Are children with cystic fibrosis who are treated with a proton-pump inhibitor at risk for vitamin B-12 deficiency?

Background: In a recent study, the authors demonstrated the beneficial effe ct of proton-pump inhibitors (PPI) on fat malabsorption and bone mineral co ntent in children with cystic fibrosis (CF). Prolonged use of PPI could res ult in vitamin B-12 deficiency as a consequence of impaired release of vita min B-12, from food in a nonacid environment. The aim of this study was to evaluate the vitamin B-12, status of CF patients either treated with a PPI or not by measuring vitamin B-12 and homocysteine blood levels, the latter being a sensitive indicator of vitamin B-12 deficiency. Methods: The study population consisted of 20 CF patients, I I patients tre ated with a PPI for at least 2 years and 9 patients not treated with a PPI, and 10 healthy, age-matched control participants. Homocysteine blood level s were measured by highperformance liquid chromatography, and vitamin B-12 levels were measured by a competitive protein-binding assay. Results: Vitamin B-12 levels were significantly higher in both CF groups co mpared with the control participants (PPI+, P = 0.02; PPI-, P = 0.009), The re was no significant difference in vitamin B-12 levels between both CF gro ups. Homocysteine levels were normal and similar in all groups. Conclusions: Cystic fibrosis patients treated with a PPI for at least 2 yea rs show no si ans of vitamin B-12 deficiency. JPGN 33:342-345, 2001. (C) 20 01 Lippincott Williams & Wilkins, Inc.