scholarly journals Effect of metformin on serum level of vitamin B12 and folate in patients of type-2 diabetes mellitus

2021 ◽  
Vol 8 (7) ◽  
pp. 922
Author(s):  
Rajesh Meena ◽  
Ramesh Kumar ◽  
Atul Meena ◽  
Om Prakash Meena ◽  
Lokesh Meena ◽  
...  

Background: Several types of DM are caused by a complex interaction of genetic and environmental factors. Depending on the etiology of the DM, factors contributing to hyperglycaemia include- reduced insulin secretion, decreased glucose utilization, and increased glucose production.Objective of the current study was to study the effect of metformin on the level of vitamin B12 and folate in patients of type 2 DM.Methods: This is hospital based study before and after metformin therapy randomized controlled trial was conducted in medicine ward of M. B. hospital, Udaipur. Baseline serum vitamin B12 and folate level of all patients were measured and treatment with metformin 500 mg twice a day was given for 6 months. After 6 months serum vitamin B12 and folate level of all patients were re-evaluated.Results: There was a significant positive correlation (r=0.824, p<0.001) between decrease in vitamin B12 and decrease in folate level after metformin treatment. When analysis for change in vitamin B12 is compared with change in MCV values after 6 months, negative correlation (r=-0.08, p>0.05) was obtained. A non significant correlation (r=-0.08, p>0.05) with change in level of serum folate and change in MCV values or haemoglobin level was obtained.Conclusions: Low serum vitamin B12 level is associated with longer duration and higher dose of metformin use. Routine determination of vitamin B12 level in patients with type 2 DM on high dose of metformin and those with prolonged use of metformin might help in identifying patients that would benefit from vitamin B12 supplements.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Maria Heffernan ◽  
Leanne C. Doherty ◽  
Roberta Hack Mendes ◽  
Michelle Clarke ◽  
Stephanie Hodge ◽  
...  

Abstract Background Older adults are reported to have sub-optimal B vitamin status; targeted food-based solutions may help to address this. The objectives of the OptiAge food intervention study were to develop and investigate the effectiveness of a B vitamin-fortified drink in improving B vitamin biomarkers in older Irish adults with a primary outcome of change in the B vitamin biomarker status. Methods A double-blinded randomised controlled trial was performed in parallel at University College Dublin and Ulster University. Participants aged > 50 years were recruited following screening for exclusion criteria (i.e. taking medications known to interfere with B vitamin metabolism, supplements containing B vitamins, consuming > 4 portions of B vitamin-fortified foods per week or diagnosed with gastrointestinal, liver or pulmonary disease). Recruited participants meeting the inclusion criteria were randomised (by sex and study centre) to receive daily for 16 weeks either B vitamin-fortified or placebo drinks as developed by Smartfish, Norway. Each B vitamin-fortified drink (200 ml) contained 200 µg folic acid, 10 µg vitamin B12, 10 mg vitamin B6 and 5 mg riboflavin, while the placebo was an identical, isocaloric formulation without added B vitamins. Fasting blood samples were collected pre- and post-intervention which were used to measure the primary outcome of change in B vitamin biomarker levels. Results A total of 95 participants were randomised, of which 81 commenced the trial. Of these, 70 completed (37 in the active and 33 in the placebo groups). Intention to treat (ITT) analysis of the B vitamins demonstrated a significant improvement in all B vitamin biomarkers in the active compared to placebo groups: p < 0.01 for each of serum folate, serum vitamin B12 and plasma pyridoxal 5′-phosphate (vitamin B6) and the functional riboflavin biomarker, erythrocyte glutathione reductase activation coefficient (EGRac). Correspondingly, a significant lowering of serum homocysteine from 11.9 (10.3–15.1) µmol/L to 10.6 (9.4–13.0) µmol/L was observed in response to the active treatment (P < 0.001). Similar results were seen in a per-protocol analysis. Conclusions The results demonstrate that a B vitamin-fortified drink was effective in optimising B vitamin status, making this a useful intervention option to improve B vitamin status in older adults. Trial registration ISRCTN, ISRCTN61709781—Retrospectively registered, https://www.isrctn.com/ISRCTN61709781


PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 584-589
Author(s):  
Ambadas Pathak ◽  
Herman A. Godwin ◽  
Luis M. Prudent

The relationship of serum vitamin B12 and folic acid was studied in 24 premature infants. In 14 of the 24, low serum vitamin B12 values were found around 40 days of age. Serum folic acid concentrations were less frequently depressed and were usually associated with normal red cell folate values. No correlation between hematocrits and vitamin B12 or folate levels was found. It is suggested that low concentrations of serum folate and vitamin B12 result from low dietary intake coupled with increased demand by the prematurely born infant.


Author(s):  
Tuphan Kanti Dolai ◽  
Somnath Mondal ◽  
Manisha Jain ◽  
Prakas Kumar Mandal

Background: Tribal population in West Bengal constitutes a significant proportion (5.1%) and the vulnerable group because of lower socio-economic status, poor literacy rate and malnutrition. The present study was conducted to evaluate hemoglobin level and prevalence of anemia among the tribal children from the western districts of West Bengal, India.Methods: A cross-sectional study was conducted on school going (class I to class VIII) tribal children (≥5 to <13years) during March 2019 to February 2020. A complete blood count was done by automated blood cell counter and anemia was classified as per WHO criteria.  They were also tested for markers of common nutritional anemias (serum ferritin, serum vitamin B12 and serum folate). Data entry and analysis was done on SPSS version 15. A p-value of <0.05 was considered statistically significant.Results: Total 1, 010 tribal children were included with male:female=1:1.35. Among these, 46.34% (n=468) children had anemia. Among all anemic children 47.65% (n=223), 51.93% (n=243/468) and 0.42% (n=2) respectively had mild, moderate and severe anemia. There was a high prevalence (81.68%) of microcytic red blood cells in the total cohort; among anemic children, 53.94% have microcytosis while no macrocytosis was revealed. Among all grade anemias, iron, folate and vitamin B12 deficiency were found in 44.65% (n=209/468), 13.24% (n=62/468) and 25% (n=117/468) respectively.Conclusions: The prevalence of anemia among tribal children of West Bengal is a matter of concern. The high prevalence of microcytic indices in non-anemic population highlights the dire need for screening for the causes of anemia in this population. 


Author(s):  
Dimitrios Kazantzis ◽  
Panagiotis Theodossiadis ◽  
Christos Kroupis ◽  
George Theodossiadis ◽  
Irini Chatziralli

Abstract Purpose To evaluate the association between serum vitamin B12/folate and retinal vein occlusion (RVO). Methods A comprehensive search of the PubMed database was performed, which identified 271 abstracts to be screened. Ten studies met our inclusion criteria and a meta-analysis of these comparative case-control studies was performed on the mean ± standard deviation serum vitamin B12 and folate levels, without language restrictions. Nine studies with 720 patients with RVO and 613 controls were included in the meta-analysis for vitamin B12, and 10 studies with 784 patients with RVO and 677 controls in the meta-analysis for folate. Results There was no statistically significant difference between patients with RVO and controls in serum vitamin B12 levels (mean difference: − 40.25 pg/mL, p = 0.28), either central RVO (mean difference: − 18.24 pg/mL, p = 0.71) or branch RVO (mean difference: − 23.56 pg/mL, p = 0.48). On the contrary, the plasma folate level was significantly lower in RVO patients than in controls (mean difference: − 1.34 ng/mL, p = 0.001), as well as in patients with CRVO compared to controls (mean difference: − 1.48 ng/mL, p = 0.006), but not in BRVO patients (mean difference: − 0.72 ng/mL, p = 0.11). Conclusions RVO is associated with low serum folate levels, but not with serum vitamin B12 levels.


2019 ◽  
Vol 44 (5) ◽  
pp. 661-666
Author(s):  
Dilber Çoban Ramazan ◽  
Ülker Anadol ◽  
A. Destina Yalçın ◽  
A. Süha Yalçın

Abstract Objective Homocysteine is a sulfur containing amino acid that is formed during methionine metabolism. Patients under long-term antiepileptic drug treatment often have hyperhomocysteinemia. These patients have low levels of serum folate, vitamin B12 and vitamin B6, all of which are associated with homocysteine metabolism. We have investigated the effects of valproic acid and new generation antiepileptic drugs (lamotrigine and levetiracetam) on plasma levels of homocysteine and aminothiols as well as serum vitamin B12 and folic acid. Materials and methods Forty-seven idiopathic epileptic patients on antiepileptic drugs were compared with 38 age-matched healthy controls. Commercial immunoassay methods were used for vitamin B12 and folic acid analyses. Homocysteine, cysteine, cysteinylglycine and glutathione levels were determined by high performance liquid chromatography. Results There was no significant difference in patient and control values in terms of vitamin B12, folic acid and homocysteine. Valproic acid and lamotrigine seemed to effect aminothiol redox status. Glutathione levels of epileptic patients receiving valproic acid and lamotrigine were higher than controls. Conclusion Our results suggest that redox homeostasis may be impaired and glutathione synthesis increased in response to the oxidative stress caused by antiepileptic drug use.


Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2815 ◽  
Author(s):  
Ann-Kathrin Lederer ◽  
Luciana Hannibal ◽  
Manuel Hettich ◽  
Sidney Behringer ◽  
Ute Spiekerkoetter ◽  
...  

Vegans are at an increased risk for certain micronutrient deficiencies, foremost of vitamin B12. Little is known about the short-term effects of dietary change to plant-based nutrition on vitamin B12 metabolism. Systemic biomarkers of vitamin B12 status, namely, serum vitamin B12 and holotranscobalamin, may respond quickly to a reduced intake of vitamin B12. To test this hypothesis, 53 healthy omnivore subjects were randomized to a controlled unsupplemented vegan diet (VD, n = 26) or meat-rich diet (MD, n = 27) for 4 weeks. Vitamin B12 status was examined by measurement of serum vitamin B12, holotranscobalamin (holo-TC), methylmalonic acid (MMA) and total plasma homocysteine (tHcy). Holo-TC decreased significantly in the VD compared to the MD group after four weeks of intervention, whereas metabolites MMA and tHcy were unaffected. Body weight remained stable in both groups. VD intervention led to a significant reduction of cholesterol intake, and adequate profiles of nutrient and micronutrient status. Lower intake of vitamin B12 was observed in VD, which was mirrored by a lower concentration of serum vitamin B12 and reduced holo-TC after 4 weeks. Plasma holo-TC may be a fast-responding biomarker to monitor adequate supply of vitamin B12 in plant-based individuals.


Pteridines ◽  
2007 ◽  
Vol 18 (1) ◽  
pp. 122-127
Author(s):  
Bakhouche Houcher ◽  
Mirande Candito ◽  
Pierre Gibelin

Abstract Elevated plasma total homocysteine (tHcy) is an independent risk factor for cardiovascular disease (CVD). Also known is that plasma folate and vitamin B12 influence homocysteine metabolism as cosubstrate and cofactor, respectively. This population-based study was conducted to evaluate the plasma concentrations of tHcy, folate, and vitamin B12 in 54 older patients aged ≥51 years (40 males; 14 females) of Nice hospital cardiology service. After excluding cases with a serum creatinine >120 mmol/L, we established the test properties of a plasma tHcy concentration <15 μmol/L (Group 1) or ≥15 μmol/L (Group 2). In the population aged ≥51 years, plasma tHcy was higher in women (18.0 μmol/L) than in men (15.5 μmol/L; not significant), conversely, serum vitamin B12 was higher in men (376.9 pg/ml) than in women (340.7 pg/ml; not significant). Average plasma tHcy was 11.5 μmol/L in Group 1 and 21.6 μmol/L in Group 2. Vice versa, serum vitamin B12 was higher in Group 1 (419.5 pg/ml) than in Group 2 (307.2 pg/ml) (p <0.05). Correlation analysis (Pearson's r) in the total study population (20-84 years) indicated an inverse correlation between serum folate and age (r = -0.231, p <0.05). In the subjects, aged ≥51 years, there was a significant negative correlation between age and tHcy levels (r = -0.283, p <0.05) and serum vitamin B12 concentrations (r = -0.326, p <0.01) but not with serum folate. However, in subjects with tHcy <15 μmol/L, a significant inverse correlation existed between plasma tHcy and serum folate (r = -0.455; p <0.05). In conclusion, these results highlight the relevance of the vitamin status and particularly of folate levels in the modulation of fasting tHcy levels in the patients with clinical hyperhomocysteinemia, defined as plasma tHcy >15 μmol/L.


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