Vitamin B12 status in hospitalised cancer patients: Prevalence and clinical implications of depletion and hypervitaminosis.

Autor: Sottotetti F; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Malovini A; Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Maccarone S; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Riva G; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Tibollo V; Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Palumbo R; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Tagliaferri B; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Bellazzi R; Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy; Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy., Cena H; Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Clinical Nutrition Unit, General Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Di Sabatino A; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy; First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy., Locati LD; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy., Lenti MV; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy; First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy. Electronic address: marco.lenti@unipv.it.
Jazyk: angličtina
Zdroj: Clinical nutrition ESPEN [Clin Nutr ESPEN] 2024 Oct; Vol. 63, pp. 585-594. Date of Electronic Publication: 2024 Jul 23.
DOI: 10.1016/j.clnesp.2024.07.017
Abstrakt: Background & Aims: The prevalence and clinical significance of vitamin B12 alterations in patients with cancer are poorly understood. We aimed to assess the prevalence and risk factors of vitamin B12 depletion or hypervitaminosis in patients with cancer.
Methods: We retrospectively included hospitalised patients with cancer in 2017-2022. Plasma B12 levels were stratified as very low (VL, <200 pg/ml), low (L, 200-299 pg/ml), normal (N, 300-812 pg/ml), or high (H, ≥813 pg/ml). We collected demographic and several clinical data (e.g., comorbidities, nutritional status, ECOG-PS, cancer site and stage). Univariate and multivariate analyses for factors associated to the vitamin B12 status were fitted.
Results: 788 patients (F/M ratio 1.05, median age 72 years, [25th, 75th percentiles 62, 78 years]) were included. Vitamin B12 was VL in 14.1%, L in 19.4%, N in 49.4%, and H in 17.1% cases. Vitamin B12 distribution increased significantly as function of ECOG-PS levels. Patients with breast cancer were characterized by the highest median B12 value, while colorectal cancer patients by the lowest. Vitamin B12 was also significantly higher in advanced compared to early-stage patients as well as in those who had liver failure. Multivariate analysis showed that the probability of H vs. VL B12 levels was significantly increased in patients with hypoproteinemia, hypo-prealbuminemia, and ECOG-PS≥2, and decreased in those with colorectal and gastric cancer.
Conclusion: Vitamin B12 impairment is common in cancer patients. Increased vitamin B12 is associated with an impaired clinical status, while vitamin B12 depletion is more common in early-stage cancer and in elderly patients.
Competing Interests: Declaration of competing interest The authors report no conflict of interest.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: