{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:44:57Z","timestamp":1782297897031,"version":"3.54.5"},"reference-count":87,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction\/Objectives:<\/jats:title>\n                    <jats:p>\n                      Vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      deficiency (B12D) is associated with multiple risk factors and comorbidities; however, there are no firm guidelines regarding screening for B12D in the population at risk. We aimed to identify the risk factors and comorbidities associated with B12D in an adult population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective review of entire cohort of adult patients who received outpatient medical care in our large urban tertiary healthcare system between January 1, 2011, and December 31, 2020. Variables were compared between the group who had B12D and those who did not (NoB12D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients with B12D (n\u2009=\u20092666) were younger than NoB12D group (n\u2009=\u20092334; 62.2\u2009\u00b1\u200918.5 vs 76.5\u2009\u00b1\u20097.6\u2009year;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). There were significantly higher associations of certain factors in the B12D group compared to NoB12D group, such as female sex, recreational drug use, congestive heart failure (CHF), cerebrovascular accident (CVA), chronic obstructive pulmonary disease (COPD), asthma, peripheral neuropathy (PN), subacute combined degeneration of spinal cord (SCD), dementia, mild cognitive impairment (MCI), gastroesophageal reflux disorder (GERD), gastritis, inflammatory bowel disease (IBD), small bowel resection (SBR), colorectal surgery (CRS), bariatric surgery (BS), depression, bipolar disorder, anxiety disorder, schizophrenia, anemia, use of non-steroidal anti-inflammatory drug (NSAID), proton pump inhibitor (PPI), histamin-2 receptor antagonist (H2RA), and lithium. Compared to White race, Black and Hispanic races had higher odds of B12D (OR\u2009=\u20091.43, 95% CI\u2009=\u20091.02-2.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.040, and OR\u2009=\u20093.15, 95% CI\u2009=\u20092.23-4.45;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001, respectively). Additional comorbidities with greater odds of B12D included respiratory disorders (COPD and asthma; OR\u2009=\u20091.41, 95% CI\u2009=\u20091.12-1.78;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.003), anemia (OR\u2009=\u2009253.72, 95% CI\u2009=\u2009164.66-390.93;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), neurological diseases (PN and SCD; OR\u2009=\u20092.78, 95% CI\u2009=\u20092.16-3.58;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), cognitive disorders (dementia and MCI; OR\u2009=\u20093.37, 95% CI\u2009=\u20092.40-4.74;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), gastrointestinal disorders (GERD, gastritis, IBD, SBR, CRS, and BS; OR\u2009=\u20092.38, 95% CI\u2009=\u20091.95-2.90;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), PPI use (OR\u2009=\u20092.81, 95% CI\u2009=\u20091.88-4.20;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and NSAID use (OR\u2009=\u20091.40, 95% CI\u2009=\u20091.08-1.81;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Younger age, female sex, Black and Hispanic races, recreational drug use, CHF, CVA, COPD, asthma, PN, SCD, dementia, MCI, GERD, IBD, SBR, colorectal surgery, bariatric surgery, depression, bipolar disorder, anxiety disorder, schizophrenia, anemia, use of PPI, H2RA, NSAIDs, and lithium are associated with B12D.<\/jats:p>\n                  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