Vitmain B12 as Severity and Prognostic Marker in Chronic Liver Disease

Chronic liver disease is an immuno-compromised state is well known established fact but there are falsely elevated vitamin B12 levels in patients with chronic liver disease, which can be used as severity and prognostic marker. This study was designed to investigate the association between vitamin B12 levels and liver disease severity and long term prognosis in patients with chronic liver disease.

An observational longitudinal study was carried over a period of 6 months among indoor patients admitted in department of medicine of a tertiary care hospital in North-Eastern India. A total of 50 patients diagnosed with chronic liver disease were enrolled. Serum vitamin B12 concentration and other blood parameters were determined. The data were analyzed accordingly by descriptive statistics using Spss for the result.

The study population were predominantly male with mean age 50.80 ± 10.35. Mean total serum vitamin B12 concentration was significantly higher in patients with chronic liver disease (1639 ± 504 pg/ml) when compared to normal people (650 ± 300pg/ml). Also among patients with chronic liver disease Child-Pugh C (1858 ± 359pg/mL) had higher B12 levels when compared to those with Child-Pugh B (1076 ± 370 pg/mL). Out of 50 people, 4 were died and their mean B12 was (2113 ± 112 pg/ml).

Falsely increased B12 levels are due to increased excretion of vitamin B12 in to serum from the liver and these serum B12 levels correlates with the severity and prognosis of the patient. References Sugihara T, Koda M, Okamoto T, et al. Falsely elevated serum vitamin B12 levels were associated with the severity and prognosis of chronic viral liver disease. Yonago Acta Med 2017;60(1):31-39. Dou J, Xu W, Ye B, et al. Serum vitamin B12 levels as indicators of disease severity and mortality of patients with acute-on-chronic liver failure. Clin Chim Acta 2012;413(23-24):1809-1812.