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. 2022 Feb;41(1):77-83.
doi: 10.1007/s12664-021-01210-7. Epub 2022 Jan 11.

Deficiency of folate and vitamin B12 increases oxidative stress in chronic pancreatitis patients

Banavara Narasimhamurthy Girish  1 , Gopalakrishna Rajesh  2 , Kannan Vaidyanathan  3
Affiliations

Deficiency of folate and vitamin B12 increases oxidative stress in chronic pancreatitis patients

Banavara Narasimhamurthy Girish et al. Indian J Gastroenterol. 2022 Feb.

Abstract

Background: Folate and vitamin B12 are involved in metabolic reactions for combating oxidative stress. We measured erythrocyte folate and plasma vitamin B12 and compared these with blood antioxidants - erythrocyte glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD), and plasma vitamin C - and marker of lipid peroxidation, thiobarbituric acid reactive substance (TBARS), in chronic pancreatitis (CP) patients.

Methods: One hundred and seventy-five CP patients (91 tropical, 84 alcoholic) and 113 healthy controls were recruited. Erythrocyte folate and plasma vitamin B12 were measured using microbiological assay, and antioxidant levels and erythrocyte TBARS by spectrophotometry.

Results: Erythrocyte folate and plasma vitamin B12 were significantly lower in CP patients than controls (225.4 ± 9.13 vs. 380.38 ± 17.29 nmol/L, p < 0.001 and 233.23 ± 10.4 vs. 338.84 ± 19.01 pmol/L, p < 0.001), and in diabetic- vs. non-diabetic CP patients. Blood antioxidant levels were significantly lower and TBARS was higher in CP patients as compared to controls. Low folate level correlated with low GSH levels (r = 0.314, p < 0.001). CP patients with low folate and vitamin B12 had low GSH and GPx levels as compared to patients with normal folate and vitamin B12 levels. Low vitamin B12 level was associated with 3.24 (95% CI 1.11-9.46, p < 0.05) fold increased risk of pancreatic insufficiency. Smoking was associated with 9.82 (95% confidence interval [CI] 3.3-29.22, p < 0.05) fold increased risk of having low folate levels.

Conclusion: Low folate and vitamin B12 levels were associated with increased oxidative stress in CP patients.

Keywords: Antioxidants; Ascorbic acid; Cobalamin; Diabetes; Folic acid; Inflammation; Pain; Pancreatic elastase 1; Pancreatic insufficiency; Steatorrhea.

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