Deficiency of micronutrients in patients affected by chronic atrophic autoimmune gastritis: A single-institution observational study

Abstract

Background: Chronic atrophic autoimmune gastritis (CAAG) leads to vitamin B₁₂ deficiency, but other micronutrient deficiencies are largely understudied.

Aims: To investigate the prevalence of micronutrient deficiencies in CAAG patients and their potential relationship with the grading of gastric atrophy or entero-chromaffin-like cells hyperplasia or body mass index (BMI).

Methods: From 2005 to 2016 a number of CAAG patients underwent regular follow-up with annual blood testing and upper gastrointestinal tract endoscopy every years.

Results: Out of the 122 CAAG patients checked (100 F; median age 65 years), 76 presented nutritional deficiencies, single in 24 and multiple in 52 cases: a deficiency of B₁₂ and iron showed in 42 patients, 25-OH vitamin D lacked in 76 and folic acid in 6 cases. 25-OH vitamin D levels directly correlated with B₁₂ levels and were significantly lower in patients with macronodular than in those with linear or micronodular hyperplasia. No significant correlation was observed between B₁₂, folic acid or ferritin levels and BMI, blood gastrin levels, the grading of gastric atrophy or ECL cells hyperplasia.

Conclusions: 25-OH vitamin D deficiency was the main one in CAAG patients: its correlation with B₁₂ deficiency may indicate underlying shared pathogenic mechanisms, although further studies are needed to confirm this hypothesis.

Keywords: Atrophic gastritis; Vitamin B(12) deficiency; Vitamin D deficiency.