Vitamin B12 deficiency causes raised serum and tissue levels of homocysteine.
Atrophic corpus gastritis results in impaired secretion of intrinsic factor. This may lead to malabsorption of vitamin B12 in the intestine.
In this study, physicians from Finland evaluated undiagnosed vitamin B12 deficiency among elderly men in the general population. They also determined how often vitamin B12 deficiency was related to atrophic corpus gastritis.
The team assayed the serum level of pepsinogen I (S-PGI) in a population-based sample of 12,252 men (aged 51 to 65 years) from 2 cities in Finland.
Of the 12,252 men, 635 had S-PGI <25g/l. These patients formed series A (atrophic corpus gastritis).
Subjects without atrophic corpus gastritis formed a control group (series B).
Series C included 402 patients with a non-atrophic gastric corpus who had S-PGI ≥50g/l.
|3% of men aged 51 to 65 years had a low serum vitamin B12 level.|
|Scandinavian Journal of Gastroenterology|
The team measured serum levels of vitamin B12 (S-B12), folate (S-Fol), total homocysteine (S-Hcy) and Helicobacter pylori antibodies (S-HpAb).
The men in series A had significantly lower S-B12 and S-Fol levels than those in series C.
The physicians found that of the subjects in series A, 28% had S-B12 <170 mol/l, and 22% had S-B12 in the range 170-219 mol/l. This compared with 7% and 17% in series C, respectively.
Furthermore, the mean S-Hcy was significantly higher in men with low S-B12.
The prevalence of S-Hcy > 15 mol/l was 27% in series A and 15% in series C .
Among subjects with S-B12 < 220 mol/l, 46% in Series A and 16% in Series C had S-Hcy 15 mol/l.
The mean S-Hcy was significantly higher in men with S-B12 in the range 170-219 mol/l in series A than in series C.
The physicians extrapolated that 3% of men aged 51 to 65 years had a low S-B12 level, associated with atrophic corpus gastritis. Of these, 72% had an elevated S-HpAb level.
Dr Sipponen's team concluded, "Low S-B12 related to atrophic corpus gastritis is relatively common…among elderly males in the general population".
"An ongoing H. pylori infection occurs in three-fourths of these cases".