血维生素B12升高与住院内科病房的老年患者的短期死亡率之间的关联
Benjamin Eduin1, Camille Roubille1,2, Stéphanie Badiou2,3
1Department of Internal Medicine, University Hospital of Montpellier, Montpellier, France.
International journal of clinical practice
|December 26, 2023
概括
住院患者维生素B12水平升高是短期死亡风险增加的早期指标. 这一发现无论年龄,癌症或其他现有的健康状况如何,都是如此.
科学领域:
- 内部医学 内部医学
- 临床生物化学 临床生物化学
- 预测生物标志物 预测生物标志物
背景情况:
- 血液中维生素B12水平的预后意义受到争议,一些研究将高水平与死亡率增加联系起来,特别是在患有特定疾病的老年患者中.
- 之前的研究主要集中在特定的患者群体上,使得一般内科住院患者的预后价值变得不太清楚.
研究的目的:
- 为了调查维生素B12水平升高与所有原因的死亡率之间的联系,在非预定的住院患者被录取到内科病房.
- 为了确定维生素B12的升高是否是这种患者群体中短期死亡率的独立预测因素.
主要方法:
- 从2014年8月到2018年12月进行了一项回顾性观察研究.
- 165名血维生素B12水平高 (>600 pmol/l) 的患者与165名血维生素B12水平正常的患者进行了比较.
- 收集了人口统计,临床和生物数据,主要终点是一年后全因死亡.
主要成果:
- 维生素B12水平升高的患者年轻,BMI和白蛋白水平较低,自身免疫性疾病和ICU转诊的患病率更高.
- 一年后,B12水平升高的患者中有39%死亡,而正常B12患者中有26% (p=0.018).
- 多变量分析证实,维生素B12水平升高是1年死亡率的重要风险因素 (HR: 1.71,p=0.022),独立于其他因素.
结论:
- 维生素B12水平升高是内科住院患者短期死亡率增加的早期预警信号.
- 这种关联独立于年龄,癌症或并发症,这表明维生素B12可能作为一种新的预后标志物.
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