TITLE:
Cyanocobalamin and 25-Hydroxy Vitamin D Levels in Gout Patients: An Overlooked Issue
AUTHORS:
Yunus Emre Yandı, Ercan Gencer, Beyza Kılavuz, Ali Erdem Baki, Hatice Şahin, Muammer Bilici, Metin Işık, Tamer Alışkan
KEYWORDS:
Gout, Vitamin B12, Vitamin D
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.6 No.4,
November
4,
2016
ABSTRACT: Gout is one of the most frequent type of
inflammatory arthritis in developed countries. The elevation of serum uric acid
levels and the deposition of monosodium urate crystals in joints and/or soft
tissues are the mechanisms of pathogenesis. Uric acid is a product of the
metabolic cleavage of purine nucleotides and organ meats, beef, pork, and lamb,
anchovies, sardines, herring, mackerel, scallops, gravy and beer are known to
be very rich in purine. On the other hand, some of these foods are also the
main sources of vitamin B12 (cyanocobalamin). As a chronic inflammatory
arthritis corticosteroids are frequently prescribed for gout patients, meaning
a higher risk for osteoporosis which may be blocked by daily calcium and
vitamin D replacement. However, there are no recommendations about screening or
replacement of Gout patients for vitamin D and B12. Herein, we evaluated our
patients retrospectively to document their vitamin levels and also to find the
factors associated with vitamin deficiency. Totally, 90 patients, 71 (79.9%) male
and 19 (20.1%) female patients with a median diagnostic age of 55 (19 - 80)
were included. Thirty six (40%) patients were newly diagnosed (group 1) but 54
(60%) patients had established diseases (group-2) with median disease duration
of 36 (11-240) months. Nearly half (47.2%) of the patients in group-1 and 37%
of the patients in group-2 had vitamin B 12 deficiency. Similarly, 38.9% in
each group had vitamin D deficiency and 52.8% in group-1 and 44.4% in group-2
had vitamin D insufficiency. In conclusion, we strongly recommend routine
screening and replacement of vitamin B12 and D for patients with Gout.