Prevalence of vitamin B12 deficiency in vegetarian population and assessment their clinical presentations: An unsearched cause of anemia.

Research Report.

ABSTRACT: Introduction: Cobalamin is an essential molecule for humans. It acts as a cofactor in one-carbon transfers through methylation and molecular rearrangement. These functions take place in fatty acid, amino acid and nucleic acid metabolic pathways. A strict vegetarian diet has been associated with an increased risk of vitamin B12 deficiency. Clinical manifestations of cobalamin deficiency are hematologic and neurological symptoms. Objective: The objective of the study was to identify the prevalence of Vitamin B12 deficiency among vegetarian Population and to further study the prevalence of clinical features of respondents with B12 deficiency. Methods: This study was of descriptive and quantitative design. Descriptive method was used for analysis and interpretation of the collected data, vegetarian population visiting the research site were assessed for serum B12 level clinical features of respondents were studied. Results: Total 162 respondents were enrolled in study, out of them 115 were female and 47 were male. All the respondents were assessed for clinical features and neurological findings associated with cobalamin deficiency, irrespective of B12 level. The mean serum cobalamin level among all respondents was 199.88 pg/ml and mean cobalamin level among respondents with deficiency was 91.48 pg/ml. The prevalence of Vitamin B12 deficiency was 77.16 percent and among them 74.4 percent were male and 78.2 percent were female. Symptoms involving neurological function was found in 75 percent which was tingling extremities, followed by forgetfulness 44 percent and 32 percent parasthesia. 2.4 percent presented with Psychiatric disorder and hameparesis, where lower limb was involved in all. On clinical examination majority found feature was Increased tendon reflexes in 69.6 percent followed by glossitis in 34.4 percent, impaired sensory function in 4.8 percent, followed by Optic atrophy in 2.4 percent. Hematological parameters of respondents were also assessed which showed bicytopenia in 60.8 percent and pancytopenia in 27.27 percent respondents with B12 deficiency. Macrocytosis was seen in only 10.4 percent and the prevalence of anemia among B12 deficiency was 56 percent. Conclusion: In Nepal prevalence of Vitamin B12 deficiency is high in general population also due to the composition of dietary intake. The research also showed high prevalence of cobalamin deficiency in vegetarian population. The respondents did not landed with typical features of B12 deficiency and also the clinical and hematological finding was not suggestive of B12 deficiency in all cases, so during an eye should be kept on B12 deficiency in vegetarian population for assessment of B12 level. No significant pancytopenia or bicytopenia were seen in vitamin B12 deficient population. Few clinical features were present in vitamin B12 deficient subjects but neurological features specific to vitamin B12 deficiency were not seen.