Nutritional status and drugs may cause cobalamin (Vit B12) deficiency in people with systemic sclerosis (SSc) gastrointestinal (GI) involvement. Researchers wanted to find out how common and what causes Vit B12 insufficiency in SSc patients. In a single-center during a one-year period, they performed a cross-sectional analysis on 62 SSc patients. Patients’ medical histories and physical examinations were reevaluated. The information on organ involvement was collected from hospital file records. The Malnutrition Universal Screening Tool was used to examine the nutritional status of the patients (MUST). All patients had their vitamin B12, homocysteine (save for three), and Helicobacter Pylori Immunoglobulin G (H. Pylori IgG) levels tested. A vitamin B12 deficit was defined as a blood vitamin B12 level of 200 pg/mL or being on vitamin B12 replacement treatment. Patients’ serum Vit B12 levels were also classified as low (200 pg/mL), borderline (200–300 pg/mL), and normal (>300 pg/mL). The patients’ plasma homocysteine levels were categorized as high (>9 mol/L) or hyperhomocysteinemia (>15 mol/L). To compare parameters between groups, the Mann–Whitney U and Kruskal–Wallis tests were utilized. Spearman’s correlation coefficient was used to assess correlation.

Forty-four (71.0%) of the patients were classified as Vit B12 deficient; 22 had Vit B12 levels less than 200 pg/mL (four were on Vit B12 replacement medication), and the remaining 22 had Vit B12 levels greater than 200 pg/mL and were already on Vit B12 replacement therapy. The number of patients with hyperhomocysteinemia was substantially greater in the Vit B12 200 pg/mL group compared to the other groups (P=0.004), yet only 33.3% (7/21) of the Vit B12 200 pg/mL patients had hyperhomocysteinemia. There were no statistically significant variations in age, mean illness duration, MUST scores, mean hemoglobin levels, H. Pylori IgG positivity, or organ involvements between patients with and without Vit B12 deficiency (P>0.05 for all).

Vitamin B12 insufficiency is common in SSc and has several reasons. Vitamin B12 deficiency should be monitored in all patients. Homocysteine levels are unlikely to be useful in confirming vitamin B12 insufficiency.

Reference:journals.lww.com/jclinrheum/Abstract/2018/08000/Evaluation_of_Vitamin_B12_Deficiency_and.2.aspx