Indigenous indicators of vitamin B12 deficiency
Introduction: Clinical manifestations of vitamin B12 deficiency are mostly non-specific. An entity called subclinical deficiency has become popular where the need has arisen to perform costly investigations which indicate functional deficiency of vitamin B12 even when vitamin B12 levels are norm...
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| Format: | Article |
| Language: | English |
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Prathima Institute of Medical Sciences
2020-08-01
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| Series: | Perspectives In Medical Research |
| Subjects: | |
| Online Access: | https://www.pimr.org.in/2020-vol8-issue-2/originalarticle7_v1.pdf |
| Summary: | Introduction: Clinical manifestations of vitamin B12 deficiency
are mostly non-specific. An entity called subclinical deficiency
has become popular where the need has arisen to perform
costly investigations which indicate functional deficiency of
vitamin B12 even when vitamin B12 levels are normal. These
factors pose a challenge in planning management of patients.
Aims and objectives : The study was conducted as an attempt
to identify affordable and credible laboratory indicators of
vitamin B12 deficiency which can be used as screening tests
before choosing patients for further evaluation or treatment.
Material and Methods : This was a time bound cross-sectional
study where 100 adult patients who had undergone the
following investigations were randomly chosen: Complete
Blood Count with red cell indices, serum bilirubin and serum
vitamin B12 levels. The sensitivity, specificity and predictive
values (positive-PPV and negative-NPV) of the variables that
could hypothetically identify vitamin B12 deficiency, both
individually or in combinations were calculated and compared.
Results and conclusion : Hemoglobin, MCV (Mean Corpuscular
Volume), MCH (Mean Corpuscular Hemoglobin), platelets and
bilirubin were not equally distributed between vitamin B12
deficient and normal groups(p values for these variables were
0.029, 0.000, 0.000, 0.003 and 0.029 respectively).When these
variables were tested individually and in combination, the
combination of [MCV=95 fl or MCH=30 pg or Platelets =1.4
lakh/µl or Bilirubin =1 mg/dl] had sensitivity of 68.2%,
specificity of 85.7%, PPV of 78.9% and NPV of 77.4%. This
proposed combination used as a screening test has potential
for wide application considering its simplicity and cost
advantage. |
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| ISSN: | 2348-1447 2348-229X |