Zahit BOLAMAN, Bilal ACAR, İrfan YAVAŞOĞLU, Gürhan KADIKOYLU

Vitamin B12 deficiency and thrombosis

Amaç: Tromboembolik hastalıklar multi-faktöriyeldir. Hiperhomosisteinemi (HH) bu faktörlerdendir. B12vitamini eksikliği HH için kazanılmış nedenlerinden biridir. HH arteriyel ve venöz tromboz için risk faktörüdür.B12 vitamin eksikliğine bağlı HH’de homosistein düzeylerindeki artışa bağlı olarak tromboz insidansı yüksektir.Ancak bu durum açık değildir karşıt görüşler de vardır. Çalışmamızda B12 vitamini eksikliği saptanan kişilerdetromboembolik olay sıklığını belirlemeyi amaçladık.Yöntem: Retrospektif olarak kazanılmış B12 vitamin eksikliği saptanan (200 pg/ml altında) 143 hasta (63 kadın,80 erkek, yaş ortalaması 59±13 yıl) çalışmaya alındı. Tanı anında ve 3 yıl önceki arteriyel ve venöz trombozöyküsü sorgulandı. Klinik, laboratuar ve görüntüleme ile saptanmış tromboembolik olaylar belirlendi. Kontrolgurubu olarak yaş ve cins gurubu uygun, B12 vitamin düzeyi normal, hasta gurubundaki dışlama kriterlerine uyan129 sağlıklı kişi (62 kadın, 67 erkek, yaş ortalaması 58±8) alındı.Bulgular: Kontrol gurubunda ortalama B12 düzeyi 244±32 pg/ml, olgularımızda ise 136±58pg/ml idi. B12vitamini eksikliği olan olgularda %9.8 oranında tromboembolik (on koroner arter hastalığı, iki derin venöztrombozu, iki serebrovasküler) olay saptanır iken kontrol gurubunda bu oran %3.9 (dört koroner arter hastalığı,bir derin venöz tromboz) idi. Bu oran istatistiksel olarak anlamlı değildi (p>0.05).Sonuç: B12 vitamin eksikliği nedeni ile oluşan HH tek başına tromboz riskini arttırmamaktadır.

B12 vitamini eksikliği ve tromboz

Purpose: Thromboembolic diseases are multi-factorial. Hyperhomocysteinemia (HH) is one of these factors.Vitamin B12 deficiency is acquired reasons for HH. HH is a risk factor for arterial and venous thrombosis. Theincidence of thrombosis is high due to increase of homocystein levels in HH associated with vitamin B12deficiency. However, this situation is not clear and there are opposing views. In our study, we aimed todetermine the frequency of thromboembolic events in individuals with vitamin B12 deficiency.Methods: One hundred forty-three patients (63 female, 80 male, mean age 59±13 years), who were diagnosed ashaving vitamin B12 deficiency (below 200 pg/ml), were included in the study retrospectively. The history ofarterial and venous thrombosis for a period of last three years before the time of diagnosis and was searched. Thethromboembolic events, which are detected via clinical and laboratory studies and via imaging, were determined.The control group was consisted of 129 healthy subjects (62 female, 67 male; mean age 58±8) of appropriateage, sex and excluded criteria whose B12 level was normal.Results: In control group, mean B12 level was 244±32 pg/ml. The patients’ mean B12 level was 136±58 pg/ml.Fourteen (9.8%) thromboembolic (10 coronary artery disease, two deep venous thrombosis, two cerebrovascular)events were determined in vitamin B12 deficiency group, whereas this ratio was 3.9% in the control group (fourcoronary artery disease, one deep venous thrombosis). This ratio was not statistically significant different (p>0.05).Conclusion: Alone HH due to vitamin B12 deficiency did not increase the risk of thrombosis.

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