B12 VİTAMİN EKSİKLİĞİNİN ETİYOLOJİSİNİN ARAŞTIRILMASI VE B12 VİTAMİN DÜZEYİ İLE MCV,HOMOSİSTEİN, FOLAT DÜZEYLERİ VE TİROİD FONKSİYON TESTLERİ ARASINDAKİ İLİŞKİNİN SAPTANMASI Investigation of Etiology of Vitamin B12 deficiency and the Association of Vitamin B12 Levels with MCV, Homocysteine, Folic Acid Levels and Thyroid Function Tests

OZET Amac: DNA sentezinde rol alan B12 vitamini kan hucre olgunlasmasi ve sinir sisteminin normal fonksiyonlarini yapabilmesi icin gereklidir (1). Bu calismada B12 vitamini eksikligi olan kisilerde etiyolojik etkenleri ve B12 vitamin duzeyi ile MCV, homosistein, folat duzeyleri ve tiroid fonksiyon testleri arasindaki iliskiyi arastirdik. Gerec ve Yontem: Temmuz 2009 - Eylul 2009 tarihinde Haseki Egitim Arastirma Hastanesine basvuran hastalarda B12 vitamin duzeyi 189 (normal aralik) altinda bulunan 115 hasta calismaya dahil edildi. Fe eksikligi anemisi, talasemi, akut lokoz tanisi alan hastalar calismadan cikarildi. Hastalarda etiyolojik acidan incelemek icin yas, alim eksikligi, emilimi bozacak ilac kullanimi, kronik hastalik, cerrahi oyku sorgulandi. B12 vitamin duzeyi ile Htc, MCV, homosistein, folat duzeyleri ve tiroid fonksiyon testleri arasindaki iliskiyi istatistiksel olarak degerlendirildi. Bulgular: Yas gruplari arasinda B12 duzeyleri bakimindan istatistiksel olarak anlamli bir farklilik yoktu. 115 hastadan 56’sinda (%48,69) etiyolojik faktorlerden herhangi biri bulunamadi. Vitamin B12 eksikligine neden olan en sik proton pompa inhibitoru kullanimi ve alim eksikligi tespit edildi. Tiroid hormonlari ile B12 vitamin duzeyi arasinda anlamli bir iliski bulunamaz iken homosistein degerleri arasinda zayif derecede anlamli negatif korelasyon saptandi. Sonuc: B12 vitamin eksikligi olusturan en sik neden ilac kullanimi ve alim eksikligi olarak tespit edildi. Hastalarin %48.69’ unda etyolojik neden bulunamadi. B12 vitamin eksikligi halen tum dunya da onemli bir saglik sorunu olarak karsimiza cikmaktadir. Bu nedenle yapilacak daha ileri arastirmalara ihtiyac vardir. Anahtar Sozcu¨kler: B12 vitamini eksiligi; Hematokrit; MCV; Folat; Homosistein, Tiroid fonksiyon testleri. ABSTRACT Objectives: Vitamin B12 plays a role as coenzyme in the chemical reactions involved in DNA synthesis and deficiency is still a common health problem in our society. In our study, we investigated the etiology of vitamin B12 deficiency and the relationship of this deficiency with MCV, homocysteine, folic acid levels and thyroid function tests Material and Methods: 115 patients with vitamin B12 deficiency, who admitted to the Haseki Education and Research Hospital between July 2009 and September 2009, were included into the study. All patiens were recorded and analyzed for etiologic factors age, deficiency in dietary, using drug use, chronic illness, operations. we investigated the etiology of vitamin B12 deficiency and the relationship of this deficiency with MCV, homocysteine, folic acid levels and thyroid function tests Results: There was no statistically significant difference in B12 levels among the age groups. No one of the etiologic factors was found in 56 of 115 patients (48.69%). The most common cause of vitamin B12 deficiency was proton pump inhibitor using in 28 patients (24.4%) and 19 patients had low food intake. A significant correlation was also not observed between thyroid hormones and vitamin B12 levels. There was a significant negative correlation between B12 levels and homocysteine levels. Conclusion: we found the most frequent use of PPI and the low intake of dietary supplements for possible causes of vitamin B 12 deficiency in our study. As vitamin B12 deficiency is still an important health problem all over the world, further research is needed. Keywords: Vitamin B12 deficiency; Hematocrit; MCV; Folate; Homocysteine; Thyroid function tests.