Micronutrient Deficiencies In Patients With Chronic Atrophic Autoimmune Gastritis: A Review
F. Cavalcoli, A. Zilli, D. Conte, S. Massironi
Published 2017 · Medicine
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Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach’s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.
This paper references
Regulation of vitamin C transport.
J. X. Wilson (2005)
Iron deficiency, gastric atrophy and Helicobacter pylori.
W. Dickey (2002)
Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial.
Y. Sato (2005)
Effect of L-lactic
O Chonan (1967)
Níveis séricos de vitamina B12 não se relacionam com baixa densidade mineral óssea em mulheres brasileiras na pós-menopausa
Adriana Maria Kakehasi (2012)
Plasma B vitamins, homocysteine, and their relation with bone loss and hip fracture in elderly men and women.
R. Mclean (2008)
Long-term proton pump inhibitor therapy and risk of hip fracture.
Yu-Xiao Yang (2006)
Roles of vitamins B5, B8, B9, B12 and molybdenum cofactor at cellular and organismal levels.
F. Rébeillé (2007)
The Relationship Between Proton Pump Inhibitor Use and Longitudinal Change in Bone Mineral Density: A Population-Based From the Canadian Multicentre Osteoporosis Study (CaMos)
L. Targownik (2012)
Detection of latent pernicious anaemia in iron-deficiency anaemia.
J. H. Dagg (1966)
The parathyroid glands in experimentally induced hypergastrinemia in the rat.
L. Grimelius (1977)
Low plasma vitamin B12 is associated with lower BMD: the Framingham Osteoporosis Study.
K. Tucker (2005)
Hip fracture risk in patients with a diagnosis of pernicious anemia.
N. Merriman (2010)
31 the basis of variability in cobalamin levels in the general population
E Lahner (2013)
Vitamin B12 deficiency.
J. Pacala (1993)
Pernicious anaemia as a risk factor for osteoporosis.
R. Eastell (1992)
salivary nitrite in human gastric juice
P Sipponen (2003)
Published by Baishideng Publishing Group Inc 8226 Regency Drive
Acid-Suppressive Medications and Risk of Bone Loss and Fracture in Older Adults
E. Yu (2008)
Calcium absorption and achlorhydria.
R. Recker (1985)
Megaloblastic and nonmegaloblastic macrocytic anemias
Lukens J Wintrobe (1981)
Alterations in intragastric nitrite
C Mowat (1941)
Effect of omeprazole, an inhibitor of H+, K+-ATPase, on bone resorption in humans
K. Mizunashi (2005)
Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients.
D. Corley (2010)
High prevalence of atrophic body gastritis in patients with unexplained microcytic and macrocytic anemia
M. Marignani (1999)
Observations on the absorption of iron from foods tagged with radioiron.
C. Moore (1951)
Calcium gluconate supplementation is effective to balance calcium homeostasis in patients with gastrectomy
Mathias B. Krause (2014)
Autoimmune gastritis presenting as iron deficiency anemia in childhood.
Cristina Gonçalves (2014)
Unravelling the basis of variability in cobalamin levels in the general population.
T. Andrew (2013)
Ascorbic acid chelates in iron absorption: a role for hydrochloric acid and bile.
M. Conrad (1968)
Effects of vitamin
GS 042737-200112000-00008 Kim (2000)
Megaloblastic anemia in North Africa.
C. Maktouf (2006)
Roles of Vitamins B5, B8, B9, B12 and Molybdenum Cofactor at Cellular and Organismal Levels
F. Rébeillé (2008)
Examining the Link Between Bariatric Surgery, Bone Loss, and Osteoporosis: a Review of Bone Density Studies
L. Scibora (2012)
Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study.
S. Massironi (2013)
Hypochlorhydric stomach: a risk condition for calcium malabsorption and osteoporosis?
P. Sipponen (2010)
R. Charlton (1983)
Inhibition by vitamins C and E of in vivo nitrosation and vitamin C occurrence in the stomach
S. Mirvish (1996)
Calcium in the diet: food sources, recommended intakes, and nutritional bioavailability.
D. Miller (1989)
Alterations in intragastric nitrite and vitamin C levels during acid inhibitory therapy.
C. Mowat (2001)
High prevalence of atrophic body gastritis in patients with unexplained microcytic and macrocytic anemia: A prospective screening study
M. Marignani (1999)
Risk of fractures in patients with pernicious anemia.
J. Goerss (1992)
Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms.
B. Annibale (2001)
Simple Achlorhydric Anemia.
Nathan Rosenthal (1933)
Serum levels of vitamin B12 are not related to low bone mineral density in postmenopausal Brazilian women.
Adriana Maria Kakehasi (2012)
intakes, and nutritional bioavailability
RR Recker (1989)
Effect of L-lactic acid on the absorption of calcium in gastrectomized rats.
O. Chonan (1998)
The long‐term effects of cure of Helicobacter pylori infection on patients with atrophic body gastritis
B. Annibale (2002)
Systematic review: gastric cancer incidence in pernicious anaemia
L. Vannella (2013)
Pernicious anaemia patients should be WJG|www.wjgnet.com
H Demiroğlu (2002)
Impaired skeletal health in patients with chronic atrophic gastritis
K. Aasarød (2016)
Pernicious Anemia in Chinese: A Study of 181 Patients in a Hong Kong Hospital
Joyce Chee Wun Chan (2006)
Studies of Nitric Oxide Generation from Salivary Nitrite in Human Gastric Juice
K. Iijima (2003)
Studies on ascorbic acid deficiency in gastric diseases : incidence, diagnosis and treatment.
John B. Ludden (1941)
Vitamin C, Gastritis, and Gastric Disease: A Historical Review and Update
A. Aditi (2012)
Growth of the parathyroid glands in omeprazole-treated chickens.
R. Gagnemo-Persson (1994)
reaction: possible means of blocking the formation of carcinogenic N-nitroso compounds
SS Mirvish (1972)
70 acid on the absorption of calcium in gastrectomized rats
R Eastell (1998)
Ascorbate-Nitrite Reaction: Possible Means of Blocking the Formation of Carcinogenic N-Nitroso Compounds
S. Mirvish (1972)
Helicobacter pylori--is it a novel causative agent in Vitamin B12 deficiency?
K. Kaptan (2000)
Screening for vitamin B-12 and folate deficiency in older persons.
R. Clarke (2003)
Vitamin B12: one carbon
EC Rush (2013)
Single nucleotide polymorphisms related to vitamin B12 serum levels in autoimmune gastritis patients with or without pernicious anaemia.
Edith Lahner (2015)
Nutritional deficiency in atrophic autoimmune gastritis screened for iron deficiency during follow up
JX Wilson (1997)
Genome-wide significant predictors of metabolites in the one-carbon metabolism pathway.
A. Hazra (2009)
Prevalence of undiagnosed pernicious anemia in the elderly.
R. Carmel (1996)
Consequences of Helicobacter pylori infection on the absorption of micronutrients.
B. Annibale (2002)
Atrophic body gastritis patients with enterochromaffin-like cell dysplasia are at increased risk for the development of type I gastric carcinoid
B. Annibale (2001)
Cobalamin and osteoblast-specific proteins.
R. Carmel (1988)
Common features of patients with autoimmune atrophic gastritis.
E. Miceli (2012)
Genome-wide association study identifies novel loci associated with serum level of vitamin B12 in Chinese men.
X. Lin (2012)
Lack of specific association between gastric autoimmunity hallmarks and clinical presentations of atrophic body gastritis.
B. Annibale (2005)
Effects of vitamin B 12 on cell proliferation and cellular alkaline phosphatase activity in human bone marrow stromal osteoprogenitor cells and UMR 106 osteoblastic cells
GS Kim (1996)
Diagnosis and classification of autoimmune gastritis.
B. Toh (2014)
Variation at ABO histo‐blood group and FUT loci and diffuse and intestinal gastric cancer risk in a European population
E. Duell (2015)
F. Nabavi (2012)
An update on cobalamin deficiency in adults.
N. Dali-Youcef (2009)
The absorption of calcium carbonate.
P. Ivanovich (1967)
Pernicious anemia: new insights from a gastroenterological point of view.
E. Lahner (2009)
Immunological and morphogenic basis of gastric mucosa atrophy and metaplasia
G. Faller (2004)
Prevalence of Chronic Atrophic Gastritis in Different Parts of the World
M. Weck (2006)
Effects of vitamin B12 on cell proliferation and cellular alkaline phosphatase activity in human bone marrow stromal osteoprogenitor cells and UMR106 osteoblastic cells.
G. Kim (1996)
Atrophic Gastritis: A Related Factor for Osteoporosis in Elderly Women
Hye Won Kim (2014)
Diagnosis and management of clinical and subclinical
R. Carmel (2000)
Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies.
Elaine W. Yu (2011)
Effect of L-lactic acid on calcium absorption in rats fed omeprazole.
O. Chonan (1998)
Evaluation of Bone Mineral Density Loss in Morbidly Obese Women After Gastric Bypass: 3-Year Follow-Up
N. Vilarrasa (2011)
Autoantibodies to parietal cells as predictors of atrophic body gastritis: a five-year prospective study in patients with autoimmune thyroid diseases.
R. Tozzoli (2010)
The effect of achylia gastrica
JD Cook (1931)
Vitamin B12 deficiency in the elderly.
E. Norman (1985)
Pernicious anaemia patients should be screened for iron deficiency during follow up.
H. Demiroğlu (1997)
Diagnosis and management of clinical and subclinical cobalamin deficiencies: why controversies persist in the age of sensitive metabolic testing.
R. Carmel (2013)
Exocrine and Endocrine Epithelial Changes in Types A and B Chronic Gastritis
E. Solcia (1990)
Hip fracture risk
NA Merriman (2010)
E-mail: firstname.lastname@example.org Help Desk: http://www.wjgnet.com/esps/helpdesk
Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion.
C. Hershko (2006)
THE EFFECT OF ACHYLIA GASTRICA ON IRON ABSORPTION.
J. Cook (1964)
Vitamin B12 absorption: mammalian physiology and acquired and inherited disorders.
R. Kozyraki (2013)
Proton Pump Inhibitors, Histamine H2 Receptor Antagonists, and Other Antacid Medications and the Risk of Fracture
P. Vestergaard (2006)
Two‐thirds of Atrophic Body Gastritis Patients Have Evidence of Helicobacter pylori Infection
B. Annibale (2001)
64 condition for calcium malabsorption and osteoporosis
DD Miller (2010)
Vitamin B12 absorption: mammalian
R Kozyraki (1981)
THE BLOOD PLASMA ASCORBIC ACID IN PATIENTS WITH ACHLORHYDRIA (PERNICIOUS AND IRON DEFICIENCY ANEMIA)
Howard L. Alt (1939)
Proton pump inhibitors reduce the bioavailability of dietary vitamin C
E. Henry (2005)
Determination of calcium salt solubility with changes in pH and P(CO(2)), simulating varying gastrointestinal environments.
Sandra L. Goss (2007)
Vitamin B12: one carbon metabolism, fetal growth and programming for chronic disease
E. Rush (2014)
M. Israél̀s (1957)
[Vitamin B 12 deficiency in the aged].
É. Pautas (1999)
Hypovitaminosis D as Predisposing Factor for Atrophic Type A Gastritis: a Case–Control Study and Review of the Literature on the Interaction of Vitamin D with the Immune System
A. Antico (2011)
This paper is referenced by
Fetal spina bifida in a pregnant woman following omega gastric bypass: Case report and literature review
Lionel El Khoury (2020)
Association of dietary patterns and endoscopic gastric mucosal atrophy in an adult Chinese population
Song Lin (2019)
Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Ita
E. Lahner (2019)
A Review of Dietary (Phyto)Nutrients for Glutathione Support
Deanna M Minich (2019)
Relevance of vitamin D deficiency in patients with chronic autoimmune atrophic gastritis: a prospective study
Sara Massironi (2018)
M. Lenti (2020)
Non-invasive method for the assessment of gastric acid secretion
Miraglia Chiara (2018)
A comparison of serum and plasma specimens in NMR-based metabonomics and its application in chronic atrophic gastritis rats
Yuetao Liu (2019)
Adverse Effects of Proton Pump Inhibitors—Evidence and Plausibility
R. Fossmark (2019)
Correlation between serum vitamin B12 level and peripheral neuropathy in atrophic gastritis
G. Yang (2018)
[Hypoparathyroidism - un underestimated problem?]
Stephan Petersenn (2019)
Frailty and the gut.
A. Di Sabatino (2018)
Severe megaloblastic anemia: Vitamin deficiency and other causes
Daniel S Socha (2020)
The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective.
S. Massironi (2019)
Unusual presentation of pica in iron-deficiency anaemia associated with primary biliary cholangitis
N. Onuorah (2019)
Deficiency of micronutrients in patients affected by chronic atrophic autoimmune gastritis: A single-institution observational study.
Alessandra Zilli (2019)
Thyro-entero-gastric autoimmunity: Pathophysiology and implications for patient management.
Edith Lahner (2019)