vitamin-b-12 and Liver-Cirrhosis--Alcoholic

Topics: Chromium; Cobalt; Humans; Liver; Liver Cirrhosis, Alcoholic; Manganese; Models, Biological; Nutritional Physiological Phenomena; Selenium; Trace Elements; Vitamin A; Vitamin B 12; Zinc

The purpose of this study was to investigate the protective effects of combined treatment of folate and vitamin B12 against alcoholic liver disease.. Male Wistar rats weighing about 160 g were divided into four groups: an ethanol group fed an ethanol liquid diet; a control group pair-fed an isoenergetic diet without ethanol; an ethanol and vitamin group fed an ethanol-containing diet that was supplemented with folate (10 mg/kg of body weight per day) and vitamin B12 (0.5 mg/kg of body weight per day); and a control and vitamin group fed an isoenergetic diet without ethanol, which was supplemented with folate (10 mg/kg of body weight per day) and vitamin B12 (0.5 mg/kg of body weight per day).. After 16 wk, the plasma folate concentration in the ethanol group was significantly lower than in the other three groups. The plasma homocysteine concentration in the ethanol group was significantly higher than in the other three groups. The hepatic matrix metalloproteinase-2 concentration in the ethanol group was significantly higher than in the control and ethanol/vitamin groups. Furthermore, the plasma homocysteine concentration at the 16th week and the hepatic matrix metalloproteinase-2 concentration showed a significant positive correlation in rats of each group. In addition, pathologic evidence of liver fibrosis was observed only in the ethanol group. Furthermore, hepatic cytochrome 2E1 protein expression in group E increased significantly.. These results suggest that combined treatment of folate and vitamin B12 can alleviate alcoholic liver injury that may be related to normalization of plasma homocysteine levels.

Topics: Animals; Cytochromes; Folic Acid; Homocysteine; Hyperhomocysteinemia; Liver; Liver Cirrhosis, Alcoholic; Liver Function Tests; Male; Matrix Metalloproteinase 2; Rats; Rats, Wistar; Vitamin B 12; Vitamin B Complex

Patients with liver disease frequently experience changes in their nutritional status.. To determine changes in vitamin B12 and folic acid plasma levels in patients with chronic cirrhosis and to assess whether these parameters may be useful in the etiologic diagnosis of this disease.. Thirty-nine patients admitted for decompensated cirrhosis (29 with alcoholic etiology and 10 with non-alcoholic etiology) and 35 controls were prospectively studied. Plasma levels of vitamin B(12), folate acid, mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, and gamma-glutamyltransferase (GGT), among other parameters, were measured.. Vitamin B(12) levels were 1151+/-568pg/ml in patients with decompensated cirrhosis and 440+/-133pg/ml in controls (p<0.05). Plasma folate levels were 8.57+/-3.8ng/ml in controls and 6.68+/-2.74ng/ml in patients with cirrhosis (p<0.05). Folate levels were lower in patients with alcoholic cirrhosis (mean value, 5.7+/-2.1) than in those with non-alcoholic cirrhosis (9.3+/-2.6; p<0.0005). The vitamin B(12)/folate ratio discriminated alcoholic etiology better than other parameters such as AST, ALT, MCV, AST/ALT ratio and GGT.. Plasma levels of vitamin B12 in patients with decompensated chronic liver disease are high, whereas plasma folate levels are low. The ratio between vitamin B12 and folic acid may be useful in the differential diagnosis of the etiology of chronic liver disease.

Topics: Adolescent; Adult; Aged; Alanine Transaminase; Aspartate Aminotransferases; Diagnosis, Differential; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; gamma-Glutamyltransferase; Homocysteine; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Diseases, Alcoholic; Liver Failure; Liver Function Tests; Male; Middle Aged; Prognosis; Prospective Studies; Vitamin B 12; Young Adult

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

Relationship between increased serum cobalamin level and liver disease have been recently reported. In this work, levels of total corrinoids, cobalamin (vitamin B12) and cobalamin analogues and levels of IgA were determined by radioisotope dilution assay and nephelometric laser analyses. They all have been measured in superior vena cava, inferior vena cava and hepatic vein of controls and of alcoholic cirrhotic patients grouped according to the Child-Pugh classification. Compared with normal subjects, venous blood content of total corrinoids, of cobalamin and of IgA in alcoholic cirrhotics increased significantly with the severity of the disease (p less than 0.01). In severe, moderate, and mild alcoholic cirrhosis total corrinoids and cobalamin were, respectively, about 5-, 2-, and 1.5-fold higher than in controls, whereas IgA was 3-, 2.5- and 1.5-fold higher, respectively. The serum IgA level was significantly correlated with the level of seric saturated haptocorrin (r = 0.54; p less than 0.01) and with the seric total corrinoids (r = 0.39; p less than 0.01). In the absence of significant hepatic cytolysis, the enhanced level of seric corrinoids in cirrhosis could be partly explained by a competitive inhibition of the liver uptake of haptocorrin by circulating asialoglycoproteins, including IgA.

Topics: Adult; Aged; Corrinoids; Humans; Immunoglobulin A; Liver Cirrhosis, Alcoholic; Middle Aged; Transcobalamins; Vitamin B 12

Topics: Aspartate Aminotransferases; Erythrocyte Count; Erythrocytes; Fatty Liver, Alcoholic; Humans; Liver Cirrhosis, Alcoholic; Vitamin B 12

Blood vitamin status (B1, B2, B6, folic acid and B12) was assessed in 41 patients (M = 39; F = 2) with alcoholic liver disease. Biochemical evidence of thiamine deficiency was observed in all groups of patients. Deficiency of riboflavin was detected in patients with histologically normal liver but not in other groups. All the groups were found to be deficient in pyridoxal-5-phosphate--the active form of vitamin B6 (pyridoxine). Serum folate was decreased in all groups except in those with alcoholic hepatitis: red cell folate was, of course within normal limits in all the groups. Vitamin B12 levels were within normal limits in all groups except the cirrhotic one where it was raised. Clinico-biochemical implications of the findings are discussed. Biochemical changes in blood vitamin status may precede clinical manifestations of a disease process and may have prognostic value.

Topics: Adult; Alcoholism; Folic Acid; Hepatitis; Humans; Liver Cirrhosis, Alcoholic; Liver Diseases; Middle Aged; Pyridoxal Phosphate; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Biopsy; Blood; Clinical Enzyme Tests; Copper; D-Alanine Transaminase; Humans; Iron; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Function Tests; Ornithine; Ornithine Carbamoyltransferase; Vitamin B 12