B12 deficiency-related glossitis is highly associated with high gastrin-17 and low pepsinogen I

Background

The causes of vitamin B12 (B12) deficiency are varied and mainly related to gastric disorders. Glossitis is a common oral manifestation of B12 deficiency and is often first seen by dentists. This study aimed to investigate the correlation between B12 deficiency-related glossitis (B12-def glossitis) and gastric serum biomarkers [gastrin-17(G17), pepsinogen I (PGI), pepsinogen II (PGII), and anti-Helicobacter pylori (H. pylori) antibodies], and preliminarily discuss the etiology of B12-def glossitis.

Methods

A cross-sectional study was conducted in patients complaining of glossodynia, burning sensation, or severe recurrent oral ulcers, but patients with a history of gastrectomy were excluded. All subjects underwent a uniform oral examination and hematological tests.

Results

Of 243 patients, 133 with B12-def glossitis were in the case group, and 110 with other oral mucosal diseases (non-glossitis) and normal B12 levels were in the control group. In the case group, 84.2% (112/133) showed high G17 and low PGI levels (G17^hi PGI^low). Univariate logistic regression showed that G17^hi PGI^low was a high-risk factor for B12-def glossitis (OR: 92.44; 95% CI: 35.91, 238.02). Subgroup analyses in the case group showed that the G17^hi PGI^low group presented with lower B12 levels and a lower positive rate of anti-H. pylori antibodies compared to the non-G17^hi PGI^low group.

Conclusion

Gastric serum biomarkers in patients with B12-def glossitis generally showed G17^hi PGI^low, suggesting possible atrophy of gastric corpus and fundus mucosa. The G17^hi PGI^low and non-G17^hi PGI^low groups may represent different etiologies of B12 deficiency.