Vitamin B12 Deficiency among Cases of Helicobacter Pylori Gastritis: A Cross Sectional Study
Main Article Content
Abstract
Background: Helicobacter pylori (H. pylori) is a gram-negative bacterium associated with various gastrointestinal diseases, including peptic ulcer disease, gastric cancer, and vitamin B12 deficiency. Recent research has highlighted a potential link between chronic H. pylori infection and significant malabsorption of vitamin B12, particularly in populations with high prevalence rates of infection.
Objective: This study aims to investigate the frequency of vitamin B12 deficiency among patients with H. pylori gastritis and to explore the association between H. pylori infection and vitamin B12 levels.
Methods: A cross-sectional study was conducted from September 2023 to March 2024 at the Department of Medicine, Ayub Teaching Hospital, Abbottabad. A total of 120 patients presenting with symptoms of gastritis were enrolled after obtaining ethical approval from the hospital’s review board. Exclusion criteria included patients already on vitamin B12 supplementation. Diagnostic testing for H. pylori was performed using stool antigen tests, and vitamin B12 levels were assessed through serum measurements. Data analysis was conducted using IBM SPSS Statistics version 23, with the Chi Square test applied to examine the association between H. pylori infection and vitamin B12 deficiency, setting the level of significance at p ≤ 0.05.
Results: Out of the 120 patients studied, 49 (40.8%) tested positive for H. pylori. Vitamin B12 deficiency was observed in 35 (29.2%) patients. Among those infected with H. pylori, 51.0% (25 patients) also had vitamin B12 deficiency, compared to 14.1% (10 patients) among those not infected (p = 0.0001).
Conclusion: The findings indicate a significant association between H. pylori infection and vitamin B12 deficiency. This study suggests that H. pylori is a potential risk factor for vitamin B12 deficiency, underscoring the need for screening and appropriate management of H. pylori in patients presenting with vitamin B12 deficiency.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Malfertheiner P, Camargo MC, El-Omar E, Liou JM, Peek R, Schulz C, Smith SI, Suerbaum S. Helicobacter Pylori Infection. Nature Reviews Disease Primers. 2023;9(1):19-23.
Jessurun J. Helicobacter Pylori: An Evolutionary Perspective. Histopathology. 2021;78(1):39-47.
Chmiela M, Kupcinskas J. Pathogenesis of Helicobacter Pylori Infection. Helicobacter. 2019;24:e12638.
Fischbach W, Malfertheiner P. Helicobacter Pylori Infection: When to Eradicate, How to Diagnose and Treat. Deutsches Ärzteblatt International. 2018;115(25):429-34.
Kim J, Wang TC. Helicobacter Pylori and Gastric Cancer. Gastrointestinal Endoscopy Clinics. 2021;31(3):451-65.
Shatila M, Thomas AS. Current and Future Perspectives in the Diagnosis and Management of Helicobacter Pylori Infection. Journal of Clinical Medicine. 2022;11(17):5086.
Fong IW. Current Trends and Concerns in Infectious Diseases. Springer; Berlin/Heidelberg, Germany: 2020.
WHO Media Centre. News Release. WHO Publishes List of Bacteria for Which New Antibiotics Are Urgently Needed. 2017.
Babior BM, Bunn FH. Megaloblastic Anemia. In: Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, editors. Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw Hill; 2005. p. 647-80.
Shuval-Sudai O, Granot E. An Association Between Helicobacter Pylori Infection and Serum Vitamin B12 Levels in Healthy Adults. J Clin Gastroenterol. 2003;36:130-3.
Harmandar FA, Dolu S, Çekin AH. Role of Pernicious Anemia in Patients Admitted to Internal Medicine with Vitamin B12 Deficiency and Oral Replacement Therapy as a Treatment Option. Clinical Laboratory. 2020;66(3):15-22.
Kaptan K, Beyan C, Ifran A. Helicobacter Pylori and Cobalamin Deficiency. Haematologica. 2006.
Pinar IE, Mavis O. The Effect of Helicobacter Pylori Density on Serum Vitamin B12 and Folate Levels in Patients With Non-Atrophic Gastritis. Cureus. 2023;15(9):45-51.
Cave DR. Transmission and Epidemiology of Helicobacter Pylori. Am J Med. 1996;100:12S-17S; discussion 17S-18S.
Perry S, de la Luz Sanchez M, Yang S, Haggerty TD, Hurst P, Perez-Perez G, Parsonnet J. Gastroenteritis and Transmission of Helicobacter Pylori Infection in Households. Emerg Infect Dis. 2006;12:1701-8.
Tsay FW, Hsu PI. H. Pylori Infection and Extra-Gastroduodenal Diseases. J Biomed Sci. 2018;25:65.
Boyanova L. Role of Helicobacter Pylori Virulence Factors for Iron Acquisition From Gastric Epithelial Cells of the Host and Impact on Bacterial Colonization. Future Microbiol. 2011;6:843-6.
Kadhim G, Shikh M, Omar H, Ismail A. Vitamin B12 Deficiency in Helicobacter Pylori Infected Patients. Open Access Lib J. 2018;5:1-4.
Gümürdülü Y, Serin E, Ozer B, Kayaselcuk F, Kul K, Pata C, et al. Predictors of Vitamin B12 Deficiency: Age and Helicobacter Pylori Load of Antral Mucosa. The Turk J Gastroenterol. 2003;14:44-49.
Osmola M, Chapelle N, Vibet MA, Bigot-Corbel E, Masson D, Hemont C, Jirka A, Blin J, Tougeron D, Moussata D, Lamarque D. Iron and Vitamin B12 Deficiency in Patients with Autoimmune Gastritis and Helicobacter pylori Gastritis: Results from a Prospective Multicenter Study. Digestive Diseases. 2024 Apr 2;42(2):145-53.