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Vitamin B12 deficiency associated with hyperbilirubinemia and cholestasis in infants
1Sahin Erdol, MD, Division of Metabolism, Uludag University Faculty of Medicine, Department of Pediatrics, 16059, Gorukle,Bursa, Turkey.
Insights
Vitamin B12 deficiency is common in infants, affecting nearly half of those studied. However, this study found no direct correlation between vitamin B12 deficiency and infant hyperbilirubinemia or cholestasis.
Area of Science:
- Pediatric Medicine
- Nutritional Science
- Biochemistry
Background:
- Infant jaundice, characterized by hyperbilirubinemia, is a common clinical issue.
- Cholestasis in infants requires prompt diagnosis and management.
- The role of vitamin B12 in neonatal metabolic pathways is not fully understood.
Purpose of the Study:
- To investigate the potential association between vitamin B12 deficiency and conditions like hyperbilirubinemia and cholestasis in infants.
- To determine the prevalence of vitamin B12 deficiency in a cohort of referred infants.
Main Methods:
- A cohort of 215 infants with suspected or diagnosed conditions underwent testing for serum vitamin B12 and bilirubin levels.
- Data collected included demographic information, medical history, and levels of vitamin B12, folate, homocysteine, urine methylmalonic acid (MMA), and bilirubin fractions.
- Infants were part of a Ministry of Health screening program between June 2011 and 2016.
Main Results:
- Vitamin B12 deficiency was identified in 48.8% of the study participants.
- No statistically significant differences in total, direct, or indirect bilirubin levels were observed between infants with and without vitamin B12 deficiency.
- Cholestasis was a rare finding, present in only 0.9% of the infants.
Conclusions:
- Vitamin B12 deficiency is prevalent in the studied infant population, consistent with findings in Turkey.
- While a potential association between vitamin B12 deficiency and hyperbilirubinemia/cholestasis is suggested, this study did not find a direct correlation.
- Further research is necessary to definitively establish any link between vitamin B12 status and these infant conditions.
Objective:
To study the correlation between vitamin B12 deficiency and hyperbilirubinemia and cholestasis in infants.
Methods:
The study group consisted of 215 infants who were tested for serum B12 and bilirubin levels out of 335 cases referred to the Centre from June 2011 to 2016 as a part of the screening program established by the Ministry of Health. The following information was obtained from the case files: demographic data; background; family history; serum vitamin B12, folate, plasma homocysteine, and urine methylmalonic acid (MMA) levels; and direct, indirect, and total bilirubin levels.
Results:
About 48.8 percent of cases had vitamin B12 deficiency. No significant differences were found when those cases with vitamin B12 deficiency and those without vitamin B12 deficiency were compared in terms of total, direct, or indirect bilirubin levels. Only two cases (0.9 percent) had cholestasis.
Conclusion:
The study suggests vitamin B12 deficiency is a common phenomenon (48.4 percent), similar to what has been suggested by other studies conducted in Turkey. Therefore, the presence of vitamin B12 deficiency in cases with cholestasis or hyperbilirubinemia may show an association. To prove the correlation between them, more studies are required.
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