Department of Medical Laboratory Science, Jadara University, Irbid, Jordan.
PLoS One. 2022 Dec 30;17(12):e0279740. doi: 10.1371/journal.pone.0279740. eCollection 2022.
To describe the prevalence of vitamin B12 deficiency among Jordanian patients with type 2 diabetes mellitus treated with metformin and to compare the findings with those who did not receive metformin.
Total 155 patients with type 2 diabetes mellitus, aged between 48 and 82 years were enrolled in the current study. They were divided into two groups; the first (n = 120) was treated with metformin while the second (n = 35) was not. Patients' demographics (age, gender, duration of type 2 diabetes mellitus, smoking status), medication parameters (daily dosage and duration of metformin therapy), and biochemical parameters (hemoglobin level, mean corpuscular volume (MCV), serum vitamin B12, and folate level) were recorded. Definite deficiency was defined as serum vitamin B12 levels of < 150 pg/ml, whereas < 200 pg/ml indicated possible deficiency.
The mean serum ± standard deviation (SD) vitamin B12 level was significantly lower in patients who were treated with metformin (268.5 ± 35.8 vs. 389.5 ± 29.8 pg/ml, p = 0.029). The metformin group had significantly higher prevalence of definite deficiency (32% vs. 9%, p < 0.02) and possible deficiency (48% vs. 30%, p < 0.02). Within the metformin group, the mean serum ± SD vitamin B12 level was significantly lower in those on high dosage (175.2 ± 30.5 vs. 315.6 ± 37.8 pg/ml, p < 0.001). MCV (μm3) levels ± SD were higher in the metformin group (87.5 ± 2.9 vs. 83.7 ± 2.4) with no statistical significance.
There is a significant association between metformin intake and vitamin B12 deficiency. Serum vitamin B12 levels should be checked by physicians and serial monitoring is necessary in patients who are treated with metformin.
描述接受二甲双胍治疗的约旦 2 型糖尿病患者维生素 B12 缺乏的患病率，并将研究结果与未接受二甲双胍治疗的患者进行比较。
共纳入 155 例年龄在 48 至 82 岁之间的 2 型糖尿病患者，将他们分为两组；第一组（n = 120）接受二甲双胍治疗，第二组（n = 35）未接受二甲双胍治疗。记录患者的人口统计学资料（年龄、性别、2 型糖尿病病程、吸烟状况）、药物参数（二甲双胍的日剂量和疗程）和生化参数（血红蛋白水平、平均红细胞体积（MCV）、血清维生素 B12 和叶酸水平）。明确缺乏定义为血清维生素 B12 水平<150pg/ml，<200pg/ml 表示可能缺乏。
接受二甲双胍治疗的患者血清维生素 B12 水平显著低于未接受二甲双胍治疗的患者（268.5 ± 35.8 比 389.5 ± 29.8pg/ml，p = 0.029）。二甲双胍组明确缺乏（32%比 9%，p<0.02）和可能缺乏（48%比 30%，p<0.02）的患病率明显更高。在二甲双胍组中，高剂量组的平均血清维生素 B12 水平显著较低（175.2 ± 30.5 比 315.6 ± 37.8pg/ml，p<0.001）。MCV（μm3）水平在二甲双胍组中较高（87.5 ± 2.9 比 83.7 ± 2.4），但无统计学意义。
接受二甲双胍治疗与维生素 B12 缺乏之间存在显著关联。接受二甲双胍治疗的患者，医生应检查血清维生素 B12 水平，必要时应进行连续监测。
