(P74) Prevalence and Factors Associated With B6 Insufficiency in NH Patients

Introduction/

Objective: Vitamin B6 plays a critical role in amino acid metabolism. While 19-27% of the US population have low B6 plasma levels, approximately 30 million Americans are affected by B6 deficiency. Lower plasma levels or B6 insufficiency have been associated with all-cause mortality, inflammation, metabolic syndrome, and higher risk of colorectal cancer. Hence, the prevalence of B6 deficiency can impact more on a vulnerable population such as nursing home (NH) patients. This study aims to estimate the prevalence of B6 insufficiency among NH patients in a rural community in Southeast Ohio and to examine factors that may be associated with B6 insufficiency status.

Design/Methodology: Patients admitted to long-term residents of a NH in Southeast Ohio between July 2016 and July 2018 were studied. All subjects were at least 20 years of age at the time of participation. At the facility, 104 patients had morning plasma pyridoxal 5'-phosphate (PLP) levels measured. B6 insufficiency was defined as a PLP plasma level less than or equal to 5 ng/mL (normal reference: 5-50 ng/mL).

Results: Fifty-nine (or 58.4%) of total participants had B6 insufficiency. Compared to those with normal B6 levels (n = 45), there was no statistically significant difference in mean age (69.3 [11.4] vs 68.8 [15.0] years), sex (57.6% vs. 48.9%), BMI (30.9 [9.4] vs 27.8 [7.9]), and percentage of being on Medicaid insurance (26.8% vs. 31.8%) between the two groups. Patients with B6 insufficiency had a significantly higher percentage of co-morbidities in diabetes/thyroid diagnosis (42.4% vs 22.2%), GI diagnosis (84.8% vs 66.7%), cardiovascular condition (47.5% vs 24.4%), and lung diseases (62.7% vs 33.3%) compared to normal B6 group. Patients with B6 insufficiency also had significantly lower serum albumin level (2.7 [0.5] vs 3.0 [0.5] g/dL), hemoglobin level (10.6 [1.9] vs 13.0 [1.9] g/dL, as well as the percentage of having anemia diagnosis (93.2% vs 43.2%). All p values < 0.05. Multiple logistic regression model adjusting for age, BMI, and alcohol use revealed that lower hemoglobin level (adjusted OR 0.74 [0.58, 0.95]), having GI disease diagnosis (adjusted OR 3.09 [1.02, 9.37]), and lung disease (adjusted OR 4.23[1.63, 10.98]) at the time of admission were associated with higher odds of B6 insufficiency.

Conclusion/

Discussion: This study revealed that over one half of the NH patients in this study had B6 insufficiency. The patients with B6 insufficiency often had lower levels of other nutritional biomarkers (such as lower hemoglobin and albumin). Lower hemoglobin levels as well as GI and lung disease diagnoses are significantly associated with higher odds of B6 insufficiency. Nutritional status assessment in NH population should include B6 intake and status to prevent or provide timely treatment for any disorders or diseases that could develop from insufficient vitamin B6.