Published online Mar 28, 2018. doi: 10.3748/wjg.v24.i12.1343
Peer-review started: December 20, 2017
First decision: January 4, 2018
Revised: February 7, 2018
Accepted: February 26, 2018
Article in press: February 26, 2018
Published online: March 28, 2018
Processing time: 96 Days and 0.9 Hours
The main clinical manifestations of chronic atrophic gastritis are excessive abdominal pain, bloating and abdominal discomfort. It is known that the insufficient secretion of substances would affect vitamin B12 (VitB12) absorption. VitB12 and folic acid deficiency can affect homocysteine metabolism, which leads to peripheral neuropathy. Therefore, the occurrence of patients with chronic atrophic gastritis numbness and other nervous system symptoms may be related to VitB12 and folic acid deficiency
At present, there are no studies reporting the effect of VitB12 supplementation on the occurrence and outcome of peripheral neuropathy in patients with chronic atrophic gastritis. The causes of peripheral neuropathy in patients with chronic atrophic gastritis are also not clear. Therefore, it is necessary to explore the risk factors of peripheral neuropathy in patients with chronic atrophic gastritis.
This study aimed to explore the clinical features of peripheral neuropathy in patients with chronic atrophic gastritis and to screen out the possible risk factors in order to find out the feasible prevention and intervention measures for the clinical treatment of chronic atrophic gastritis
In total, 593 patients diagnosed with chronic gastritis were involved and their gastric acid, serum gastrin, serum vitamin and serum creatinine tests, peripheral nerve conduction velocity and Helicobacter pylori (H. pylori) were detected. In addition, the type of gastritis was determined by gastroscopy. All detected results were used to analyze the relationship between VitB12 levels and peripheral nerve conduction velocity.
H. pylori infection and chronic atrophic gastritis were independent risk factors for chronic gastritis associated with VitB12 deficiency. The separation of VitB12 from food was affected because H. pylori infection in gastric mucosal cells damage gastric acid secretion (reducing it). This study also found that the serum VitB12 and nerve conduction velocity gradually increased after VitB12 supplement treatment, suggesting that VitB12 supplementation can improve peripheral neuropathy.
This study found that serum VitB12 is a risk factor for peripheral neuropathy in patients with chronic gastritis, and serum vitamin B12 is positively correlated with the severity of peripheral neuropathy. Chronic atrophic gastritis and H. pylori infection are the main risk factors of VitB12 deficiency in patients with chronic gastritis. In addition, timely VitB12 supplementation may be an effective treatment and even a prevention method of peripheral neuropathy in patients with chronic atrophic gastritis.
Although this study has demonstrated serum VitB12 level is related to peripheral neuropathy in patients with chronic atrophic gastritis, it is still limited since it’s a single center study. Future research should be designed as a multicenter study, and a large sample size is needed to make the findings more credible.