proteinuria in a quantitative manner, or arbitrary restriction of the range of proteinuria examined. We examined the potential independent relationship between plasma tHcy levels and a wide range of quantitatively determined proteinuria (i.e., 0.000-8.340 g/day), among 109 CRD patients with a normal range serum creatinine (range; 0.8-1.5 mg/dl; median=1.2 mg/dl). Glomerular filtration rate (GFR) was directly assessed by iohexol clearance, and plasma status of folate, pyridoxal 5'-phosphate, and B12, along with serum albumin, were also determined. Linear modeling with ANCOVA revealed that proteinuria was not independently associated with tHcy levels (partial R=0.127; P=0.201), after adjustment for potential confounding by GFR (partial R=0.408; P<0.001), age, sex, plasma B-vitamin status, and serum albumin. Moreover, descending across quartiles (Q) [from Q4 to Q1] of GFR, ANCOVA-adjusted (i.e., for age, sex, and folate status) geometric mean tHcy levels (micromol/l) were significantly increased: tHcy Q4 GFR=9.6; tHcy Q3 GFR=10.5; tHcy Q2 GFR=11.9; tHcy Q4 GFR=14.5; P<0.001 for overall Q difference. We conclude that across a broad spectrum of quantitatively determined proteinuria, after adjustment for true GFR, in particular, there is no independent relationship between proteinuria and tHcy levels among CRD patients with a normal range serum creatinine.

Topics: Adult; Aged; Chronic Disease; Creatinine; Female; Folic Acid; Glomerular Filtration Rate; Homocysteine; Humans; Kidney; Kidney Diseases; Male; Middle Aged; Proteinuria; Pyridoxal Phosphate; Serum Albumin; Vitamin B 12

To study the effects of the intravenous administration of methylcobalamin, an analogue of vitamin B12, for uremic or uremic-diabetic polyneuropathy in patients who are receiving maintenance hemodialysis. An ultra-high dose of vitamin B12 has been reported to promote peripheral nerve regeneration in experimental neuropathy.. Nine patients received a 500 microg methylcobalamin injection 3 times a week for 6 months. The effects were evaluated using neuropathic pain grading and a nerve conduction study.. Serum concentrations of vitamin B12 were ultra-high during treatment due to the lack of urinary excretion. After 6 months of treatment, the patients' pain or paresthesia had lessened, and the ulnar motor and median sensory nerve conduction velocities showed significant improvement. There were no side effects.. Intravenous methycobalamin treatment is a safe and potentially beneficial therapy for neuropathy in chronic hemodialysis patients.

Topics: Action Potentials; Aged; Chronic Disease; Diabetic Neuropathies; Female; Follow-Up Studies; Humans; Injections, Intravenous; Male; Middle Aged; Neural Conduction; Pain Measurement; Peripheral Nervous System Diseases; Renal Dialysis; Severity of Illness Index; Treatment Outcome; Uremia; Vitamin B 12

To compare the diagnostic performance of serum antibodies to H+,K+-ATPase (EC 3.6.1.36), serum pepsinogen A (EC 3.4.23.1) and the Schilling test in diagnosing chronic atrophic body gastritis; to study the interrelationships between H+,K+-ATPase antibodies, serology for Helicobacter pylori, and gastric morphology.. Patients with suspected cobalamin deficiency and serum cobalamin < 200 micromol/l were investigated using upper gastrointestinal endoscopy, the Schilling test and serum tests for H+,K+-ATPase antibodies, pepsinogen A, and H. pylori.. The Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.. Ninety seven consecutively referred patients.. Sensitivity and specificity of assays for serum H+,K+-ATPase antibodies, serum pepsinogen A, and the Schilling test.. Assays of serum antibodies to H+,K+-ATPase and of serum pepsinogen A displayed equal diagnostic sensitivity for atrophic gastritis (around 0.90 for the severe forms) and higher than that for the Schilling test (0.65). The diagnostic specificity for pepsinogen A (1.0) was higher than for H+,K+-ATPase antibodies (about 0.80). The prevalence of antral gastritis and positivity for H. pylori antibodies declined with the transition of body gastritis into severe atrophy, while the prevalence of H+,K+-ATPase antibodies increased.. Pepsinogen A is preferable to serum H+,K+-ATPase antibodies in the diagnosis of gastric body mucosal atrophy. The formation of H+,K+-ATPase antibodies does not seem to be a primary event in the development of gastric body muscosal atrophy.

Topics: Adult; Aged; Antibodies, Bacterial; Chronic Disease; Gastric Mucosa; Gastritis, Atrophic; H(+)-K(+)-Exchanging ATPase; Helicobacter pylori; Humans; Middle Aged; Pepsinogen A; Reference Values; Schilling Test; Sensitivity and Specificity; Serologic Tests; Vitamin B 12

The cobalamin status of 27 patients suffering from alcoholic cirrhosis and 20 control subjects was analyzed. Plasma cobalamin (p < 0.005), total corrinoids (p < 0.005) and their analogs (p < 0.05) were all significantly elevated in the cirrhosis patients. These differences were due to increased haptocorrin (HC)-bound corrinoid (p < 0.02), which could be explained by a deficient hepatic clearance of cobalamin bound to HC. The increase in the concentration of true cobalamin was greater than that of its analogs. There were positive correlations between cholestasis (serum alkaline phosphatase) and plasma analog concentrations (p < 0.05), HC-bound cobalamin (p < 0.005) and total corrinoids bound to HC (p < 0.005). The plasma concentrations of the indicators of cobalamin deficiency, homocysteine (p < 0.05) and methylmalonic acid (p < 0.001), were increased, which could indicate poor cellular penetration of vitamin B12 or a defect in the activation of the two vitamin-B12-dependent enzymes.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Adult; Aged; Biomarkers; Biopsy, Needle; Chronic Disease; Female; Follow-Up Studies; Homocysteine; Humans; Liver Cirrhosis, Alcoholic; Male; Methylmalonic Acid; Middle Aged; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Autoantibodies; Celiac Disease; Chronic Disease; Diarrhea; Folic Acid; Humans; Vitamin B 12

Small intestinal bacterial overgrowth (SIBO) was diagnosed by quantitative bacterial culture of duodenal juice samples obtained endoscopically in 41 of 80 dogs that were admitted with chronic diarrhea, vomiting, or weight loss. Thirteen dogs had aerobic bacterial overgrowth, most frequently comprising Escherichia coli, staphylococci, and enterococci, and 28 dogs had mixed anaerobic overgrowth, most frequently including Clostridium and Bacteroides spp. Affected dogs comprised 23 breeds, including 10 German Shepherd Dogs and median age at diagnosis was 2 years (range, 6 months to 11 years). High serum folate and low serum cobalamin concentrations had fair specificity (79 and 87%, respectively), but low sensitivity (51 and 24%, respectively) in detecting SIBO. Histologic examination of duodenal biopsy specimens did not reveal abnormalities (26/41 dogs), or revealed mild to moderate lymphocytic (12/41) or eosinophilic (2/41) infiltrates, or lymphosarcoma (1/41). Oral antibiotic treatment was effective in 77% (23/30 dogs), but prolonged treatment (> 4 weeks) was required to control signs and prevent recurrence in 50% (15/30). Corticosteroids were used alone in a dog with eosinophilic enteritis and in combination with antibiotics in 4 dogs with marked gastrointestinal lymphocytic/plasmacytic infiltrates. This study suggested that SIBO may be observed in dogs of many breeds, without an obvious primary cause, and that, although results of indirect tests may be suggestive of SIBO, bacterial culture of duodenal juice samples remains necessary for definitive diagnosis.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Biopsy; Chronic Disease; Diarrhea; Diet; Dog Diseases; Dogs; Duodenoscopy; Duodenum; Female; Folic Acid; Follow-Up Studies; Gastrointestinal Diseases; Male; Treatment Outcome; Vitamin B 12

The functional response and phenotypic characterisation of peripheral blood T cells were studied in 41 patients with autoimmune gastritis--nine patients with autoimmune gastritis alone, 11 with untreated pernicious anaemia, and 21 with resolved pernicious anaemia who were taking vitamin B-12. Phenotypic analysis showed no changes in the CD4/CD8 ratio in any group of patients. CD3+ cells were significantly decreased and CD16+ cells were significantly increased in patients with autoimmune gastritis alone. Phytohaemagglutinin induced T cell proliferation, with or without interleukin 2, was reduced in the three groups. T cell proliferation induced by phorbol myristate acetate was normal. Interleukin 2 production of phytohaemagglutinin-stimulated lymphocytes was normal in the three groups. Five patients with pernicious anaemia treated with vitamin B-12 were followed and persistent hypoproliferation of T cells in response to phytohaemagglutinin was observed. The follow up study of the phenotype of these patients showed a significant increase of the CD2+ CD3- lymphocyte population after six months' treatment. In conclusion, the three groups of autoimmune gastritis patients studied have a functional defect in T cells that is independent of B-12 treatment and of the presence of pernicious anaemia.

Topics: Aged; Anemia, Pernicious; Autoimmune Diseases; CD3 Complex; CD4-CD8 Ratio; Chronic Disease; Female; Gastritis; Humans; Lymphocyte Activation; Male; Phenotype; Prospective Studies; Receptors, IgG; T-Lymphocytes; Vitamin B 12

Deficiency of vitamin B12 is commonly reported in HIV-infected patients. We measured vitamin B12 levels in 36 HIV-infected patients with chronic diarrhea (> 3 stools/day for six weeks or more). Eight patients had an identifiable cause of diarrhea. Vitamin B12 levels were low in 39%. Sixteen of these patients were selected to undergo further testing, eight patients with low levels of vitamin B12 and eight with normal B12 levels. These 16 patients had both a stage II Schilling test and measurement of multiple serum D-xylose concentrations performed after both oral and intravenous doses of D-xylose. Integrated areas under the curves (AUC) for D-xylose concentration versus time were calculated for intravenous and oral doses, and D-xylose bioavailability was determined. Stage II Schilling tests were abnormal in 11 patients, (69%). D-Xylose bioavailability correlated closely with vitamin B12 absorption (r = 0.648, P < 0.01). Comparisons of mean values for CD4 count, serum albumin, Karnovsky score, six-month weight loss, 1-hr serum D-xylose levels and MCV failed to reveal a significant difference between those with and without abnormal serum vitamin B12 levels. These data indicate that below-normal levels of vitamin B12 are highly prevalent in HIV-infected patients with chronic diarrhea. Malabsorption of vitamin B12 occurs in the setting of an enteropathic process effecting both the proximal and distal small bowel. Since no risk factors for vitamin B12 deficiency could be identified, screening for vitamin B12 deficiency in HIV-infected patients with chronic diarrhea is strongly recommended.

Topics: Chronic Disease; Diarrhea; HIV Infections; HIV-1; Humans; Intestinal Absorption; Linear Models; Malabsorption Syndromes; Male; Prevalence; Schilling Test; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Serum vitamin B12 levels and unsaturated vitamin B12 binding capacities were measured in 24 patients with multiple sclerosis (MS), 73 patients with other neurological disorders and 21 healthy subjects. There was no decrease in the vitamin B12 levels, however, a significant decrease in the unsaturated vitamin B12 binding capacities was observed in patients with MS when compared with other groups. A massive dose of methyl vitamin B12 (60 mg every day for 6 months) was administered to 6 patients with chronic progressive MS, a disease which usually had a morbid prognosis and widespread demyelination in the central nervous system. Although the motor disability did not improve clinically, the abnormalities in both the visual and brainstem auditory evoked potentials improved more frequently during the therapy than in the pre-treatment period. We therefore consider that a massive dose methyl vitamin B12 therapy may be useful as an adjunct to immunosuppressive treatment for chronic progressive MS.

Topics: Adult; Afferent Pathways; Chronic Disease; Drug Evaluation; Evoked Potentials; Female; Humans; Male; Middle Aged; Motor Neurons; Multiple Sclerosis; Muscular Diseases; Nervous System Diseases; Vitamin B 12

Although vitamin B12 is an essential coenzyme for DNA synthesis, humans, like other mammals, are incapable of synthesizing it. The role of intrinsic factor (IF) in B12 absorption is widely known, but, in fact there exists a much more intricate and complex mechanism for the effective assimilation of this important trace element in humans. B12 binding proteins play important roles in all stages of vitamin B12 metabolism. They are involved not only in its absorption, but also in its transport in serum, uptake to cells, storage in organs, enterohepatic circulation, and elimination of its analogues. Besides IF, well-known as a vitamin B12 binding protein found in gastric juice, there are other kinds of binding proteins found in human serum which are composed to transcobalamin (TC) I, II and III. Elevation of the vitamin B12 level in chronic myelogenous leukemia was first reported in the 1950s. Since then, B12 elevation has been found to occur in other kinds of chronic myeloproliferative disorders (CMPDs) as well and to be caused by an increase of serum TC. In CMPDs, either TCI or TCIII increases, but, the degree of elevation and the type of TC involved differs for each disorder. This article describes the changes in TC of CMPD patients. With the induction of the developed radioimmunoassay for R-type B12 binding protein, many cases have been examined. In addition, detailed qualitative analysis using DEAE cellulose column chromatography has been included for conditions not previously reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Blast Crisis; Chronic Disease; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Myeloproliferative Disorders; Transcobalamins; Vitamin B 12

Topics: Chronic Disease; Follow-Up Studies; Humans; Medical Audit; Vitamin B 12; Vitamin B 12 Deficiency

The haematological status, as well as the fractional absorptions of folic acid (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.7-13.5 years (mean 3.3 years) with chronic diarrhoea due to giardiasis. Small intestinal biopsies revealed mucosal damage in 20 children; the biopsies of the remaining nine children were normal. At the initial investigation the FAFol and FAB12 values were below normal in approximately one-sixth and one-third of patients, respectively. Bacterial overgrowth of the small intestinal tract did not seem to play a role in FAB12 malabsorption. About one-fifth of patients had mild anaemia. None of the patients showed FAB12 insufficiency and only one patient suffered from folate depletion. At follow-up, FAFol, FAB12, haemoglobin and Erc-folate concentrations increased significantly while P-B12 and P-folate remained unchanged. Iron status, as well as dietary intake of iron, appeared insufficient prior to, as well as after treatment. Serum iron, transferrin saturation and haemoglobin concentrations were lower in patients who had acquired the disease abroad or suffered from persistent diarrhoea.

Topics: Child; Child, Preschool; Chronic Disease; Diarrhea; Female; Folic Acid; Follow-Up Studies; Giardiasis; Humans; Infant; Intestinal Absorption; Iron; Iron Deficiencies; Male; Nutritional Requirements; Prospective Studies; Vitamin B 12

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Chronic Disease; Coenzymes; Copper; Copper Sulfate; Drug Therapy, Combination; Female; Humans; Male; Pyelonephritis; Pyridoxal Phosphate; Vitamin B 12; Zinc

Vitamin B12 malabsorption was reported earlier to occur in patients with exocrine pancreatic insufficiency, and pancreatic extracts were shown to improve the absorption of vitamin B12. We investigated serum levels of vitamin B12 and serum folate in patients with chronic pancreatitis and different degrees of pancreatic insufficiency. 137 patients (84 males, 53 females, age 34-72 years) with chronic pancreatitis (C.P.) were included in the study. 123 of 137 (89.8%) patients had a pathologic pancreatic function test result, classified into mild (n = 24), moderate (n = 61) or severe (n = 38) insufficiency. The normal range of serum vitamin B12 and folic acid was established in 58 healthy controls and was found to be 190-1020 pg/ml for serum vitamin B12 and 2.4-16.1 ng/ml for folic acid. 7 patients (5.7%) with C.P. had vitamin B12 serum levels below 190 pg/ml; 4 of these had severe and 3 had mild or moderate exocrine pancreatic insufficiency. However there was no overall correlation between the degree of pancreatic insufficiency and vitamin B12 values. Serum levels of Vitamin B12 were 512 +/- 48 pg/ml in mild, 493 +/- 52 pg/ml in moderate and 428 +/- 45 pg/ml in severe exocrine insufficiency. Serum folic acid below 2.4 ng/ml were present in 5 patients (3.6%). Folic acid serum levels were 8.34 +/- 0.76 ng/ml in mild, 6.34 +/- 0.52 ng/ml in moderate and 7.45 +/- 0.53 ng/ml in severe exocrine insufficiency. We conclude that vitamin B12 deficiency is a rare finding in chronic pancreatitis and does not strictly depend on the degree of exocrine pancreatic insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Chronic Disease; Exocrine Pancreatic Insufficiency; Female; Folic Acid; Folic Acid Deficiency; Humans; Intestinal Absorption; Male; Middle Aged; Pancreatic Function Tests; Pancreatitis; Vitamin B 12; Vitamin B 12 Deficiency

The usefulness of the pancreatic dual-label Schilling test as an indirect test of pancreatic exocrine function was evaluated. This dual-label Schilling test was based on the difference of absorption for [58Co]cobalamin bound to hog R protein and [57Co]cobalamin bound to intrinsic factor. In this study, the test was performed in 7 normal subjects, 5 patients with pancreatectomy, 12 patients with chronic pancreatitis, 10 patients with suspicion of chronic pancreatitis, and 13 patients without chronic pancreatitis. The normal lower limit (mean -2 SD) of excretion ratio for [58Co]/[57Co] in 24-h urine was 0.68. Of the 26 patients on whom endoscopic retrograde pancreatography was performed, none of the 9 patients with normal pancreatogram, 4 of the 9 patients with mild to moderate pancreatitic changes in pancreatogram, and 7 of the 8 patients with advanced pancreatitic changes in pancreatogram showed a positive value lower than the ratio of 0.68 in this test. In 28 patients examined with the direct test of pancreatic secretory capacity, 2 of the 13 patients with normal function, 6 of the 9 patients with mild dysfunction, and 5 of the 6 patients with definite dysfunction were positive in this test. The results of the pancreatic dual-label Schilling test significantly correlated with those of a direct test of pancreatic secretory capacity and the findings of pancreatitic changes in pancreatogram (p less than 0.01, chi 2 test). The ratio for [58Co]/[57Co] correlated (r = 0.73) with the maximal bicarbonate concentration in duodenal juice of the direct test of pancreatic secretory capacity. The impairment of bicarbonate output by the pancreas may adversely affect the transfer of cobalamin from R protein to intrinsic factor. It suggested that the pancreatic dual-label Schilling test is useful for detecting not only patients with severe pancreatic insufficiency but also the relatively early stage of chronic pancreatitis with bicarbonate secretory dysfunction of the pancreas.

Topics: 4-Aminobenzoic Acid; Adult; Animals; Bicarbonates; Cholangiopancreatography, Endoscopic Retrograde; Chronic Disease; Cobalt Radioisotopes; Female; Humans; Hydrogen-Ion Concentration; In Vitro Techniques; Intrinsic Factor; Male; Middle Aged; Nuclear Proteins; Pancreas; Pancreatectomy; Pancreatic Function Tests; Pancreatitis; para-Aminobenzoates; Schilling Test; Swine; Vitamin B 12

To establish the diagnostic safety and the prognosis in outpatients with non-organic upper abdominal pain, 37 patients were followed up 5-7 years after the index investigation. In only one case had the diagnosis been changed during the follow-up period. This was in a man who erroneously had not been examined sufficiently before entry. He turned out to have gallstones. Eighty-one per cent still had abdominal pain, but 51% had improved (P less than 0.005). At the index investigation back pain was reported by 76% and headache by 60%. At the follow-up study back pain was unchanged in severity, but headache was significantly improved. The course of abdominal pain was significantly correlated with the course of back pain and headache. At the index investigation a psychic symptom score indicating vulnerability was significantly higher than in a matched patient group with well-defined pain. It was unchanged high at the follow-up study and unrelated to the course of the abdominal pain. Fifty-four per cent of the patients had symptoms of irritable bowel syndrome, but the course of the abdominal pain was unrelated to this.

Topics: Adult; Amylases; Calcium; Chronic Disease; Female; Folic Acid; Follow-Up Studies; Hemoglobins; Humans; Liver; Male; Middle Aged; Pain; Prognosis; Radiography, Abdominal; Vitamin B 12

Topics: Chronic Disease; Humans; Myeloproliferative Disorders; Transcobalamins; Vitamin B 12

The B12 absorption test (Schilling test) with intrinsic factor was used to examine ileal B12 absorption in 26 patients after allogeneic transplantation. The test was well tolerated and showed a profound fall in B12 absorption, which was maximal at two weeks after transplantation and recovered by eight weeks. The predominant influence on absorption at this stage was probably the conditioning schedule, and the presence of acute graft versus host disease (GVHD) was not associated with a further impairment of absorption. Six patients with chronic GVHD were studied. When compared with nine patients without GVHD there was a significant (p less than 0.005) reduction of B12 absorption. These findings suggest that the B12 absorption test may be a useful non-invasive method of studying bowel function after bone marrow transplantation.

Topics: Adolescent; Adult; Bone Marrow Transplantation; Child; Chronic Disease; Graft vs Host Disease; Humans; Intestinal Absorption; Leukemia; Time Factors; Vitamin B 12

Two patients are described who had evidence of both multiple myeloma and chronic neutrophilic leukaemia at or near the time of presentation. Descriptions of five similar patients were found in the literature supporting an association between the two disorders. This association is further evidence of a link between myeloproliferative and lymphoproliferative disorders. Cobalamin-binding studies of the plasma and neutrophils from one of these patients showed a gross elevation of plasma unsaturated TC I and abnormal neutrophils which contained TC I but not TC III.

Topics: Aged; Carrier Proteins; Chronic Disease; Female; Humans; Leukemia, Myeloid; Middle Aged; Multiple Myeloma; Neoplasms, Multiple Primary; Neutrophils; Vitamin B 12

The intraluminal transport of cobalamin (Cbl) remains controversial in chronic pancreatitis. We have determined the ability of intestinal juice to degrade the digestive holohaptocorrin (R binder) and the binding of endogenous Cbl in basal intestinal juice from 22 chronic pancreatitis patients and 22 controls. The intestinal juice from patients and controls degraded 34.7 +/- 32.3% and 95.2 +/- 7.2% of holohaptocorrin, respectively. This percentage was correlated with the trypsin output but not with the Schilling test. The unsaturated Cbl-binding capacity was similar in both groups. Respectively, 62.5 +/- 26.6% and 19.6 +/- 11.7% of endogenous Cbl was bound to haptocorrin in intestinal juice from patients and controls. These percentages were correlated with the Schilling test and with the ability of intestinal juice to degrade haptocorrin. We concluded that 1) the sequestration of Cbl to haptocorrin is one of the factors responsible for the malabsorption of crystalline Cbl in patients with chronic pancreatitis and 2) enterohepatic circulation of Cbl can be interrupted in some cases of chronic pancreatitis.

Topics: Adult; Aged; Chronic Disease; Chymotrypsin; Corrinoids; Humans; Intestinal Secretions; Intrinsic Factor; Malabsorption Syndromes; Middle Aged; Pancreatitis; Schilling Test; Trypsin; Vitamin B 12

Folate levels of serum and red blood cells (RBC) and vitamin B12 serum levels were investigated in 326 urban chronically ill elderly ambulatory patients and 41 healthy young control subjects. Two laboratory methods were used for investigating the folate levels, the microbiologic assay (MBA) with Lactobacillus casei and radioassay (RA). Serum and RBC samples of 326 patients were tested by the folate MBA and 270 of the same samples by the RIA methods. In the MBA 6.8% of the patients and 12.2% of controls had low levels of folate RBC (less than 200 ng/mL) and 1.8% of patients and 4.8% of controls had low serum folate levels (less than 5 ng/mL). All of the patients with the low folate levels had normal hematologic findings and no clinical symptoms of folate deficiency. In the RIA method, all of the patients and almost all of the control subjects (except one) had normal folate levels. Ten of the patients (3%) had low levels of serum vitamin B12 (less than 200 pg/mL). They were hematologically normal. They had normal Schilling tests and normal vitamin B12 dietary intake. Their RBC folate levels were normal and even somewhat higher. Forty percent of these patients had macular degeneration of the eyes. The data indicate the superiority of the RA method over the MBA and bring into question the accuracy of previous studies. The data furnish further evidence that a low vitamin B12 level in the elderly is not necessarily a true vitamin B12 deficiency and raise the possibility of an association between low B12 serum levels and macular degeneration of the eyes.

Topics: Adult; Aged; Aging; Chronic Disease; Female; Folic Acid; Humans; Male; Middle Aged; Radioimmunoassay; Urban Population; Vitamin B 12

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; Folic Acid; Humans; Liver Diseases; Middle Aged; Radioimmunoassay; Vitamin B 12

In a prospective study, several parameters of small intestinal function have been assessed in 20 patients with chronic relapsing pancreatitis with and without steatorrhoea. By and large all routine parameters of small intestinal function were found to be normal. In particular, neither a previously reported high incidence of lactase deficiency, nor D-xylose malabsorption or vitamin B12 depletion was observed. However, there was a high incidence of abnormal 14C-cholylglycine breath tests (40%), suggesting the presence of mild bacterial overgrowth. Occasionally, this condition was associated with diarrhoea and steatorrhoea, thus indicating that steatorrhoea remaining after high-dosage pancreatin supplementation might sometimes be due to bacterial overgrowth.

Topics: Alcoholism; beta Carotene; Breath Tests; Carotenoids; Chronic Disease; Fats; Feces; Folic Acid; Glycocholic Acid; Humans; Intestinal Absorption; Intestine, Small; Pancreatitis; Prospective Studies; Recurrence; Vitamin B 12

To make a food preparation containing radioactively labelled cobalamins, rabbits were given repeated injections with 57Co-labelled cyanocobalamin. The liver was removed, homogenized, and fried for 1 min or boiled for 30 min. Of the radioactivity in the fried homogenate 41.7% was recovered in the centrifuged supernatant compared with 50.8% in the boiled homogenate. The radioactivity in the supernatants had a molecular size close to that of free 57Co-labelled cyanocobalamin. Forty-two per cent of the radioactivity in the whole homogenate had been incorporated into 5-deoxyadenosyl-, 10% into methyl-, and 16.5% into hydroxy-cobalamin. To assess the validity of a double-isotope method for measuring the intestinal absorption of doses of the 57Co-labelled liver cobalamins, 51CrCl3 was used as a non-absorbable marker. In 14 healthy volunteers the correlation coefficient between the absorption measured by the double-isotope technique and the faecal excretion test was highly significant (r = 0.96, p less than 0.005), and there was only a small variation in the 57Co/51Cr ratio in successive stool collections. In 11 patients with chronic diarrhoea there was a significant correlation between the absorption measured by the double-isotope technique and the faecal excretion test (r = 0.92, p less than 0.005), but in some patients there was considerable variation in the 57Co/51Cr ratio in successive stool collections.

Topics: Adult; Aged; Animals; Chromatography, Gel; Chronic Disease; Cobalt Radioisotopes; Diagnosis, Differential; Diarrhea; Food; Humans; Intestinal Absorption; Intrinsic Factor; Liver; Middle Aged; Molecular Weight; Rabbits; Transcobalamins; Vitamin B 12

The absorption of vitamin B12 and of a synthetic bile acid analogue 75SeHCAT was measured simultaneously in 26 patients presenting with persistent diarrhoea following pelvic irradiation for treatment of carcinoma of the cervix. Four groups were identified, namely patients with isolated bile acid malabsorption, patients with isolated B12 malabsorption, patients with malabsorption of both and those with malabsorption of neither compound. The therapeutic implications are different for each. Measurement of B12 and bile acid absorption comprises an important new test for the management of patients with this disabling and unpleasant complication of radiotherapy.

Topics: Cholestyramine Resin; Chronic Disease; Diagnosis, Differential; Diarrhea; Humans; Intestinal Absorption; Radiation Injuries; Radioisotopes; Selenium; Taurocholic Acid; Vitamin B 12

A follow-up study has been performed on 14 patients, now aged 6-46 years, with Imerslund-Gräsbeck anemia (congenital, hereditary selective malasorption of vitamin B12). On intramuscular vitamin B12 therapy, the patients are clinically and hematologically normal. Those who had constant proteinuria in childhood continue to excrete protein in the urine. Our patients excrete an average of 750 mg of protein per 24 hours (range 13-1460 mg). The proteinuria is predominantly of glomerular origin, but some is also of tubular origin. Renal biopsies of the two oldest patients were normal on light microscopy. Electron microscopy revealed moderate signs of chronic glomerulopathy of mesangioproliferative type in both patients. The renal lesions do not seem to be progressive.

Topics: Adolescent; Adult; Anemia, Macrocytic; Child; Chronic Disease; Female; Follow-Up Studies; Humans; Kidney; Kidney Function Tests; Male; Middle Aged; Prognosis; Proteinuria; Recurrence; Syndrome; Vitamin B 12

The relationship between serum folate level and psychological disturbances was studied in a series of 95 chronic epileptic outpatients. All were nondrinkers. Serum folic acid in all cases and vitamin B12 in 83 cases were determined by radioimmunoassay. Only three factors were significantly related with psychological disturbances: serum levels of folic acid were significantly lower and the mean corpuscular volume of the erythrocytes was significantly higher in disturbed patients, particularly in those with the most severe psychiatric syndromes, and the incidence of disturbances was significantly higher in patients treated with three or more drugs. Conversely, variables such as number or type of seizures, duration of epilepsy, duration of treatment, presence of structural neurological lesions, previous mental retardation, or focal temporal lobe disturbances in the EEG did not show any statistical relationship to the presence of psychological disturbances. No relevant relationship was found between serum vitamin B12 and psychological disturbances.

Topics: Adolescent; Adult; Aged; Child; Chronic Disease; Epilepsy; Female; Folic Acid; Humans; Male; Mental Disorders; Middle Aged; Vitamin B 12

Quantitative and qualitative bacteriological studies were performed on duodenal juice from 19 dogs with chronic small intestinal disease. Bacterial overgrowth was demonstrated in seven German shepherd dogs with minimal histological but specific biochemical abnormalities in the jejunal mucosa. Most frequently this overgrowth comprised bacteria of the normal flora, particularly Escherichia coli and enterococci, but these were occasionally accompanied by bacteria rarely present in the proximal small intestine of the normal dog, particularly Clostridium species. In most cases this overgrowth was associated with raised serum folate and reduced serum vitamin B12 concentrations, a finding consistent with the capacity of many enteric bacteria to synthesise folate and bind vitamin B12.

Topics: Animals; Bacteria; Chronic Disease; Dog Diseases; Dogs; Duodenum; Enteritis; Female; Folic Acid; Intestinal Diseases; Intestinal Secretions; Intestine, Small; Male; Species Specificity; Vitamin B 12

Typical features on the blood smear suggest the diagnosis in some types of anemia, such as the common microcytic anemias, megaloblastic anemias, and certain hemolytic anemias. Some laboratory tests used in anemia, particularly measurement of serum vitamin B12 and folate levels, may present problems in interpretation, which must be recognized if diagnostic errors are to be avoided. Normocytic anemias that are nonhemolytic, have no obvious cause, and are characterized by marked red cell changes on the blood smear should prompt careful investigation for malignancy or marrow fibrosis. Anemias are often multifactorial, and the diagnosis must be reevaluated after the apparent contributing causes have been treated. A number of "danger signs" in a patient with anemia point to the need for hematologic consultation.

Topics: Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Bone Marrow Examination; Chronic Disease; Diagnosis, Differential; Folic Acid; Humans; Thalassemia; Vitamin B 12

Topics: Aged; Anemia, Pernicious; Chronic Disease; Humans; Male; Vitamin B 12; Vitamin B 12 Deficiency

Serum B12 and erythrocyte folate were measured in 16 non-dialysed uraemic patients, 28 peritoneal dialysed patients, 28 haemodialysed patients, 14 renal transplanted patients with normal renal function and 49 healthy control subjects. Serum B12 values in non-dialysed uraemic patients were higher than in control subjects (P less than 0.01). Serum B12 values in peritoneal dialysed, haemodialysed and transplanted patients were not significantly different from the control group. Erythrocyte folate values in non-dialysed uraemic patients were lower than in controls (P less than 0.03), but all subjects had values within the normal range. Erythrocyte folate values in peritoneal dialysed, haemodialysed and renal transplanted patients were not significantly different from the control group, although 2 peritoneal and 6 haemodialysed patients had subnormal values. Blood and bone marrow examination, performed in 64 patients, demonstrated no megaloblastic changes.

Topics: Adolescent; Adult; Child; Chronic Disease; Erythrocytes; Female; Folic Acid; Humans; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Renal Dialysis; Transplantation, Homologous; Uremia; Vitamin B 12

Topics: Antibodies, Antinuclear; Bone Marrow; Chronic Disease; Cytodiagnosis; Female; Humans; Leukemia; Middle Aged; Myeloproliferative Disorders; Neutrophils; Vitamin B 12

36% of a total of chronic liver patients suffered from anaemia and 50.5% of patients affected with liver cirrhosis. In most cases the anaemias were normochrome and hypochrome or hyperchrome only in some cases. In analyzing possible single factors the reductions of vitamin B12 absorption could be made probable by means of the Schilling test and sometimes a folic acid deficiency in macrocyte anaemia with normal vitamin B12 absorption by determining the folic acid content in the serum and by successes of test treatment 82% of patients with liver cirrhosis showed a latent or manifest haemolysis. However, it was only in 1/3 of the patients with liver cirrhosis that the spleen turned out to be the place of an increased degradation of erythrocytes. In some cases an increased erythrocytoclasia into the liver could be identified. Predominantly, however, an increased degradation of erythrocytes in the total RHS had to be assumed. Twice an ineffective erythropoiesis could be found by ferrokinetic examinations. As a whole ferrokinetic examinations cannot be interpreted easily, because their static and dynamic values of iron transport in the plasma volume of liver patients will undergo considerable changes. Patients with disturbances of haematopoiesis and with haemolysis remaining in the latent stage may develop a manifest anaemia because of the influence of additional factors, such as increase of the plasma volume at lowered haematocrit value or microbleedings. The cause of anaemia cannot be concluded with sufficient probability from the type of anaemia; in a single case all pathogenetic factors will rather have to be analyzed. Therapeutic possibilities for hepatogenous anaemia of complex genesis are discussed.

Topics: Adult; Anemia; Chronic Disease; Erythrocyte Count; Erythrocyte Volume; Folic Acid; Hematocrit; Humans; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Neoplasm Metastasis; Vitamin B 12

Topics: Age Factors; Aged; Chronic Disease; Denmark; Folic Acid; Folic Acid Deficiency; Humans; Long-Term Care; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Aplastic; Anemia, Sideroblastic; Arginine; Chronic Disease; Erythroblasts; Esterases; Glycogen; Histones; Humans; Iron; Leukemia, Erythroblastic, Acute; Methyltransferases; Vitamin B 12

Topics: Adolescent; Adult; Aged; Chronic Disease; Dietary Fats; Female; Folic Acid; Heart Failure; Humans; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12; Xylose

Topics: Adrenal Cortex Hormones; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Phenobarbital; Spironolactone; Vitamin B 12

Topics: Adult; Aged; Blood Proteins; Chronic Disease; Humans; Liver Diseases; Middle Aged; Vitamin B 12

The presence of several serum protein abnormalities in Gaucher's disease prompted a study of vitamin B12 binding proteins, in which 14 of 15 consecutive patients displayed increased circulating transcobalamin II unassociated with elevations of serum vitamin B12 or other vitamin B12 binders. Transcobalamin II levels were most significantly increased in nine patients with disease severe enough to require splenectomy (P less than 0.01), but were not correlated with liver size or levels of any other laboratory feature of Gaucher's disease studied. Splenectomy, per se, did not alter circulating transcobalamin II. Chracterization of the binder in Gaucher's disease revealed identity with normal serum transcobalamin II in acid inhibition of vitamin B12 binding, chromatographic behavior, immunologic specificity and functional integrity in vitamin B12 delivery. This observation suggests a relation between reticuloendothelial-cell activity and transcobalamin II metabolism. Elevated transcobalamin II levels may provide an additional means for diagnosis and assessment of Gaucher's disease.

Topics: Adolescent; Adult; Blood Proteins; Chronic Disease; Epitopes; Gaucher Disease; Humans; Middle Aged; Mononuclear Phagocyte System; Protein Binding; Splenectomy; Transcobalamins; Vitamin B 12

Topics: Adult; Aged; Amino Acids; Chronic Disease; Drug Combinations; Fatty Liver; Female; Folic Acid; Hepatitis; Humans; Male; Middle Aged; Niacinamide; Vitamin B 12

Three cases of congenital selective malabsorption of vitamin B12 (Imerslund-Grasbeck syndrome) are presented. Pathophysiological aspected and clinical symptoms of this disease are discussed together with other megaloblastic anaemias in childhood caused by vitamin B12 deficiency.

Topics: Anemia, Macrocytic; Anemia, Megaloblastic; Chronic Disease; Female; Humans; Infant; Intestinal Absorption; Recurrence; Syndrome; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acute Disease; Chronic Disease; Female; Humans; Male; Pancreatitis; Vitamin B 12

Topics: Adult; Aged; Arthritis, Rheumatoid; Chronic Disease; Female; Humans; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Macrocytic; Biopsy; Chronic Disease; Humans; Infant; Intestinal Mucosa; Intestine, Small; Malabsorption Syndromes; Male; Syndrome; Vitamin B 12

Topics: Adult; Chronic Disease; Female; Hepatitis; Humans; Intestinal Absorption; Liver Cirrhosis; Vitamin B 12

The mean absorption of vitamin B12 (Schilling test) was 13.1 +/- 1.0 (% +/- S.E.M.) in 21 patients with chronic pancreatic insufficiency and 17.6 +/- 1.4 in 13 control patients (p less than 0.01). There was no correlation between pancreatic bicarbonate production after secretion stimulation and vitamin B12 absorption in the patient group (r = 0.117). Human duodenal juice reduced the uptake of 57CoB12-rat intrinsic factor (IF) by perfused rat small intestinal segments in vivo (p less than 0.01) as well as the uptake of 57CoB12-human IF by purified guinea-pig intestinal brush borders in vitro (p less than 0.01). The results confirm reduced absorption of vitamin B12 in chronic pancreatic insufficiency, but the mechanism remains uncertain.

Topics: Adolescent; Adult; Aged; Animals; Bicarbonates; Chronic Disease; Duodenum; Female; Guinea Pigs; Hot Temperature; Humans; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Male; Middle Aged; Pancreatic Diseases; Pancreatic Juice; Rats; Schilling Test; Vitamin B 12

Topics: Adolescent; Age Factors; Child; Child, Preschool; Chronic Disease; Female; Hepatitis; Humans; Infant; Male; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Female; Humans; Male; Middle Aged; Pancreatitis; Vitamin B 12

Topics: Aged; Anemia, Megaloblastic; Chronic Disease; Female; Humans; Male; Middle Aged; Myeloproliferative Disorders; Polycythemia; Vitamin B 12

Topics: Adolescent; Anemia, Macrocytic; Chronic Disease; Female; Humans; Recurrence; Syndrome; Vitamin B 12

Topics: Adolescent; Child; Child, Preschool; Cholecalciferol; Chronic Disease; gamma-Globulins; Humans; Infant; Infant Nutritional Physiological Phenomena; Nutrition Disorders; Vitamin A; Vitamin B 12

Topics: Alcohol Oxidoreductases; Alcoholism; Chronic Disease; Diet Therapy; Digestive System; Dose-Response Relationship, Drug; Ethanol; Folic Acid; Gastrointestinal Motility; Humans; Intestinal Absorption; Intestines; Malabsorption Syndromes; Methionine; Nutrition Disorders; Thiamine; Vitamin B 12; Xylose

Topics: Adult; Alcoholism; Biological Transport, Active; Chronic Disease; Cobalt Radioisotopes; Diet Therapy; Dose-Response Relationship, Drug; Ethanol; Humans; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Lipid Metabolism; Malabsorption Syndromes; Male; Middle Aged; Nutrition Disorders; Pancreatin; Vitamin B 12; Vitamins; Xylose

Topics: Alcoholism; Chronic Disease; Diet Therapy; Enzyme Inhibitors; Erythrocytes; Ethanol; Female; Folic Acid; Humans; Iron; Male; Nutrition Disorders; Phosphotransferases; Pyridoxal Phosphate; Pyridoxine; Vitamin B 12; Vitamin B 6 Deficiency

New tests and test methods aid in the diagnosis of pancreatic disorders. Pancreatic carcinoma, especially, may have an improved prognosis with earlier detection as a result of refinements in arteriography, cytology, pancreatic radioisotopic scanning, and endoscopic retrograde cholangiopancreatography. Acute pancreatitis results most commonly from alcoholism, biliary tract disease, and trauma. Management is directed primarily at decreasing pancreatic exocrine secretion. Surgery is usually best avoided in the acute phase. Chronic pancreatitis is most often a result of recurrent attacks of acute pancreatitis. Diabetes and malassimilation become manifest as pancreatic destruction progresses. Management consists of replacement of pancreatic enzymes and diet supplements. Once chronic pancreatitis is established, surgery can only be directed at complications of the disease. Pancreatic ascites is usually associated with a break in the pancreatic ductal system. Ascites caused by trauma responds well to surgical intervention, but the alcoholic type is less amenable to treatment.

Topics: Acute Disease; Alcoholism; Antacids; Ascites; Carcinoembryonic Antigen; Cholangiography; Chronic Disease; Cysts; Diabetes Mellitus; Diet Therapy; Endoscopy; Gastrointestinal Hemorrhage; Humans; Metabolic Diseases; Methionine; Pancreatic Diseases; Pancreatic Juice; Pancreatic Neoplasms; Pancreatin; Pancreatitis; Prognosis; Selenium; Ultrasonics; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Megaloblastic; Child; Chronic Disease; Follow-Up Studies; Humans; Male; Recurrence; Syndrome; Vitamin B 12

The occurrence of anemia in a group of aged persons residing in a home for the aged and in a chronic disease hospital was reviewed with regard to etiology, choice of treatment, and therapeutic response. Of the 484 patients, 151 (31 per cent) had anemia or were receiving antianemia therapy. Iron-deficiency anemia was the most common type, and iron was the most common form of treatment. Seventy-eight patients were given antianemia therapy in 97 courses, and a good therapeutic result was achieved in about one-fourth of the courses. The most frequent error in iron therapy was its use in the anemia associated with chronic disorders. Often there was a combination deficiency of iron, vitamin B12 and folic acid. The response to iron in the elderly can be very slow, so therapy should not be discontinued too soon. Anemia may directly contribute to other serious pathologic conditions, especially in aged persons with impaired circulation. In some cases the physiologic concentration of hemoglobin may be higher than the accepted "normal" value. The course of the anemia in relation to the general state of the patient is more significant than any laboratory data in choosing antianemia therapy. Practical laboratory screening procedures for elderly anemic patients are discussed.

Topics: Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Male; Vitamin B 12

Steatorrhea due to chronic pancreatitis was found in 23 percent of a consecutive series of 107 new african diabetics; 3 had pancreatic calcification. Of 16, 14 had definitely abnormal exocirne secretion function testing using secreation pancreozymin stimultion. Themorphology and function of the small intestine were normal by local standards. When compared with diabetics without steatorrhea they weighed less, their fasting blood sugars were lower, and their insulin requirements were greater. High alcoholic intake might be significant cause, but the incidence was similar in the diabetics without steatorrhea. No evidence of childhood or adult malnutrition was established. The etiology of this high incidence of chronic pancreatitis among african diabetics remains unexplained.

Topics: Adult; Amylases; Bicarbonates; Calcinosis; Celiac Disease; Chronic Disease; Diabetes Complications; Duodenum; Feces; Female; Humans; Intestinal Absorption; Jejunum; Male; Middle Aged; Pancreatitis; Prospective Studies; Proteins; Vitamin B 12; Xylose; Zimbabwe

Topics: Anemia, Pernicious; Bipolar Disorder; Chronic Disease; Depression; Gastrointestinal Diseases; Humans; Malabsorption Syndromes; Psychosurgery; Psychotic Disorders; Schizophrenia; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6 Deficiency

Topics: Acute Disease; Chronic Disease; Diagnosis, Differential; Female; Galactose; Hepatitis; Humans; Liver Cirrhosis; Male; Prognosis; Vitamin B 12

Topics: Alcoholism; Chronic Disease; Humans; Vitamin B 12

Topics: Alcoholism; Bone Marrow; Chronic Disease; Erythrocytes, Abnormal; Humans; Vitamin B 12

Topics: Adrenal Cortex Hormones; Azathioprine; Chronic Disease; Diet Therapy; Hepatitis; Humans; Lipotropic Agents; Prednisolone; Vitamin B 12; Vitamin K

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Anti-Bacterial Agents; Arteriosclerosis; Basilar Artery; Cerebrovascular Disorders; Chronic Disease; Deoxyribonucleases; Diabetic Neuropathies; Diuretics; Facial Nerve; Facial Paralysis; Female; Herpes Zoster; Humans; Hypertension; Ischemia; Male; Middle Aged; Physical Therapy Modalities; Prednisolone; Recurrence; Tonsillitis; Vertebral Artery; Vitamin B 12

Topics: Administration, Oral; Adult; Anemia; Chronic Disease; Female; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Pancreatitis; Schilling Test; Trypsin; Vitamin B 12

Topics: Adult; Antibody Formation; Biopsy; Blood Donors; Carrier State; Chronic Disease; Hepatitis B; Hepatitis B Antigens; Humans; Iron; Liver; Male; Transaminases; Vitamin B 12

Topics: Adult; Chronic Disease; Female; Humans; Lipids; Male; Middle Aged; Trinitrotoluene; Vitamin B 12

Topics: Adolescent; Adult; Amylases; Bicarbonates; Cholecystokinin; Chronic Disease; Chymotrypsin; Clinical Enzyme Tests; Cobalt Radioisotopes; Diabetes Mellitus, Type 1; Female; Humans; Injections, Intravenous; Lipase; Male; Pancreatic Diseases; Pancreatitis; Proteins; Secretin; Trypsin; Vitamin B 12

Topics: Body Fluids; Chronic Disease; Chymotrypsin; Cobalt Radioisotopes; Duodenum; Humans; Intestinal Absorption; Pancreatitis; Trypsin; Vitamin B 12

Topics: Adult; Amylases; Bicarbonates; Cholecystokinin; Chronic Disease; Chymotrypsin; Cobalt Radioisotopes; Depression, Chemical; Duodenum; Female; Gastric Juice; Humans; Male; Pancreas; Pancreatitis; Secretin; Stimulation, Chemical; Time Factors; Trypsin; Vitamin B 12

Topics: Adult; Anemia; Biopsy; Blind Loop Syndrome; Chronic Disease; Diarrhea; Gastrointestinal Hemorrhage; Humans; Intestinal Absorption; Intestinal Mucosa; Malabsorption Syndromes; Male; Radiography; Ulcer; Vitamin B 12

Topics: Animals; Blood Proteins; Carrier Proteins; Chromatography, Paper; Chronic Disease; Hepatitis; Humans; Leukemia, Myeloid; Male; Rats; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Chronic Disease; Female; Humans; Infant, Newborn; Leukemia, Myeloid; Male; Maternal-Fetal Exchange; Multiple Myeloma; Myeloproliferative Disorders; Placenta; Polycythemia Vera; Pregnancy; Primary Myelofibrosis; Vitamin B 12

Topics: Chronic Disease; Fatty Liver; Hepatitis; Humans; Intestinal Absorption; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Radioimmunoassay; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Alpha-Globulins; Beta-Globulins; Blood Proteins; Child, Preschool; Chronic Disease; Female; Fever of Unknown Origin; Hodgkin Disease; Humans; Infections; Leukocyte Count; Leukocytosis; Liver Neoplasms; Lymphoma; Male; Middle Aged; Neoplasm Metastasis; Neoplasms; Protein Binding; Splenectomy; Vitamin B 12

Topics: Bicarbonates; Chronic Disease; Cobalt Isotopes; Fasting; Food; Humans; Intestinal Absorption; Malabsorption Syndromes; Pancreatic Juice; Pancreatitis; Sodium; Vitamin B 12; Whole-Body Counting

Topics: Anemia; Arthritis, Rheumatoid; Blood Proteins; Bone Marrow; Bone Marrow Cells; Chronic Disease; Erythropoietin; gamma-Globulins; Hematocrit; Humans; Infections; Iron; Neoplasms; Protein Biosynthesis; Serum Albumin; Transferrin; Vitamin B 12

Topics: Acute Disease; Amino Acids; Aprotinin; Calcium; Chronic Disease; Humans; Pancreatitis; Vitamin B 12

Topics: Alcoholism; Cholecystectomy; Chronic Disease; Diabetes Mellitus; Gastrectomy; Hepatitis; Hepatitis A; Humans; Liver; Liver Cirrhosis; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Child; Child, Preschool; Chronic Disease; Diarrhea; Duodenal Ulcer; Female; Humans; Iron; Italy; Liver Extracts; Male; Menorrhagia; Menstruation; Metrorrhagia; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Stomach Ulcer; Vitamin B 12

Topics: Adult; Aged; Chronic Disease; Female; Hepatitis; Humans; Intestinal Absorption; Liver Cirrhosis; Male; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Anemia; Asthenia; Body Weight; Cachexia; Chronic Disease; Cytidine; Diabetes Complications; Female; Heart Diseases; Humans; Hyperthyroidism; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Uridine; Vitamin B 12

Topics: Acute Disease; Adult; Aged; Alanine Transaminase; Alkaline Phosphatase; Amino Acids; Aspartate Aminotransferases; Bilirubin; Body Weight; Chronic Disease; Citric Acid Cycle; Drug Combinations; Evaluation Studies as Topic; Female; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Vitamin B 12

Topics: Biopsy; Celiac Disease; Chronic Disease; Fatty Acids; Feces; Humans; Intestinal Absorption; Intestinal Diseases; Iron; Jejunum; Lipids; Malabsorption Syndromes; Vitamin B 12

Topics: Carbon Isotopes; Chronic Disease; Cobalt Isotopes; Female; Gastrectomy; Humans; Intestinal Diseases; Iron; Malabsorption Syndromes; Male; Radiometry; Vitamin B 12

Topics: Adolescent; Adult; Aged; Alcoholism; Chronic Disease; Humans; Intestinal Absorption; Male; Middle Aged; Vitamin B 12; Xylose

An investigation of 102 men comprising alcoholics, patients with non-ulcer dyspepsia, and healthy controls is reported. It demonstrates that alcohol is a cause of chronic gastritis and the severity of the mucosal lesion is directly related to the duration of excess drinking. Contrary to popular belief, chronic gastritis does not give rise to symptoms. The effect of alcohol on the gastric mucosa is a direct one and is not mediated by malnutrition, hepatic damage, intestinal malabsorption, anaemia, ascorbic acid deficiency, or any disturbance in immune tolerance. The natural history of chronic gastritis is described, involving an initial hypertrophy and hyperfunction of the gastric mucosa, followed by atrophy and hypofunction. Cigarette smoking is confirmed as another cause of chronic gastritis. The non-ulcer dyspepsia syndrome is unrelated to chronic gastritis.

Topics: Adolescent; Adult; Alcoholism; Atrophy; Chronic Disease; Dyspepsia; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Hypertrophy; Male; Middle Aged; Nutrition Disorders; Radiography; Smoking; Time Factors; Vitamin B 12

Topics: Bilirubin; Cholinesterases; Chronic Disease; Folic Acid; gamma-Globulins; Hepatitis; Humans; Liver Cirrhosis; Methionine; Niacinamide; Nucleosides; Riboflavin; Serum Albumin; Vitamin B 12

Intestinal function was studied in 26 patients with seven types of acute and chronic liver disease, documented by liver biopsy. Steatorrhea, defined by a stool fat higher than 6 g. per day, was present in 18 of 23 consecutive patients studied, an incidence of 78.3%. Two patients with infectious hepatitis associated with steatorrhea studied previously were added and the 20 cases were analyzed. The malabsorption found was confined to fat and fat-soluble vitamins; stool excretion varied from 6.1 to 22 g. per day in the seven groups studied. No histological abnormality was seen on jejunal biopsy, serum vitamin B(12), D-xylose and Schilling tests were normal, and no radiological findings associated with malabsorption were detected in the small bowel. It is concluded that steatorrhea is a common finding in a wide variety of acute and chronic liver diseases and cannot be attributed to a primary defect of the small bowel.

Topics: Acute Disease; Adolescent; Adult; Alkaline Phosphatase; Aspartate Aminotransferases; Bilirubin; Celiac Disease; Chromatography, Thin Layer; Chronic Disease; Diagnosis, Differential; Female; Hepatitis A; Humans; Intestinal Absorption; Intestine, Small; Liver Diseases; Liver Function Tests; Malabsorption Syndromes; Male; Middle Aged; Pancreatitis; Vitamin B 12

Topics: Alkaline Phosphatase; Anabolic Agents; Antimetabolites; Chronic Disease; Diet Therapy; Glucocorticoids; Hepatitis; Humans; Immunosuppressive Agents; Liver Extracts; Transaminases; Vitamin B 12

Topics: Agranulocytosis; Anemia, Aplastic; Anemia, Macrocytic; Bone Marrow; Chronic Disease; Folic Acid; Humans; Leukemia, Myeloid; Leukocyte Count; Leukocytes; Muramidase; Myeloproliferative Disorders; Neutrophils; Polycythemia Vera; Protein Binding; Vitamin B 12

Topics: Administration, Oral; Antibodies; Bacteria; Calcium; Chronic Disease; Cobalt Isotopes; Feces; Hemoglobins; Humans; Hydrogen-Ion Concentration; Ileum; Intestinal Absorption; Intestinal Secretions; Intrinsic Factor; Jejunum; Lipid Metabolism; Lipids; Malabsorption Syndromes; Pancreas; Pancreatic Diseases; Pancreatic Extracts; Vitamin B 12

Fasting gastrin levels in serum were measured in 49 patients with different types of chronic gastritis and in matched controls. In 15 patients with established pernicious anaemia the mean (+/- S.E. of mean) level of gastrin was greatly raised (699 +/- 99 pg/ml). In 17 patients with chronic atrophic gastritis, seropositive for parietal cell antibody but with adequate vitamin-B(12) absorption, the level was also raised (476 +/- 74 pg/ml). By contrast, in "simple" atrophic gastritis seronegative for parietal cell antibody the gastrin levels were significantly lower for both diffuse atrophic gastritis (129 +/- 31 pg/ml) and multifocal gastritis (14 +/- 4 pg/ml). These levels were similar to those in the controls (46 +/- 7 pg/ml).The mechanism of the raised gastrin levels remains uncertain, but neither achlorhydria nor in vivo action of the parietal cell antibody wholly accounted for the hypergastrinaemia.We conclude that hypergastrinaemia is characteristic of gastritis associated with autoimmune reactions to gastric antigens and pernicious anaemia and that a raised serum gastrin is a useful marker of the type of gastritis that tends to progress to the gastric lesion of pernicious anaemia. The findings suggest that this type of gastritis is an essentially different disease from "simple" atrophic gastritis, and the differences in gastrin levels may be due to sparing of the antral mucosa in the autoimmune type but not in "simple" gastritis.

Topics: Achlorhydria; Aged; Anemia, Pernicious; Antibodies; Antigens; Autoimmune Diseases; Chronic Disease; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Sickle Cell; Anemia, Sideroblastic; Blood Cell Count; Blood Platelets; Child; Chronic Disease; Erythrocyte Count; Erythrocytes; FIGLU Test; Folic Acid; Folic Acid Deficiency; Humans; Leukocyte Count; Vitamin B 12

Topics: Adult; Celiac Disease; Chronic Disease; Diet Therapy; Duodenum; Escherichia coli; Fats; Female; Folic Acid; Humans; Ileum; Intestinal Absorption; Jejunum; Male; Middle Aged; Neomycin; Nutrition Disorders; Protein Deficiency; Stomach; Tetracycline; Vitamin B 12; Xylose

Topics: Aged; Chronic Disease; Cobalt Isotopes; Duodenal Ulcer; Female; Follow-Up Studies; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Histamine; Humans; Male; Middle Aged; Radiation Effects; Radiotherapy; Stomach; Time Factors; Vitamin B 12

Topics: Adult; Aged; Antidepressive Agents; Barbiturates; Chronic Disease; Epilepsy; Female; Folic Acid; Folic Acid Deficiency; Hematologic Diseases; Humans; Male; Middle Aged; Neurocognitive Disorders; Phenothiazines; Schizophrenia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adrenal Cortex Hormones; Anabolic Agents; Chronic Disease; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Prednisolone; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Acute Disease; Chronic Disease; Coenzymes; Folic Acid; Hepatitis; Histidine; Humans; Liver Cirrhosis; Liver Diseases; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Vitamin B 12

Topics: Blood Cell Count; Bone Marrow; Chronic Disease; Hematopoiesis; Humans; Liver; Liver Diseases; Liver Extracts; Liver Function Tests; Nucleosides; Vitamin B 12

Topics: Acid Phosphatase; Adolescent; Adult; Alkaline Phosphatase; Blood Proteins; Chronic Disease; Depression, Chemical; Diet Therapy; Female; Hepatitis; Hepatolenticular Degeneration; Histocytochemistry; Humans; Iron; Lipase; Liver; Liver Cirrhosis; Liver Function Tests; Male; Penicillamine; Potassium; Pyridoxine; Radionuclide Imaging; Stimulation, Chemical; Sulfides; Vitamin B 12

Topics: Anabolic Agents; Body Weight; Calorimetry; Chronic Disease; Depression, Chemical; Diet Therapy; Feces; Food Analysis; Humans; Liver Cirrhosis; Liver Diseases; Nitrogen; Prednisone; Proteins; Pyridoxine; Vitamin B 12

Topics: Autoantibodies; Autoimmune Diseases; Chronic Disease; Female; Gastric Juice; Humans; Intestinal Absorption; Intrinsic Factor; Middle Aged; Purpura, Thrombocytopenic; Thyroid Gland; Vitamin B 12

Topics: Adult; Chronic Disease; Cyanides; Female; Food Analysis; Humans; Male; Nervous System Diseases; Optic Atrophy; Smoking; Vitamin B 12

Topics: Adult; Chronic Disease; Crohn Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; Ileum; Intestinal Mucosa; Male; Middle Aged; Polyps; Stomach; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Age Factors; Arthritis, Rheumatoid; Chronic Disease; Erythrocyte Aging; Hematologic Diseases; Humans; Reticulocytes; Sex Factors; Vitamin B 12

Topics: Animals; Aspartic Acid; Carbon Tetrachloride Poisoning; Chronic Disease; Cobalt Isotopes; Kidney; Liver; Rats; Vitamin B 12

Topics: Chronic Disease; Humans; Liver Diseases; Vitamin B 12; Vitamins

Topics: Adult; Age Factors; Aged; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Blood Proteins; Chronic Disease; Female; Folic Acid; Hematocrit; Hemoglobinometry; Humans; Iron; Male; Middle Aged; Protein Deficiency; Pyridoxine; Serum Albumin; Serum Globulins; Sex Factors; Thiamine; Vitamin B 12; Vitamins

Topics: Alcoholism; Chronic Disease; Dietary Fats; Feces; Gastric Acidity Determination; Histamine; Humans; Intestinal Absorption; Malabsorption Syndromes; Male; Nitrogen; Vitamin B 12; Xylose

Topics: Adult; Aged; Barbiturates; Chronic Disease; Female; Folic Acid; Hematologic Diseases; Humans; Male; Mental Disorders; Middle Aged; Nutritional Physiological Phenomena; Phenothiazines; Pregnancy; Vitamin B 12

Topics: Acute Disease; Chronic Disease; Female; Hepatitis; Hepatitis A; Humans; Male; Vitamin B 12

Topics: Aged; Choline; Chronic Disease; Homocysteine; Humans; Liver; Vitamin B 12

Topics: Blood Proteins; Cachexia; Chronic Disease; Humans; Kidney Diseases; Liver Diseases; Liver Extracts; Neoplasms; Vitamin B 12

Topics: Adolescent; Adult; Aged; Alkaline Phosphatase; Bone Marrow Diseases; Chromosome Aberrations; Chromosome Disorders; Chromosomes, Human, 1-3; Chromosomes, Human, 13-15; Chromosomes, Human, 4-5; Chronic Disease; Diagnosis, Differential; Female; Hemorrhage; Hemostasis; Hepatomegaly; Humans; Leukemia, Myeloid; Leukocytes; Male; Megakaryocytes; Middle Aged; Myeloproliferative Disorders; Polycythemia Vera; Primary Myelofibrosis; Splenomegaly; Thrombocytosis; Vitamin B 12

Topics: Choline; Chronic Disease; Folic Acid; Hepatitis; Humans; Liver Cirrhosis; Orotic Acid; Thioctic Acid; Vitamin B 12

Topics: Acute Disease; Adrenal Cortex Hormones; Cholestyramine Resin; Chronic Disease; Diet Therapy; Hepatitis; Humans; Liver; Liver Cirrhosis; Long-Term Care; Organotherapy; Tissue Extracts; Vitamin B 12

Topics: Anemia, Macrocytic; Anti-Bacterial Agents; Bile Acids and Salts; Biopsy; Chronic Disease; Cobalt Isotopes; Fats; Feces; Folic Acid; Hemoglobinometry; Humans; Indican; Intestinal Diseases; Intestinal Secretions; Intestine, Small; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Time Factors; Vitamin B 12; Xylose

Topics: Biopsy; Chronic Disease; Cobalt Isotopes; Diarrhea; Dietary Proteins; Fats; Feces; Folic Acid; Humans; Ileum; India; Intestinal Mucosa; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Tropical Climate; Vitamin B 12; Xylose

Topics: Cholestasis; Chronic Disease; Fatty Liver; FIGLU Test; Folic Acid; Hepatitis A; Histidine; Humans; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Aged; Anemia; Bilirubin; Blood Cell Count; Cholesterol; Chronic Disease; Humans; Liver Diseases; Liver Extracts; Liver Function Tests; Middle Aged; Nitrogen; Nucleosides; Transaminases; Vitamin B 12; Vitamin B Complex

Topics: Chronic Disease; Cobalt Isotopes; Hepatitis; Humans; Injections, Intramuscular; Injections, Intravenous; Intestine, Small; Liver; Liver Cirrhosis; Myocardium; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia; Child; Cholesterol; Chronic Disease; Coronary Disease; Female; Humans; Lipids; Male; Middle Aged; Phospholipids; Splenectomy; Triglycerides; Vitamin B 12

Topics: Adenosine Triphosphate; Adrenocorticotropic Hormone; Adult; Ascorbic Acid; Chronic Disease; Female; Humans; Injections, Intravenous; Isoniazid; Male; Middle Aged; Pyridoxine; Streptomycin; Thiamine; Tuberculosis, Pulmonary; Vitamin B 12; Vitamins

Topics: Cholagogues and Choleretics; Chronic Disease; Folic Acid; Humans; Liver Diseases; Liver Extracts; Nicotinic Acids; Vitamin B 12

Topics: Anemia; Blood Protein Electrophoresis; Blood Proteins; Chronic Disease; Hepatitis; Humans; Leukemia; Vitamin B 12

Topics: Adult; Aged; Chronic Disease; Female; Gastric Acidity Determination; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Topics: Aged; Chronic Disease; Complement System Proteins; Female; Humans; Immunity; Leukemia, Lymphoid; Leukocytes; Lymphatic Diseases; Lymphatic System; Properdin; Vitamin B 12

Topics: Biliary Tract Diseases; Chemical and Drug Induced Liver Injury; Chronic Disease; Fatty Liver; Health Resorts; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Vitamin B 12

Topics: Adolescent; Chronic Disease; Fatty Liver; Female; Folic Acid; Hepatitis; Hepatitis A; Humans; Liver Cirrhosis; Middle Aged; Vitamin B 12

Topics: Ascorbic Acid; Chronic Disease; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Niacinamide; Pyridoxine; Riboflavin; Thiamine; Tryptophan; Vitamin B 12; Vitamin B 6 Deficiency; Vitamins

Topics: Anemia, Pernicious; Chronic Disease; Cobalt Isotopes; Glycoproteins; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Multiple Sclerosis; Polycythemia; Vitamin B 12

Topics: Chronic Disease; Folic Acid; Humans; Liver Diseases; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Autoimmune Diseases; Blood Group Antigens; Chronic Disease; Diabetes Complications; Female; Humans; Male; Middle Aged; Thyroid Diseases; Vitamin B 12

Topics: Ascorbic Acid; Carbon Tetrachloride; Chronic Disease; Folic Acid; Humans; Liver Diseases; Niacinamide; Vitamin B 12; Vitamin K; Vitamins

Topics: Anemia; Child; Chronic Disease; Cobalt; Humans; Infant; Propionates; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Chronic Disease; Corrinoids; Folic Acid; Hematinics; Humans; Recurrence; Vitamin B 12

Topics: Blood; Chronic Disease; Corrinoids; Hematinics; Humans; Leukemia; Vitamin B 12

Topics: Chronic Disease; Colitis; Hematinics; Humans; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Chronic Disease; Hematinics; Liver; Liver Extracts; Recurrence; Vitamin B 12

Topics: Celiac Disease; Chronic Disease; Hematinics; Recurrence; Sprue, Tropical; Vitamin B 12; Vitamin B Complex