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Alcoholic cirrhosis and cobalamin metabolism
D Lambert1, S Benhayoun, C Adjalla
1INSERM U 308, School of Medicine, Vandoeuvre, France.
Digestion
|January 1, 1997
Summary
Patients with alcoholic cirrhosis show elevated vitamin B12 (cobalamin) levels, primarily bound to haptocorrin (HC). This suggests impaired liver clearance, despite indicators of cellular vitamin B12 deficiency.
Area of Science:
- Biochemistry
- Hepatology
- Nutritional Science
Background:
- Alcoholic cirrhosis is a severe liver condition with complex metabolic alterations.
- Cobalamin (vitamin B12) metabolism is crucial for cellular function and can be affected by liver disease.
Purpose of the Study:
- To investigate cobalamin status in patients with alcoholic cirrhosis.
- To explore the binding forms of cobalamin and their relationship with liver function and deficiency indicators.
Main Methods:
- Analysis of plasma cobalamin, total corrinoids, and their analogs in 27 alcoholic cirrhosis patients and 20 controls.
- Measurement of haptocorrin (HC)-bound corrinoids and indicators of cobalamin deficiency (homocysteine, methylmalonic acid).
- Correlation analysis with cholestasis markers (serum alkaline phosphatase).
Main Results:
- Significantly elevated plasma cobalamin, total corrinoids, and analogs in cirrhosis patients compared to controls.
- Increased HC-bound corrinoids, suggesting deficient hepatic clearance of HC-cobalamin.
- Elevated homocysteine and methylmalonic acid indicate potential cellular cobalamin deficiency despite high plasma levels.
Conclusions:
- Alcoholic cirrhosis is associated with altered cobalamin binding and elevated plasma levels, likely due to impaired hepatic clearance.
- The findings suggest a complex picture of vitamin B12 status in cirrhosis, with potential cellular deficiency despite high circulating concentrations.
- Further research is needed to elucidate the mechanisms of impaired vitamin B12 utilization in liver disease.