2025; 8(2): 34-45

DOI: 10.32114/CCI.2025.8.2.34.45
Published online: 2025-06-30 (first online 2025-06-18)

Correlation of serum vitamin B12, folate, and magnesium levels with severity of fibrosis in non-alcoholic fatty liver disease in the medical ICU.

Kartik Goel [1] , Shailesh Kumar [1] , Rupesh Yadav [2] .

[1] Department of Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India
[2] Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India

    Abstract:

Abstract [EN]   - INTRODUCTION: Non-Alcoholic Fatty Liver Disease (NAFLD) has emerged as a major public health concern worldwide. Characterised by the accumulation of fat in liver cells in the absence of significant alcohol consumption, NAFLD spans a spectrum of conditions, from simple steatosis to more severe forms such as non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis and liver cancer. Recent research has also highlighted the critical role of micronutrients in the development and management of NAFLD, suggesting that deficiencies or imbalances in essential vitamins and minerals may influence disease progression and response to treatment. Therefore, the objective of the study was to evaluate the correlation of serum vitamin B12, folate, and magnesium levels with the severity of fibrosis in non-alcoholic fatty liver disease in the medical ICU. MATERIALS AND METHODS: A prospective cross-sectional observational study was evaluated involving 70 patients with NAFLD diagnosis based on history, ultrasound abdomen and fulfilling inclusion criteria during the study period. The severity of liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) was evaluated using the NAFLD Fibrosis Score. RESULTS: Patients with low vitamin B12 had a mean fibrosis score of 0.46 (SD 1.59), compared to -1.05 (SD 1.43) for those with normal Vitamin B12 levels, with a p-value of 0.009, indicating a significant difference. Patients with low folate levels had a mean fibrosis score of -0.36 (SD 1.63), while those with normal folate levels had a mean score of -1.19 (SD 1.40), with a p-value of 1x10-6. Patients with low magnesium levels had a mean fibrosis score of -0.3 (SD 1.6), while those with normal levels had a score of -1.28 (SD 1.38) (p = 0.001), suggesting a significant difference. CONCLUSIONS: The study concluded that serum levels of Vitamin B12, folate, and magnesium are all correlated with the severity of fibrosis in patients with NAFLD, with folate showing the strongest association. Folate had a significant negative correlation of -0.45 with fibrosis scores, compared to -0.34 for Vitamin B12 and -0.31 for magnesium.

Streszczenie [PL]   - WSTĘP: Niealkoholowa stłuszczeniowa choroba wątroby (NAFLD) stała się poważnym problemem zdrowia publicznego na całym świecie. Charakteryzująca się gromadzeniem tłuszczu w komórkach wątroby przy braku znacznego spożycia alkoholu, NAFLD obejmuje spektrum stanów, od prostego stłuszczenia do cięższych postaci, takich jak niealkoholowe stłuszczeniowe zapalenie wątroby (NASH), które może prowadzić do marskości wątroby i raka wątroby. Ostatnie badania podkreśliły również krytyczną rolę mikroelementów w rozwoju i leczeniu NAFLD, sugerując, że niedobory lub zaburzenia równowagi niezbędnych witamin i minerałów mogą wpływać na postęp choroby i odpowiedź na leczenie. Dlatego celem badania była ocena korelacji poziomów witaminy B12, kwasu foliowego i magnezu w surowicy z ciężkością włóknienia w niealkoholowej stłuszczeniowej chorobie wątroby na oddziale intensywnej terapii medycznej. MATERIAŁY I METODY: Przeprowadzono prospektywne badanie obserwacyjne przekrojowe z udziałem 70 pacjentów z rozpoznaniem NAFLD na podstawie historii choroby, badania ultrasonograficznego jamy brzusznej i spełnienia kryteriów włączenia w okresie badania. Nasilenie włóknienia wątroby u pacjentów z niealkoholową stłuszczeniową chorobą wątroby (NAFLD) oceniano przy użyciu skali włóknienia NAFLD. WYNIKI: Pacjenci z niskim poziomem witaminy B12 mieli średni wynik włóknienia wynoszący 0,46 (SD 1,59), w porównaniu do -1,05 (SD 1,43) u osób z prawidłowym poziomem witaminy B12, przy wartości p wynoszącej 0,009, co wskazuje na istotną różnicę. Pacjenci z niskim poziomem kwasu foliowego mieli średni wynik włóknienia wynoszący -0,36 (SD 1,63), podczas gdy pacjenci z prawidłowym poziomem kwasu foliowego mieli średni wynik -1,19 (SD 1,40), przy wartości p wynoszącej 1x10-6. Pacjenci z niskim poziomem magnezu mieli średni wynik włóknienia wynoszący -0,3 (SD 1,6), podczas gdy pacjenci z prawidłowym poziomem mieli wynik -1,28 (SD 1,38) (p = 0,001), co wskazuje na istotną różnicę. WNIOSKI: Badanie wykazało, że poziom witaminy B12, kwasu foliowego i magnezu w surowicy koreluje z ciężkością włóknienia u pacjentów z NAFLD, przy czym najsilniejszy związek wykazywał kwas foliowy. Kwas foliowy miał istotną ujemną korelację -0,45 z wynikami włóknienia, w porównaniu do -0,34 dla witaminy B12 i -0,31 dla magnezu.

    Citation:

VANCOUVER FORMAT

Goel K, Kumar S, Yadav R. Correlation of serum vitamin B12, folate, and magnesium levels with severity of fibrosis in non-alcoholic fatty liver disease in the medical ICU. Crit. Care Innov. 2025; 8(2): 34-45.
DOI: 10.32114/CCI.2025.8.2.34.45

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