Vitamin B12 in Health and Disease 英文参考文献.docVIP

Nutrients 2010, 2, 299-316; doi:10.3390/nu2030299 OPEN ACCESS nutrients ISSN 2072-6643 /journal/nutrients Review Vitamin B12 in Health and Disease Fiona O’Leary and Samir Samman * Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, NSW 2006, Australia; E-Mail: fiona.oleary@.au * Author to whom correspondence should be addressed; E-Mail: samir.samman@.au. Received: 2 February 2010 / Accepted: 1 March 2010 / Published: 5 March 2010 Abstract: Vitamin B12 is essential for DNA synthesis and for cellular energy production. This review aims to outline the metabolism of vitamin B12, and to evaluate the causes and consequences of sub-clinical vitamin B12 deficiency. Vitamin B12 deficiency is common, mainly due to limited dietary intake of animal foods or malabsorption of the vitamin. Vegetarians are at risk of vitamin B12 deficiency as are other groups with low intakes of animal foods or those with restrictive dietary patterns. Malabsorption of vitamin B12 is most commonly seen in the elderly, secondary to gastric achlorhydria. The symptoms of sub-clinical deficiency are subtle and often not recognized. The long-term consequences of sub-clinical deficiency are not fully known but may include adverse effects on pregnancy outcomes, vascular, cognitive, bone and eye health. Keywords: vitamin B12; physiology; nutrition; adults; chronic disease Vitamin B12 deficiency was first described in 1849, and was considered to have a fatal outcome until 1926 when a diet of liver, high in vitamin B12, was shown to slow the disease process. Much is now known about the biochemistry and metabolism of vitamin B12, however, the diagnosis of its deficiency has become more complicated with the classification of a “sub-clinical” deficiency category, characterized by serum vitamin B12 concentrations that were once considered to be adequate. Vitamin B12 deficiency was