Metaxas Corina, Zurwerra Chantal, Rudofsky Gottfried, Hersberger Kurt E, Walter Philipp N
Pharmaceutical Care Research Group, University of Basel, Switzerland.
Department of Medicine, Kantonsspital Olten, Switzerland.
Exp Clin Endocrinol Diabetes. 2018 Jun;126(6):394-400. doi: 10.1055/s-0043-120760. Epub 2018 Feb 2.
Assessment of the impact of type 2 diabetes (T2DM) and metformin use on vitamin B12 (VB12) associated biomarkers and their suitability to represent VB12 supply.
Differences of VB12, holotranscobalamine (HoloTc), the biologically active fraction (%AB12)=HoloTc/VB12*100 and homocystein (Hcy) were analysed i) among diabetic outpatients with (DMMet+ ) and without metformin use (DMMet-) and ii) in comparison to an external non-diabetic reference group with low VB12 (<200 pmol/L).
VB12 associated biomarkers were distributed equally between DMMet+ (n=29, 58%) and DMMet- (n=21, 42%). Significant differences in %AB12 in diabetic patients with low VB12 (n=19) compared to the non-diabetic reference group (n=31) were found. Higher %AB12 was associated with diabetes. Hcy levels were significantly associated with age, folic acid level, renal function and HoloTc but not with VB12.
In T2DM patients with low VB12, %AB12 was confirmed as being higher in comparison to nondiabetic patients. The effect was not clearly attributable to metformin use. HoloTc was unaffected by the lowering of VB12 and significantly associated with the functional marker Hcy. Both findings support the use of HoloTc for the assessment of VB12 supply in diabetic patients.
评估2型糖尿病（T2DM）及二甲双胍的使用对维生素B12（VB12）相关生物标志物的影响，以及这些生物标志物用于代表VB12供应情况的适用性。
分析了i）使用二甲双胍的糖尿病门诊患者（DMMet+，n = 29，58%）和未使用二甲双胍的糖尿病门诊患者（DMMet-，n = 21，42%）之间以及ii）与VB12水平低（<200 pmol/L）的外部非糖尿病参考组相比，VB12、全转钴胺素（HoloTc）、生物活性部分（%AB12）=HoloTc/VB12×100以及同型半胱氨酸（Hcy）的差异。
VB12相关生物标志物在DMMet+组和DMMet-组之间分布均匀。发现VB12水平低的糖尿病患者（n = 19）与非糖尿病参考组（n = 31）相比，%AB12存在显著差异。较高的%AB12与糖尿病相关。Hcy水平与年龄、叶酸水平、肾功能和HoloTc显著相关，但与VB12无关。
在VB12水平低的T2DM患者中，与非糖尿病患者相比，%AB12确实更高。这种影响不能明确归因于二甲双胍的使用。HoloTc不受VB12降低的影响，且与功能标志物Hcy显著相关。这两个发现均支持使用HoloTc来评估糖尿病患者的VB12供应情况。
