胃癌患者胃切除术前及术后早期维生素B-12缺乏症发生率高。

IF 1.3 4区 医学 Q4 NUTRITION & DIETETICS
Misora Ao, Masaaki Awane, Yoshito Asao, Sadahiko Kita, Takashi Miyawaki, Kiyoshi Tanaka
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引用次数: 0

摘要

背景与目的:胃切除术导致维生素B-12缺乏,因为维生素B-12需要胃酸和内在因子才能吸收。维生素B-12缺乏症被认为是在胃切除术后几年发生的,因为肝脏储存过多。然而,大多数胃癌是在长期萎缩性胃炎伴维生素B-12吸收不良后发生的。方法与研究设计:我们对22例胃癌患者在胃切除术前和53例胃切除术后的维生素B-12状况进行了调查,并考虑了胃切除术后贫血的情况。结果:血液维生素B-12、叶酸、同型半胱氨酸浓度、贫血参数和饮食摄入量均被评估。重度维生素B-12缺乏症(血清维生素B-12 < 150 pmol/L)和维生素B-12缺乏症(150 pmol/L至< 258 pmol/L)在三年内胃切除术患者中所占比例分别为19.0%和52.4%。在胃切除术前,分别有3例和7例患者表现为严重营养不足和营养不足。在胃切除术患者中,血浆同型半胱氨酸浓度与血清维生素B-12浓度呈负相关,维生素B-12缺乏症和缺铁性贫血共存,其平均红细胞体积在参考范围内。结论:胃切除术后和术前早期患者普遍缺乏维生素B-12。维生素B-12和铁缺乏症的共存模糊了胃切除术后贫血的诊断,需要血液维生素B-12的测量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High prevalence of vitamin B-12 deficiency before and early after gastrectomy in patients with gastric cancer.

Background and objectives: Gastrectomy causes vitamin B-12 deficiency since vitamin B-12 requires gastric acid and intrinsic factor for its absorption. Vitamin B-12 deficiency is considered to develop years after gastrectomy because of large hepatic storage. However, most gastric cancer develops after long-standing atrophic gastritis with vitamin B-12 malabsorption.

Methods and study design: We have investigated vita-min B-12 status in 22 patients before gastrectomy and 53 patients after gastrectomy due to gastric cancer, also with consideration on post-gastrectomy anemia.

Results: Blood vitamin B-12, folic acid, homocysteine concentrations, parameters of anemia, and dietary intake were evaluated. Percentage of patients with severe vitamin B-12 deficiency (serum vitamin B-12 < 150 pmol/L), vitamin B-12 deficiency (150 pmol/L to < 258 pmol/L) was 19.0 %, and 52.4 % respectively in patients gastrectomized within three years. Before gastrectomy, three and seven patients exhibited severe deficiency and deficiency, respectively. In gastrectomized patients, plasma homocysteine concentration was inversely associated with serum vitamin B-12 concentration, and vitamin B-12 deficiency- and iron deficiency- anemia coexisted with their mean corpuscular volume within the reference range.

Conclusions: Vitamin B-12 deficiency is prevalent in patients early after and before gastrectomy. Coexistence of vitamin B-12 and iron deficiency obscures the diagnosis of post-gastrectomy anemia, and necessitates the blood vitamin B-12 measurement.

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来源期刊
CiteScore
2.50
自引率
7.70%
发文量
58
审稿时长
6-12 weeks
期刊介绍: The aims of the Asia Pacific Journal of Clinical Nutrition (APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health promotion and disease prevention. APJCN will publish original research reports, reviews, short communications and case reports. News, book reviews and other items will also be included. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by at least two anonymous reviewers and the Editor. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as material cannot be returned. Final acceptance or rejection rests with the Editorial Board
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