Vitamin B12 deficiency-related glossitis is highly associated with serum high gastrin-17 and low pepsinogen I

Abstract

Abstract Background To investigate the correlation between vitamin B12 deficiency-related glossitis (B12-def glossitis) and gastric serum biomarkers [gastrin-17(G17), pepsinogen I (PGI), pepsinogen II (PGII), and anti-H. pylori antibodies] and to analyze the association between B12 deficiency and gastric mucosal function and status. Methods A total of 148 patients diagnosed with B12-def glossitis were enrolled in the case group. Another 110 patients without manifestations of glossitis and B12-def were in the control group. General information, medical history, oral mucosa examination, and hematological results were extracted from patients’ medical records. The gastric serum biomarkers were compared between the case and control groups. Based on the oral lesions, case group patients were divided into atrophic or erythematous types, and hematological results were compared between the two groups. Subgroup analysis was also performed according to the results of gastric serum biomarkers in the case group to compare the degree of B12 deficiency in different subgroups and the effects on erythrocytes and oral mucosa. Results Of the 133 patients in the case group who underwent gastric serological testing, 112 (84.6%) showed serum high G17 and low PGⅠ levels (hereafter referred to as G17hi PGⅠlow), compared with 6.4% in the control group and the difference between the two groups was statistically significant. Hemoglobin (HB) concentration and red blood cell (RBC) amount were more likely to decrease in atrophic type, while the mean corpuscular volume (MCV) increased. Low serum B12 concentration, high serum folate concentration, and low prevalence of H. pylori infection were found in the G17hi PGⅠlow group and the gastrectomy group, all with statistically significant differences compared with those of the non- G17hi PGⅠlow group. Conclusion Gastric serum biomarkers in patients with B12-def glossitis generally showed G17hi PGⅠlow, suggesting possible atrophy of gastric corpus mucosa. The G17hi PGⅠlow and non- G17hi PGⅠlow groups may represent two or more different etiologies of B12 malabsorption. Patients with the erythematous form are probably in the early stages of B12 deficiency.