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Vitamin B12 deficiency among Newly-Arrived Syrian Refugees in Central Anatolia of Turkey

Year 2017, Volume: 2 Issue: 1, 22 - 30, 22.05.2017

Abstract

Purpose: Vitamin B12 (cobalamin) has the most complex chemical structure of all vitamins and it 

is  obtained naturally only from products of animal origin  in developing countries.  Vitamin B12

deficiency is prevalent in countries of origin of refugees.  The aim of this study was to determine 

the  prevalence  of  vitamin  B12  deficiency  among  newly-arrived  Syrian  refugees  in  Central 

Anatolia of  Turkey. 

Journal of Anatolian Medical Research 2017; 2(1): 22-30

Orjinal 

Araştırma

23

Methods:  Newly  arrived  256  refugees  aged  ≥  16  years  were  tested  for  vitamin  B12  level  and 

other hematological parameters. 

Results: We found that 50 participants (19.5%) had vitamin B12 deficiency (≤ 150 pmol/L).  Low 

levels of vitamin B12 were  prevalent  among males those over the age of 50 (44.4%)  (p=0.01) and 

females those under the age of 50 (75%) (p<0.001). 

Conclusion:  The results of this study shown that, the prevalence of vitamin B12 deficiency was 

higher in Syrian refugees, especially in older men and younger women.  To our knowledge, this is 

the  first  nationally  representative  study  for  Central  Anatolia  of  Turkey  about  vitamin  B12 

deficiency in refugees. 

References

  • 1. Dali-Youcef, N. and E. Andres, An update on cobalamin deficiency in adults. Qjm. 2009;102: 17-28. 2. McLean, E.D., L.H. Allen, C.G. Neumann, J.M. Peerson, J.H. Siekmann, S.P. Murphy, N.O. Bwibo, and M.W. Demment, Low plasma vitamin B-12 in Kenyan school children is highly prevalent and improved by supplemental animal source foods. J Nutr. 2007; 137:676-682. 3. Stabler, S.P. and R.H. Allen, Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr. 2004; 24: 299-326. 4. McLean, E., B. de Benoist, and L.H. Allen, Review of the magnitude of folate and vitamin B12 deficiencies worldwide. Food Nutr Bull. 2008; 29: 38-51. 5. Laillou, A., T.V. Pham, N.T. Tran, H.T. Le, F. Wieringa, F. Rohner, S. Fortin, M.B. Le, T. Tran do, R. Moench-Pfanner, and J. Berger, Micronutrient deficits are still public health issues among women and young children in Vietnam. PLoS One. 2012; 7: 34906. 6. Garcia-Casal, M.N., C. Osorio, M. Landaeta, I. Leets, P. Matus, F. Fazzino, and E. Marcos, High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005; 59:1064-1070. 7. Vitamin B12 deficiency in resettled Bhutanese refugees--United States, 2008-2011. MMWR Morb Mortal Wkly Rep. 2011; 60:343-346. 8. Benson, J., C. Phillips, M. Kay, M.T. Webber, A.J. Ratcliff, I. Correa-Velez, and M.F. Lorimer, Low vitamin B12 levels among newly-arrived refugees from Bhutan, Iran and Afghanistan: a multicentre Australian study. PLoS One. 2013; 8: 57998. 9. Paxton, G.A., K.J. Sangster, E.L. Maxwell, C.R. McBride, and R.H. Drewe, Post-arrival health screening in Karen refugees in Australia. PLoS One. 2012; 7: 38194. 10. de Benoist, B., Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008; 29:238-244. 11. Allen, L.H., How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009; 89: 693-696. 12. Benson, J., T. Maldari, and T. Turnbull, Vitamin B12 deficiency - why refugee patients are at high risk. Aust Fam Physician. 2010; 39:215-217. 13. Thamm, M., G.B. Mensink, and W. Thierfelder, Folic acid intake of women in childbearing age. Gesundheitswesen. 1999; 61:207-212. 14. Green, T.J., B.J. Venn, C.M. Skeaff, and S.M. Williams, Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders. Eur J Clin Nutr. 2005; 59:205-210. 15. Allen, L.H., Causes of vitamin B12 and folate deficiency. Food Nutr Bull. 2008; 29:20-37. Journal of Anatolian Medical Research 2017; 2(1): 22-30 Orjinal Araştırma 30 16. Kaptan, K., C. Beyan, A.U. Ural, T. Cetin, F. Avcu, M. Gulsen, R. Finci, and A. Yalcin, Helicobacter pylori--is it a novel causative agent in Vitamin B12 deficiency? Arch Intern Med. 2000; 160:1349-1353. 17. Clarke, R., J. Grimley Evans, J. Schneede, E. Nexo, C. Bates, A. Fletcher, A. Prentice, C. Johnston, P.M. Ueland, H. Refsum, P. Sherliker, J. Birks, G. Whitlock, E. Breeze, and J.M. Scott, Vitamin B12 and folate deficiency in later life. Age Ageing. 2004; 33:34-41. 18. Carmel, R., I. Aurangzeb, and D. Qian, Associations of food-cobalamin malabsorption with ethnic origin, age, Helicobacter pylori infection, and serum markers of gastritis. Am J Gastroenterol. 2001; 96:63-70. 19. Green, R., Is it time for vitamin B-12 fortification? What are the questions? Am J Clin Nutr. 2009; 89:712-716. 20. Rosenberg, I.H., Science-based micronutrient fortification: which nutrients, how much, and how to know? Am J Clin Nutr.2005; 82:279-280. 21. Dary, O., Establishing safe and potentially efficacious fortification contents for folic acid and vitamin B12. Food Nutr Bull. 2008; 29:214-224. 22. McLean, E., M. Cogswell, I. Egli, D. Wojdyla, and B. de Benoist, Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr. 2009; 12:444-454. 23. Pottie, K., C. Greenaway, J. Feightner, V. Welch, H. Swinkels, M. Rashid, L. Narasiah, L.J. Kirmayer, E. Ueffing, N.E. MacDonald, G. Hassan, M. McNally, K. Khan, R. Buhrmann, S. Dunn, A. Dominic, A.E. McCarthy, A.J. Gagnon, C. Rousseau, and P. Tugwell, Evidence-based clinical guidelines for immigrants and refugees. Cmaj. 2011; 183:824-925.
Year 2017, Volume: 2 Issue: 1, 22 - 30, 22.05.2017

Abstract

References

  • 1. Dali-Youcef, N. and E. Andres, An update on cobalamin deficiency in adults. Qjm. 2009;102: 17-28. 2. McLean, E.D., L.H. Allen, C.G. Neumann, J.M. Peerson, J.H. Siekmann, S.P. Murphy, N.O. Bwibo, and M.W. Demment, Low plasma vitamin B-12 in Kenyan school children is highly prevalent and improved by supplemental animal source foods. J Nutr. 2007; 137:676-682. 3. Stabler, S.P. and R.H. Allen, Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr. 2004; 24: 299-326. 4. McLean, E., B. de Benoist, and L.H. Allen, Review of the magnitude of folate and vitamin B12 deficiencies worldwide. Food Nutr Bull. 2008; 29: 38-51. 5. Laillou, A., T.V. Pham, N.T. Tran, H.T. Le, F. Wieringa, F. Rohner, S. Fortin, M.B. Le, T. Tran do, R. Moench-Pfanner, and J. Berger, Micronutrient deficits are still public health issues among women and young children in Vietnam. PLoS One. 2012; 7: 34906. 6. Garcia-Casal, M.N., C. Osorio, M. Landaeta, I. Leets, P. Matus, F. Fazzino, and E. Marcos, High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005; 59:1064-1070. 7. Vitamin B12 deficiency in resettled Bhutanese refugees--United States, 2008-2011. MMWR Morb Mortal Wkly Rep. 2011; 60:343-346. 8. Benson, J., C. Phillips, M. Kay, M.T. Webber, A.J. Ratcliff, I. Correa-Velez, and M.F. Lorimer, Low vitamin B12 levels among newly-arrived refugees from Bhutan, Iran and Afghanistan: a multicentre Australian study. PLoS One. 2013; 8: 57998. 9. Paxton, G.A., K.J. Sangster, E.L. Maxwell, C.R. McBride, and R.H. Drewe, Post-arrival health screening in Karen refugees in Australia. PLoS One. 2012; 7: 38194. 10. de Benoist, B., Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008; 29:238-244. 11. Allen, L.H., How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009; 89: 693-696. 12. Benson, J., T. Maldari, and T. Turnbull, Vitamin B12 deficiency - why refugee patients are at high risk. Aust Fam Physician. 2010; 39:215-217. 13. Thamm, M., G.B. Mensink, and W. Thierfelder, Folic acid intake of women in childbearing age. Gesundheitswesen. 1999; 61:207-212. 14. Green, T.J., B.J. Venn, C.M. Skeaff, and S.M. Williams, Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders. Eur J Clin Nutr. 2005; 59:205-210. 15. Allen, L.H., Causes of vitamin B12 and folate deficiency. Food Nutr Bull. 2008; 29:20-37. Journal of Anatolian Medical Research 2017; 2(1): 22-30 Orjinal Araştırma 30 16. Kaptan, K., C. Beyan, A.U. Ural, T. Cetin, F. Avcu, M. Gulsen, R. Finci, and A. Yalcin, Helicobacter pylori--is it a novel causative agent in Vitamin B12 deficiency? Arch Intern Med. 2000; 160:1349-1353. 17. Clarke, R., J. Grimley Evans, J. Schneede, E. Nexo, C. Bates, A. Fletcher, A. Prentice, C. Johnston, P.M. Ueland, H. Refsum, P. Sherliker, J. Birks, G. Whitlock, E. Breeze, and J.M. Scott, Vitamin B12 and folate deficiency in later life. Age Ageing. 2004; 33:34-41. 18. Carmel, R., I. Aurangzeb, and D. Qian, Associations of food-cobalamin malabsorption with ethnic origin, age, Helicobacter pylori infection, and serum markers of gastritis. Am J Gastroenterol. 2001; 96:63-70. 19. Green, R., Is it time for vitamin B-12 fortification? What are the questions? Am J Clin Nutr. 2009; 89:712-716. 20. Rosenberg, I.H., Science-based micronutrient fortification: which nutrients, how much, and how to know? Am J Clin Nutr.2005; 82:279-280. 21. Dary, O., Establishing safe and potentially efficacious fortification contents for folic acid and vitamin B12. Food Nutr Bull. 2008; 29:214-224. 22. McLean, E., M. Cogswell, I. Egli, D. Wojdyla, and B. de Benoist, Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr. 2009; 12:444-454. 23. Pottie, K., C. Greenaway, J. Feightner, V. Welch, H. Swinkels, M. Rashid, L. Narasiah, L.J. Kirmayer, E. Ueffing, N.E. MacDonald, G. Hassan, M. McNally, K. Khan, R. Buhrmann, S. Dunn, A. Dominic, A.E. McCarthy, A.J. Gagnon, C. Rousseau, and P. Tugwell, Evidence-based clinical guidelines for immigrants and refugees. Cmaj. 2011; 183:824-925.
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Details

Subjects Health Care Administration
Journal Section Makale
Authors

Muzaffer Keklik This is me

Uğur Kalan This is me

Serdal Korkmaz This is me

Özerhan Özer This is me

Pınar İpek This is me

Adile Ortaköylüoğlu This is me

Ertuğrul Keklik This is me

Publication Date May 22, 2017
Published in Issue Year 2017 Volume: 2 Issue: 1

Cite

Vancouver Keklik M, Kalan U, Korkmaz S, Özer Ö, İpek P, Ortaköylüoğlu A, Keklik E. Vitamin B12 deficiency among Newly-Arrived Syrian Refugees in Central Anatolia of Turkey. JAMER. 2017;2(1):22-30.