{"references": ["1. Schuppan D, Afdhal NH. Liver cirrhosis. Lancet 2008; 371: 838\u201351 2. Sugihara T, Koda M, Okamoto T, Miyoshi K, Matono T, Oyama K, Hosho K, Okano JI, Isomoto H, Murawaki Y. Falsely elevated serum vitamin B12 levels were associated with the severity and prognosis of chronic viral liver disease. Yonagoactamedica. 2017;60(1):31. 3. Rachmilewitz M, Stein Y, Aronovitch J, Grossowicz N. The clinical significance of serum cyanocobalamin (vitamin B12) in liver disease. AMA archives of internal medicine. 1958 ;101(6):1118-25. 4. Baker H, Leevy CB, De Angelis B, Frank O, Baker ER. Cobalamin (vitamin B12) and holotranscobalamin changes in plasma and liver tissue in alcoholics with liver disease. J Ameri Colle Nutrit. 1998;17(3):235-8. 5. Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. CMAJ. 2005;172(3) :367-79. 6. Port GZ, Oliveira K, Soldera J, Tovo CV. Biochemical nutritional profile of liver cirrhosis patients with hepatocellular carcinoma. Arquivos de Gastroent- erologia. 2014;51(1):10-5. 7. Moore CM, Van Thiel DH. Cirrhotic ascites review: Pathophysiology, diagnosis and management. World J Hepatology. 2013;5(5):251. 8. Haq MI, Salim A, Malik K, Dilshad A, Amin J, Butt AK, Alam A. Correlation of Child-Pugh Class of Cirrhosis and Lipid Profile. Proceeding SZPGMI. 2016;30(1): 19-23. 9. Bosy-Westphal A, Ruschmeyer M, Czech N, Oehler G, Hinrichsen H, Plauth M, Lotterer E, Fleig W, M\u00fcller MJ. Determinants of hyperhomocysteinemia in patients with chronic liver disease and after orthotopic liver transplantation. Ameri J Clin Nutrit. 2003;77(5):1269- 77. 10. Jamil Z, Arif S, Khan A, Durrani AA, Yaqoob N. Vitamin D Deficiency and Its Relationship with Child- Pugh Class in Patients with Chronic Liver Disease. J Clini Translat Hepatol. 2018;6(2):1-6."]}

Concentrations of cyanocobalamin (vitaminB12) in serum have been found to be elevated in acute and chronic liver disease associated with hepatocellular damage.In severe liver disease, liver tissue B12 binding is disrupted and causes B12 to leak out of the liver into the circulation. The cross sectional study was conducted on 50 cirrhotic patients presenting to OPD or admitted in the Department of Medicine, People's Hospital, Bhopal, from November 2017 to April 2018 with objective to estimate serum vitamin B12 levels in patients with chronic liver disease and to find out the relationship between severity of cirrhosis (Child Pugh) with levels of serum Vitamin B12. The inclusion criteria was age>18 years and known and established cases of cirrhosis by ultrasound abdomen. Patients with the history of chronic alcoholic liver disease and patients taking vitamin B12 supplements. Details regarding socio-demographic variables and history was obtained followed by physical, biochemical and histological examination of liver. Majority of the patients belonged to the age group 41-60 years (48%) and 74.0% were males. Mean Vitamin B 12 level in present study was estimated to be 518.2±245.4 pg/ml. The association of mean Vitamin B12 in relation to Child Pugh Class was found to be statistically significant (p<0.05). Vitamin B 12 levels in present study were found to be elevated amongst the patients of cirrhosis. Also the association of mean Vitamin B12 in relation to Child Pugh Class was found to be statistically significant (p<0.05).