Abstract | BACKGROUND:
Cobalamin is released during hepatic cytolysis associated with liver injury. Serum B12 concentration is frequently elevated in patients that receive long-term parenteral nutrition (PN). We hypothesized that serum B12 concentration would become elevated in intestinal failure-associated liver disease and would reflect in disease severity. METHODS: RESULTS: Thirteen biopsies were available for analysis. Serum B12 concentration and hepatic chemistries were available for all biopsy times. The mean serum B12 concentration was 619+/-222 pg/mL. The mean daily parenteral B12 dose was 3.3+/-1.3 mcg. Mean NAS, Brunt, and Dixon scores were 2, 1, and 1, respectively. The Spearman correlation coefficients between serum B12 concentration and liver biopsy scores were 0.15, 0.1, and 0.1 for the NAS, Brunt, and Dixon scores, respectively, indicating that there was no correlation between serum B12 concentration and liver pathology. The Spearman correlation coefficient between the NAS inflammation subscore and serum B12 concentration was 0.02. B12 concentration also failed to correlate with hepatic chemistries. There was surprisingly little correlation between serum B12 concentration and exogenous B12 daily dose through PN (r=0.19, P=0.45). CONCLUSIONS: Elevated serum B12 concentration is commonly encountered in patients who receive long-term parenteral nutrition. This does not seem to be an indicator of hepatic pathology; rather it may reflect the provision of excessive intravenous vitamin B12 and other as yet unknown factors.
|
Authors | Imad Elkhatib, Wenqing Cao, Sambasiva Rao, Jonathon Fryer, Alan L Buchman |
Journal | Journal of clinical gastroenterology
(J Clin Gastroenterol)
Vol. 44
Issue 8
Pg. 571-4
(Sep 2010)
ISSN: 1539-2031 [Electronic] United States |
PMID | 20421811
(Publication Type: Journal Article)
|
Chemical References |
- Biomarkers
- Vitamin B Complex
- Vitamin B 12
|
Topics |
- Adult
- Aged
- Biomarkers
(blood)
- Biopsy
- Female
- Humans
- Ileum
(pathology, surgery)
- Liver Diseases
(diagnosis, etiology, pathology)
- Male
- Middle Aged
- Parenteral Nutrition
(adverse effects, methods)
- Retrospective Studies
- Severity of Illness Index
- Short Bowel Syndrome
(complications, surgery)
- Statistics, Nonparametric
- Vitamin B 12
(administration & dosage, blood)
- Vitamin B Complex
(administration & dosage, blood)
|