Iron and Vitamin B12 Deficiency in Patients with Autoimmune Gastritis and Helicobacter pylori Gastritis: Results from a Prospective Multicenter Study.

Introduction Iron and vitamin B12 deficiencies are common in patients with atrophic gastritis, but there is limited data on the prevalence of these deficiencies in different types of atrophic gastritis. Methods This multicenter prospective study assessed micronutrient concentrations in patients with histologically confirmed autoimmune gastritis (AIG, n=45), H. pylori-related non-autoimmune gastritis (NAIG, n=109), and controls (n=201). A multivariate analysis was performed to determine the factors influencing those deficiencies. Results The median vitamin B12 concentration was significantly lower in AIG (367.5 pg/mL) than in NAIG (445.0 pg/mL, p=0.001) and control patients (391.0 pg/mL, p=0.001). Vitamin B12 deficiency was found in 13.3%, 1.5%, and 2.8% of AIG, NAIG, and controls, respectively. Median ferritin concentration was significantly lower in AIG (39.5 ng/mL) than in NAIG (80.5 ng/mL, 133.9, p=0.04) and controls (66.5 ng/mL, p = 0.007). Iron deficiency and iron deficiency adjusted to CRP were present in 28.9% and 33.3% of AIG, 12.8% and 16.5% of NAIG, 12.9% and 18.4% of controls, respectively. Multivariate analysis demonstrated that AIG had a higher risk of developing vitamin B12 deficiency (OR 11.52 (2.85-57.64, p=0.001)) and iron deficiency (OR 2.92 (1.32- 6.30, p=0.007)) compared to controls. Age, sex, and H. pylori status did not affect vitamin B12 or iron deficiency. Conclusion Iron and vitamin B12 deficiencies are more commonly observed in patients with AIG than in NAIG or controls.

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