Retrospective analysis of the effect of vitamin b12 deficiency on hemogram parameters

iii. SUMMARY Introduction and purpose: Vitamin B12 deprivation can be seen in common and in addition to that, sometimes subclinical (suspicious) deficiency of clinical evidences could be worn, reflection to hemogram parameters could be late and in labs, vitamin B12 level could result to normal range values, can cause delays in the treatment. The neurologic diseases and arteriosclerotic changes caused by the deprivation of vitamin B12, should be determined in earlier periods and be cured and this makes quite importance. In the research that we carried in "Medical Faculty of Abant İzzet Baysal University"; the purpose is to find to what extent the hemogram parameters and other laboratory values can contribute to earlier diagnosis of deprivation of vitamin B12, and the neurological and arteriosclerotic changes that can be reversible with earlier treatment and their possibility of being overcome without any damage is determined with early vitamin B12 treatment. Materials and Methodology: This research incorporates 67 patients over the age of 18 who are investigated with vitamin B12 deprivation and have vitamin B12 deprivation, and 54 patients who do not have vitamin B12 deprivation. As a result, 121 patients are included in the research in "Medical Faculty of Abant İzzet Baysal University" between dates of 01.03.2017 and 29.06.2017. Serum vitamin B12 level, above 187 pg/ml which is the reference value of our laboratory, is accepted as normal while below 187pg/ml accepted as deprivation. Anemia presence (according to WHO criteria) is accepted below the values of 13gr/dl in men and 12 gr/dl in women. The other laboratory examinations; urea, creatinine, eGFR, sodium, potassium, ALT, AST, TSH, ferritin, iron, iron chelation, TDBK, vitamin B12, folate, sedimentation, CRP, WBC, RBC, HGB, HCT, MCV, MCH, MCHC, NEU, EOS, BASO, LYM, MPV, PCT, PDW are recorded. For these parameters, our hospital laboratory normal ranges are taken as reference. Findings: When the ages of two groups who have vitamin B12 deprivation and who do not is compared, no meaningful difference is observed (p= 0,334). All the laboratory parameters that are excluded from hemogram have likely distribution. Between the hemogram parameters, in the normal distributed values, PCT value is observed meaningfully different between the groups (p = 0,017). In the not normal distributed values between the hemogram parameters, PDW value is observed meaningfully different (p=0,030). From the calculated values of hemogram parameters, the PDW/PLT ratio is found as meaningfully different (p=0,037). There was no meaningful difference between the other hemogram values comparison. Vitamin B12, HGB and MCV values are evaluated statistically by normal distribution. HGB is observed as normally distributed. The other parameters are found as not distributed normal. Vitamin B12, HGB, MCV values are evaluated statistically by correlation among themselves. HGB and MCV values are found to be meaningfully correlated (p=0,0001). When it is evaluated separately according to sex, in men and women according to deprivation of B12 there was no meaningful difference between the two groups in the sense of anemia presence. When anemia presence and MCV values are compared categorically, meaningful difference is observed (p = 0,0001). When it is evaluated separately according to sex, this meaningful difference is maintained in women (p = 0,0001), while in men this meaningfulness disappeared (p = 0,451). In the comparison of groups, values that are founded as the meaningful PDW, PCT and ratio of PDW/PLT, after the ROC analysis; from these values PDW, can predict vitamin B12 deprivation presence with 64,2% sensitivity and 63,7% specifity when the highest specifity and sensifity with estimate value 17,650 is taken. Conclusion and Discussion: In our research that takes "the effect of hemogram parameters to vitamin B12 deprivation" as the topic; PCT, PDW and PDW/PLT ratio statistically made sense and with the guidance of former research; we think that the mentioned parameters can be used as parameters of diagnosing early period of atherosclerotic period caused by deprivation of vitamin B12. In order to uncover the effect of vitamin B12 deprivation on the hemogram parameters, more wide and prospective works are needed. Keywords: Vitamin B12, Anemia, MCV