Association of Vitamin B12 Deficiency and Metformin Use in Patients with Type 2 Diabetes.
10.3346/jkms.2014.29.7.965
- Author:
Sun Hye KO
1
;
Sun Hee KO
;
Yu Bae AHN
;
Ki Ho SONG
;
Kyung Do HAN
;
Yong Moon PARK
;
Seung Hyun KO
;
Hye Soo KIM
Author Information
1. Division of Endocrinology & Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. drkhs@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Diabetes Mellitus;
Type 2;
Metformin;
Vitamin B12 Deficiency
- MeSH:
Aged;
Area Under Curve;
Diabetes Mellitus, Type 2/complications/diagnosis/*drug therapy;
Female;
Folic Acid/blood;
Humans;
Hypoglycemic Agents/adverse effects/*therapeutic use;
Immunoassay;
Male;
Metformin/adverse effects/*therapeutic use;
Middle Aged;
Odds Ratio;
Patients;
Prevalence;
ROC Curve;
Time Factors;
Vitamin B 12/blood;
Vitamin B 12 Deficiency/diagnosis/epidemiology/*etiology
- From:Journal of Korean Medical Science
2014;29(7):965-972
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated the prevalence of vitamin B12 deficiency and associated factors in type 2 diabetes patients using metformin. A total of 799 type 2 diabetes patients using metformin was enrolled. Vitamin B12 and folate levels were quantified by chemiluminescent enzyme immunoassay. Vitamin B12 deficiency was defined as vitamin B12 < or = 300 pg/mL without folate deficiency (folate > 4 ng/mL). The prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B12 level was 662.5 +/- 246.7 pg/mL. Vitamin B12 deficient patients had longer duration of metformin use (P < 0.001) and higher daily metformin dose (P < 0.001) than non-deficient patients. Compared with daily metformin dose of < or = 1,000 mg, the adjusted odds ratio for 1,000-2,000 mg, and > or = 2,000 mg were 2.52 (95% CI, 1.27-4.99, P = 0.008) and 3.80 (95% CI, 1.82-7.92, P < 0.001). Compared with metformin use of < 4 yr, the adjusted odds ratios for 4-10 yr, and > or = 10 yr were 4.65 (95% CI, 2.36-9.16, P < 0.001) and 9.21 (95% CI, 3.38-25.11, P < 0.001), respectively. In conclusion, our study indicates that patients with type 2 diabetes treated with metformin should be screened for vitamin B12 deficiency, especially at higher dosages (> 1,000 mg) and longer durations (> or = 4 yr) of treatment.
