Ho Mandy, Halim Jocelyn H, Gow Megan L, El-Haddad Nouhad, Marzulli Teresa, Baur Louise A, Cowell Chris T, Garnett Sarah P
Institute of Endocrinology and Diabetes, the Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.
Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia.
Nutrients. 2014 Dec 4;6(12):5611-8. doi: 10.3390/nu6125611.
Emerging evidence indicates an association between obesity, metformin use and reduced vitamin B12 status, which can have serious hematologic, neurologic and psychiatric consequences. This study aimed to examine B12 status in obese adolescents with pre-diabetes and/or clinical features of insulin resistance. Serum B12 was measured using chemiluminescence immunoassay in 103 (43 male, 60 female) obese (mean body mass index (BMI) z-score ± SD (2.36 ± 0.29)), adolescents aged 10 to 17 years, median (range) insulin sensitivity index of 1.27 (0.27 to 3.38) and 13.6% had pre-diabetes. Low B12 (<148 pmol/L) was identified in eight (7.8%) and borderline status (148 to 221 pmol/L) in an additional 25 (24.3%) adolescents. Adolescents with borderline B12 concentrations had higher BMI z-scores compared to those with normal concentrations (2.50 ± 0.22 vs. 2.32 ± 0.30, p = 0.008) or those with low B12 concentration (2.50 ± 0.22 vs. 2.27 ± 0.226, p = 0.041). In conclusion, nearly a third of obese adolescents with clinical insulin resistance had a low or borderline serum B12 status. Therefore, further investigations are warranted to explore the cause and the impact of low B12 status in obese pediatric populations.
新出现的证据表明，肥胖、使用二甲双胍与维生素B12水平降低之间存在关联，这可能会导致严重的血液学、神经学和精神学后果。本研究旨在检查患有糖尿病前期和/或胰岛素抵抗临床特征的肥胖青少年的维生素B12水平。采用化学发光免疫分析法对103名（43名男性，60名女性）肥胖青少年（平均体重指数（BMI）z评分±标准差为（2.36±0.29））进行血清维生素B12检测，这些青少年年龄在10至17岁之间，胰岛素敏感性指数中位数（范围）为1.27（0.27至3.38），13.6%患有糖尿病前期。8名（7.8%）青少年被确定为维生素B12水平低（<148 pmol/L），另外25名（24.3%）青少年处于临界状态（148至221 pmol/L）。与维生素B12浓度正常的青少年（2.50±0.22 vs. 2.32±0.30，p = 0.008）或维生素B12浓度低的青少年（2.50±0.22 vs. 2.27±0.226，p = 0.041）相比，维生素B12浓度处于临界状态的青少年BMI z评分更高。总之，近三分之一患有临床胰岛素抵抗的肥胖青少年血清维生素B12水平低或处于临界状态。因此，有必要进一步研究以探索肥胖儿童群体中维生素B12水平低的原因及其影响。
