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Association of Vitamin B12 and Folate Deficiency with Vasovagal Syncope: A Case-Control Study
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  • Arya Aminorroaya,
  • Ali Vasheghani-Farahani,
  • Hamed Tavolinejad,
  • Zahra Aryan,
  • Somayeh Yadangi,
  • Ali Bozorgi,
  • saeed sadeghian,
  • Mohammadali Boroumand,
  • Masud Yunesian,
  • Masih Tajdini
Arya Aminorroaya
Yale University Department of Internal Medicine
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Ali Vasheghani-Farahani
Tehran Heart Center

Corresponding Author:avasheghani@tums.ac.ir

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Hamed Tavolinejad
Tehran Heart Center
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Zahra Aryan
New Jersey Medical School Department of Medicine
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Somayeh Yadangi
Tehran Heart Center
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Ali Bozorgi
Tehran Heart Center
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saeed sadeghian
Tehran Heart Center
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Mohammadali Boroumand
Tehran Heart Center
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Masud Yunesian
Tehran University of Medical Sciences
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Masih Tajdini
Tehran Heart Center
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Abstract

Aims: There is some clinical evidence of the association between vitamin B12 deficiency and vasovagal syncope (VVS) in pediatric patients. We aimed to investigate the possible association of vitamin B12 and folate deficiency with VVS in adults. Methods: In this case-control study, we included adult patients with VVS who presented to our tertiary syncope unit for a head-up tilt table test as the case group. We selected age- and sex-matched individuals without any history of syncope from the population-based Tehran Cohort Study as the control group. The exclusion criteria included but were not restricted to taking vitamin B supplements, carbamazepine, or phenobarbital, and sleeve gastrectomy. We measured and compared serum levels of vitamin B12, folate, and homocysteine. Results: From February 2020 to February 2021, we included 44 patients in the case group, matched with 44 controls, with a mean age of 37.9 years and 23 (52.3%) females in each group. There was no statistically significant difference between the study groups regarding vitamin B12 or folate deficiency, or their serum levels. The serum level of vitamin B12 was remarkably lower in patients with frequent VVS (≥3 lifetime episodes) compared to patients with infrequent VVS (<3 lifetime episodes) [233.8 (80.7) versus 305.2 (118.1) pg/mL; P=0.042] and this association remained significant after adjustment for possible confounders (P=0.026). Conclusion: We found no association between vitamin B12 or folate deficiency, or their serum levels and VVS; nevertheless, frequent VVS, compared to infrequent VVS, was associated with a lower serum vitamin B12.