Olt Serdar, Oznas Orhan
Department of Internal Medicine Adıyaman University Faculty of Medicine, Adıyaman, Turkey.
North Clin Istanb. 2017 Oct 19;4(3):233-236. doi: 10.14744/nci.2017.98705. eCollection 2017.
The relationship between vitamin B12 deficiency and peripheral neuropathy has been shown in a number of previous studies. Metformin is the indispensable first-line treatment for type 2 diabetes mellitus (DM) worldwide. One of the adverse effects of the use of metformin is vitamin B12 deficiency. In the present study, we investigated the relationship between vitamin B12 deficiency and peripheral neuropathy due to the use of metformin.
Patient's laboratory and electromyography (EMG) data were retrospectively reviewed. Patients with no EMG report and other necessary information were excluded from the study.
Eighty-six patients with type 2 DM using metformin were included in the study. Of these patients, 26 were males and 60 were females. The mean age of the patients was 55.1±7.7 years. The mean body mass index of the patients was 29.1±9.01 kg/m. The mean HbA1c level of the patients was 8.6%±2.1%. The mean duration of diabetes was 8.02±5.4 years. The incidence of vitamin B12 deficiency was 38.4%. Peripheral neuropathy was detected in 33.7% patients. There was no statistically significant difference in vitamin B12 levels between patients with peripheral neuropathy and those without peripheral neuropathy (p=0.64).
Therefore, it can be concluded that the lack of vitamin B12 secondary to the use of metformin did not significantly increase the frequency of peripheral neuropathy.
先前的多项研究已表明维生素B12缺乏与周围神经病变之间的关系。二甲双胍是全球2型糖尿病（DM）不可或缺的一线治疗药物。使用二甲双胍的不良反应之一是维生素B12缺乏。在本研究中，我们调查了因使用二甲双胍导致的维生素B12缺乏与周围神经病变之间的关系。
对患者的实验室检查和肌电图（EMG）数据进行回顾性分析。没有EMG报告及其他必要信息的患者被排除在研究之外。
86例使用二甲双胍的2型糖尿病患者纳入本研究。其中男性26例，女性60例。患者的平均年龄为55.1±7.7岁。患者的平均体重指数为29.1±9.01kg/m。患者的平均糖化血红蛋白水平为8.6%±2.1%。糖尿病平均病程为8.02±5.4年。维生素B12缺乏的发生率为38.4%。33.7%的患者检测出周围神经病变。有周围神经病变的患者与无周围神经病变的患者之间维生素B12水平无统计学显著差异（p=0.64）。
因此，可以得出结论，使用二甲双胍继发的维生素B12缺乏并未显著增加周围神经病变的发生率。
