Predictors of Vitamin B12 Deficiency Among Patients with Skin Hyperpigmentation Attending the Dermatologyclinic at Acharya Vinoba Bhave Rural Hospital Wardha, India

Abstract

Background: India like any other developing country is grappling with malnutrition cases due to avoidable factors. In developing countries like India, nutritional deficiencies are prevalent and hyperpigmentation due to protein energy malnutrition, zinc deficiency and pellagra are common (Santra et al., 2014). Prevalence of B12 deficiency varies from 3% to 5% in the general population and 5% to 20% among people older than 65 years (Agrawala et al, 2013).Aim: To determine the prevalence and factors associated with vitamin B12 deficiency among patients with skin hyper-pigmentation attending the dermatology clinic at AVBRH Hospital, India.  

Materials and Methods: A cross-sectional study involving 164 patients with skin hyperpigmentation at AVBRH hospital, India was conducted from 1st April to June 30th 2024. Interviewer-administered questionnaires were used to obtain data. Descriptive statistics followed by binary logistic regression were conducted to achieve the study objectives using Stata version 14.2.

Results: Of the 164 respondents, 73(44%) had vitamin B12 deficiency. The mean plasma vitamin B12 level was 201 pg/ml among strict vegans as compared to 314 pg/ml in non-strict vegans. Young age (OR=7.1; 95%CI: 1.120-2.737; p=0.009), distance more than 5 kilometers from nearest health facility (OR=3.8, 95%CI: 0.024-0.187; p=0.005), not employed (OR=2.5, 95%CI: 0.731-4.071; p=0.026), beingstrict vegetarian ((OR=2.1, 95%CI: 0.141-1.050; p=0.002), and reduced number of meals less than 3 per day (OR=9.1; 95%CI: 3.14-7.320, p=0.005) were independently associated with vitamin B12 deficiency among patients with skin hyperpigmentation at AVBRH hospital, India. 

Conclusions: The prevalence of Vitamin B12 deficiency among Patients with skin hyperpigmentation is high in India. Young age, residing more than 5 kilometers from health facility, being a strict vegetarian, having less than 3 meals per day and unemployment are predictive for vitamin B12 deficiency among Patients with skin hyperpigmentation at AVBRH hospital Recommendations: There is a need for routine assessment of vitamin B12 among Patients with skin hyperpigmentation at health facilities by the attending clinicians. There is a need for health authorities in AVBRH hospital to sensitize the public and healthcare workers on the predictor factors for vitamin B12 deficiency. Dietary supplementation and use of vitamin B12 fortified foods is recommended among high risk population like strict vegetarian

Funding: the work has not been funded by any external or internal sources, all the entire work was handled by the authors themselves without any funding from any sponsor or institution.

Declaration of Interest: on behalf of the Authors of the manuscript as corresponding Author i hereby declare that there is no conflict of interest among authors.

Ethical Approval: The Research and Ethics Committee (REC) of Datta Meghe Institute of higher education and research and the Department of dermatology both provided their ethical approval.

Keywords: Vitamin B12 DeficiencySkin HyperpigmentationDermatologyNutritional DeficiencyPredictive FactorsVegetarian DietMalnutrition