Higher frequencies of anemia, vitamin B12 deficiency, and gastric parietal cell antibody positivity in folic acid-deficient Taiwanese male oral submucous fibrosis patients

Yu-Hsueh Wu; Yi-Pang Lee; Julia Yu-Fong Chang; Yi-Ping Wang; Chun-Pin Chiang; Andy Sun

doi:10.1016/j.jds.2023.01.014

Higher frequencies of anemia, vitamin B12 deficiency, and gastric parietal cell antibody positivity in folic acid-deficient Taiwanese male oral submucous fibrosis patients

J Dent Sci. 2023 Apr;18(2):801-807. doi: 10.1016/j.jds.2023.01.014. Epub 2023 Jan 28.

Authors

Yu-Hsueh Wu^{1

2}, Yi-Pang Lee³, Julia Yu-Fong Chang^{4

5

6}, Yi-Ping Wang^{4

5

6}, Chun-Pin Chiang^{3

4

5

6}, Andy Sun^{4

5

6}

Affiliations

¹ Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan.
³ Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
⁴ Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
⁵ Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
⁶ Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

Abstract

Background/purpose: Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with folic acid (FA) deficiency (the serum FA level ≤6 ng/mL, so-called FA-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and vitamin B12 deficiencies, and serum gastric parietal cell antibody (GPCA) positivity.

Materials and methods: The blood Hb and serum iron, vitamin B12, FA, and GPCA concentrations in 59 Taiwanese male FA-deficient OSF patients were measured and compared with the corresponding data in 118 age-matched healthy male control subjects.

Results: We found that 3 (5.1%), 35 (59.3%), and 7 (11.9%) of the 59 FA-deficient OSF patients had blood Hb (<13 g/dL) and serum vitamin B12 (≤450 pg/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 59 FA-deficient OSF patients had significantly higher frequencies of serum vitamin B12 deficiency and serum GPCA positivity than 118 healthy control subjects (all P-values <0.05). Of the 3 anemic FA-deficient OSF patients, one had macrocytic anemia and the other two had thalassemia trait-induced anemia.

Conclusion: We conclude that Taiwanese male FA-deficient OSF patients have high frequencies of serum vitamin B12 deficiency and GPCA positivity than healthy control subjects. The vitamin B12 and FA deficiencies in FA-deficient OSF patients are more likely due to OSF symptoms and signs-caused insufficient intake, difficulty in chewing and swallowing, and malabsorption of food fragment-bound vitamin B12 and FA rather than the GPCA positivity in these OSF patients.

Keywords: Anemia; Folic acid deficiency; Gastric parietal cell antibody; Oral submucous fibrosis; Vitamin B12 deficiency.