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The Association Between Vitamin B12 Deficiency and Long-Term Use of Acid Lowering Agents: A Systematic Review and Meta-Analysis.
Intern Med J. 2015 Jan 13;
Authors: Jung SB, Nagaraja V, Kapur A, Eslick GD
Abstract
INTRODUCTION: Vitamin B12 (cobalamin) deficiency can result in irreversible structural brain changes if not treated appropriately. Long-term use of acid lowering agents (ALAs) have been linked to vitamin B12 deficiency but results are inconsistent.
AIM: To evaluate the association between prolonged ALA use and vitamin B12 deficiency by performing a meta-analysis.
METHOD: A systematic search was conducted using MEDLINE, PubMed, EMBASE, Current Contents, Cochrane Library, Google Scholar, Science Direct and Web of Science. Original data were abstracted from each study and used to calculate a pooled odds ratio (OR) and 95% confidence interval (95% CI).
RESULTS: Of the articles reviewed, four case-control studies (4,254 cases and 19,228 controls) and one observational study met full criteria for analysis. The long-term ALA use was significantly associated with development of vitamin B12 deficiency (HR 1.83, 95% CI: 1.36-2.46, p-value 0.00).
CONCLUSION: Chronic use of ALAs is a risk factor for developing vitamin B12 deficiency. Judicious prescribing of ALAs and regular monitoring of vitamin B12 in patients who are inevitably on long-term ALA therapy are recommended.
PMID: 25583062 [PubMed - as supplied by publisher]