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No Correlation Exists Between Vitamin B12 and Quality of Life in Healthy Young Adult Population

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No Correlation Exists Between Vitamin B12 and Quality of Life in Healthy Young Adult Population European Review for Medical and Pharmacological Sciences 2011; 15: 1176-1181 No correlation exists between vitamin B12 and quality of life in healthy young adult population S.I. ALAZZAM1,3, K.H. ALZOUBI1, L.T. AL-HAMBOUTH1, F. ALMAHASNEH1, S.M. ABURUZ2 1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid (Jordan) 2Department of Clinical Pharmacy, Faculty of Pharmacy, University of Jordan, Amman (Jordan) Abstract. – Background and Objectives: hematopoiesis1. B12 deficiency is a common Vitamin B12 (B12) is essential for well-being and problem that affects the general population, par- healthy life, since it plays a critical role in DNA ticularly elderly people. It may take years to de- synthesis, hematopoiesis and neurologic func- velop and begins with depletion of serum B12, tion. B12 deficiency remains one of the most common nutrition deficiencies in the world and followed by cellular deficiency and biochemical is associated with increasing risk of cardiovas- changes including elevated homocysteine (Hcy) cular disease, cancer, mental health problem, os- and methylmalonic acid (MMA)2. teoporosis, and defect-birth outcomes. The main Vitamin B12 deficiency is associated with objective of this study is to determine the impact hematologic and neuropsychiatric manifesta- of B12 levels on quality of life (QOL) among tions, including macrocytic (megaloblastic) ane- healthy university students. Materials and Methods: This cross-section- mia, paresthesias, peripheral neuropathy, im- al study involved 359 healthy university students paired memory, irritability, depression and de- (age 18-30 years) of both genders. Their QOL mentia3. Recent studies found an association be- was as vitamin B12 level was measured using tween B12 deficiency and increasing risk of car- the IMx system (Abbott laboratories IMX, USA). diovascular disease (CVD)4,5 cancer6,7, mental Results: No correlation was detected between health problem8, osteoporosis9, and defect-birth B12 levels and the two major QOL subscales: outcomes10. It has also been suggested that ade- the Physical Component Summary (PCS) and Mental Component Summary (MCS). Additional- quate levels of B12 have a protective effect 11 ly, none of the other eight subscale of the SF-36 against chronic disease and neural tube defect . was significantly correlated with b12 levels. The diagnosis of vitamin B12 deficiency has Conclusion: We conclude that no correlation traditionally been based on low serum vitamin exists between B12 levels and QOL scores B12 level, which is usually less than 200 pg/mL among young adult healthy populations. Further (150 pmol/L), along with clinical evidence of investigations are required to confirm the impact 12 of B12 status on QOL among healthy popula- disease . Furthermore, recent evidence showed tions. that methylmalonic acid and homocysteine are additional status indicators that should be evalu- Key Words: ated to enhance the diagnostic value of serum B12 concentrations13-16. B12, Quality of life, University, Students, Jordan. B12 deficiency remains one of the most com- mon nutrition deficiencies in the world. In Jor- dan, the exact prevalence of B12 deficiency in general population has not been assessed, but B12 deficiency appears to be a significant prob- Introduction lem in different age ranges17,18. A number of re- cent researches showed a high frequency of sub- Vitamin B12 (B12) is a water soluble essential optimal serum vitamin B12 level among adult in vitamin that is found mainly in animal products. Jordan18. Other studies found a high prevalence B12 plays a critical role in neurologic function, of B12 deficiency in Jordanian youth increasing and, along with folic acid, DNA synthesis and at an alarming rate17. The main objective of this 1176 Corresponding Author: Sayer Alazzam, MSc, PharmD, BCPS; e-mail: [email protected] No correlation exists between vitamin B12 and quality of life in healthy young adult population study was to investigate the correlation between limitations because of physical problems, and B12 levels and quality of life among healthy uni- role limitation due to personal or emotional prob- versity students in Jordan using a validated Ara- lems24. In addition to the eight scales, the SF-36 bic version19,20 of the Current Health Assessment authors have developed two summary scales (SF-36), which is one of the most widely used that provide a more concise measure of overall health surveys. physical and mental health, the Physical Com- ponent Summary (PCS) and Mental Component Summary (MCS). These are linear combina- tions of all eight of the original scales, with the Materials and Methods PCS heavily weighting physical measures and the MCS heavily weighting mental health mea- After an announcement of our study at various sures22. colleges in the University, three hundred and fifty nine (n= 359) healthy university students from Statistical Analysis Jordan University of Science and Technology The statistical analysis was performed using were willing to participate in the research. This the Statistical Package for Social Sciences soft- study was carried out in the Medical Laboratory ware (SPSS 15, Chicago, IL, USA). Since most at King Abdullah University Hospital and lasted variables were not normally distributed, data for approximately 4 months. The following in- analysis was conducted using Spearman’s rho clusion criteria were adopted: volunteer Univer- correlation coefficient to investigate the correla- sity students of both genders; volunteer’s age tion of vitamin B12 and each dimension of SF- should be between 18 and 30 years; volunteer 36. Group differences (such as gender difference should not have acute or chronic illness. Volun- in quality of life) were investigated using ANO- teer should not be on chronic medications; volun- VA or independent sample t-test and. p value of teer should not be on any medications that might less than 0.05 was considered significant. affect the B12 absorption parameters (e.g. met- formin, anticonvulsants, vitamin supplements, proton pump inhibitors, H2-receptor antagonists, oral contraceptives and acetylsalicylic acid). Fi- Results nally, female volunteers should not be pregnant or on contraceptives. Three hundred and fifty nine healthy Universi- The Human Research Committee at the Jordan ty students of both genders (18 to 30 years old) University of Science and Technology approved participated in this study. Table I shows demo- this research. Every volunteer signed a written graphic characteristics of the participants. Fe- informed consent after explaining the purpose of males represented 60.4% of the sample. As for the study, how much blood to be withdrawn and age, 14.5% of the sample was 18-20 years old, confidentiality of information. 80% of the sample was 21-25 years old and the A cross-sectional design was used to investi- rest was 26-30 years old. The table also shows gate the correlation between serum B12 levels that 63.2% of the sample had normal body mass and health-related quality of life (HRQOL) for index (BMI) and 15% of the participants used to healthy University students in Jordan. At the be- smoke. In addition, no correlation was found be- ginning of the study, all participants were re- tween the demographic characteristics of the vol- quested were asked to sign a written informed unteers such as age, gender, smoking, and BMI, consent. Then, they were asked to fill out a ques- and the quality of life (Table I). Therefore, it can tionnaire that provided information about stu- be concluded that none of these variables have dents including age, gender, weight, height, affected the relationship between B12 and quali- smoking status, medical and medication history ty of life. students. To assess the quality of life (QOL), par- Participants’ laboratory data showed that the ticipants were asked to fill out the Arabic version means of variables such as complete blood cell of the 36-item Short-Form (SF-36) Healthy Sur- count, serum B12 levels and folate levels were vey SF-36 questionnaire21. The survey consists of within normal ranges (Table II). eight subscales: physical functioning, bodily Among the studied sample, 96.4% (346) got pain, vitality or energy level, social functioning, normal B12 plasma level, whereas only 3.6% mental health, general health perceptions, role (n=13) showed B12 plasma level lower than nor- 1177 S.I. Alazzam, K.H. Alzoubi, L.T. Al-Hambouth, F. Almahasneh, S.M. Aburuz Table I. Demographic characteristics of volunteers (N = 359). No correlation was observed between age, gender, BMI, and physical activity, and the quality of life subscales. Volunteers Physical health Mental health Factor n (%) mean ± SD P-value mean ± SD p-value Age 0.780 0.912 18-20 yrs 52 (14.5) 53.08 ± 6.2 53.34 ± 10.4 21-25 yrs 290 (80.0) 52.20 ± 8.1 52.73 ± 10.1 26-30 yrs 17 (4.7) 52.18 ± 8.4 53.17 ± 8.2 Gender 0.153 0.734 Female 142 (60.4) 51.59 ± 8.0 52.62 ± 10.4 Male 217 (39.6) 52.81 ± 7.8 52.98 ± 9.8 BMI 0.169 0.869 Underweight 22 (6.1) 50.12 ± 7.2 54.51 ± 10.3 Normal 226 (63.2) 52.61 ± 7.8 52.89 ± 10.0 Overweight 88 (24.9) 52.68 ± 8.0 52.65 ± 10.2 Obesity 21(5.8) 49.42 ± 8.5 52.21 ± 9.4 Smoking status 0.408 0.200 Non-smoker 302 (85.0) 52.50 ± 7.8 53.13 ± 10.0 Smoker 54 (15.0) 51.54 ± 8.1 51.22 ± 10.2 mal range (<200 pg/ml). Table III shows the dis- SF-36 questionnaire (the PCS and MCS). It can tribution of volunteers between the different lev- be noticed that none of the SF-36 other subscales els of B12 plasma concentration, where the vita- had a significant correlation with vitamin B12 min levels were divided into eight categories and level.
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