Clinical Trials Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2018; 24(12): 1343-1352
Published online Mar 28, 2018. doi: 10.3748/wjg.v24.i12.1343
Correlation between serum vitamin B12 level and peripheral neuropathy in atrophic gastritis
Guo-Tao Yang, Hong-Ying Zhao, Yu Kong, Ning-Ning Sun, Ai-Qin Dong
Guo-Tao Yang, Hong-Ying Zhao, Yu Kong, Ning-Ning Sun, Ai-Qin Dong, Department of Third Neurology, Cangzhou Central Hospital, Cangzhou Clinical Medical School of Hebei Medical University, Cangzhou 061001, Hebei Province, China
Hong-Ying Zhao, Department of Elderly Internal Medicine, Cangzhou Central Hospital, Cangzhou Clinical Medical School of Hebei Medical University, Cangzhou 061001, Hebei Province, China
Yu Kong, Department of Second Digestion, Cangzhou Central Hospital, Cangzhou Clinical Medical School of Hebei Medical University, Cangzhou 061001, Hebei Province, China
Ning-Ning Sun, Department of First Digestion, Cangzhou Central Hospital, Cangzhou Clinical Medical School of Hebei Medical University, Cangzhou 061001, Hebei Province, China
Author contributions: Yang GT, Zhao HY, Kong Y, Sun NN and Dong AQ designed the research; Yang GT, Zhao HY and Dong AQ performed the research; Yang GT, Zhao HY, Sun NN and Dong AQ contributed new reagents/analytic tools; Yang GT, Zhao HY and Dong AQ analyzed the data; and Yang GT and Dong AQ wrote the paper.
Supported by Cangzhou City Science and Technology Plan Projects, No. 151302138.
Institutional review board statement: The study was reviewed and approved by the Cangzhou Central Hospital, Cangzhou Clinical Medical School of Hebei Medical University Institutional Review Board.
Clinical trial registration statement: This study is registered with the Chinese Clinical Trial Registry, No. ChiCTR-ROC-17014051.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Guo-Tao Yang, MD, Department of Third Neurology, Cangzhou Central Hospital, Cangzhou Clinical Medical School of Hebei Medical University, Gaojiao District, Cangzhou 061001, Hebei Province, China. yangguotao3815@cz_hospital.ac.cn
Telephone: +86-317-2179510 Fax: +86-317-2179510
Received: December 20, 2017
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
ARTICLE HIGHLIGHTS
Research background

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

Research motivation

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.

Research objectives

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

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.