Department of Neurology and Stroke Unit, Tzafon Medical Center, Lower Galilee, Israel, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Department of Medicine, Tzafon Medical Center, Lower Galilee, Israel.
Isr Med Assoc J. 2023 Feb;25(2):122-125.
Type 2 diabetes mellitus (T2DM) is a known risk factor for cardiovascular disease and stroke. Metformin is an old, relatively safe, first line therapy for T2DM; however, it has been associated with stroke.
To study the effects of metformin use and vitamin B12 deficiency on stroke rate among patients with T2DM.
We conducted a prospective study of patients admitted with ischemic stroke within 12 months (starting March 2020). We studied the clinical impact of metformin on vitamin B12 deficiency and stroke evolution. Student's t-test and ANOVA were used to compare the groups of patients and to determine whether there was any direct or indirect effect of metformin use on vitamin B12 deficiency and stroke.
In total, 80 patients were admitted with ischemic stroke. Clinical status and biochemical data were collected and compared with healthy volunteers. There were 39 diabetic patients, 16 took metformin for at least 1 year. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014).
T2DM is a significant risk factor to the development of ischemic stroke. We found an association between metformin use and vitamin B12 deficiency and an association between vitamin B12 deficiency and stroke risk in patients with T2DM. Diabetic patients who are taking metformin should monitor their vitamin B12 level.
2 型糖尿病（T2DM）是心血管疾病和中风的已知危险因素。二甲双胍是 T2DM 的一种古老且相对安全的一线治疗药物；然而，它与中风有关。
研究二甲双胍的使用和维生素 B12 缺乏对 T2DM 患者中风发生率的影响。
我们对 12 个月内（从 2020 年 3 月开始）因缺血性中风入院的患者进行了前瞻性研究。我们研究了二甲双胍对维生素 B12 缺乏和中风演变的临床影响。使用学生 t 检验和方差分析比较患者组，并确定二甲双胍的使用是否对维生素 B12 缺乏和中风有直接或间接影响。
共有 80 名患者因缺血性中风入院。收集临床状况和生化数据，并与健康志愿者进行比较。有 39 名糖尿病患者，其中 16 名患者至少服用 1 年的二甲双胍。在至少服用 1 年二甲双胍的患者中，有 9 人维生素 B12 水平<240pg/ml（56.2%）；23 名糖尿病患者未服用二甲双胍，只有 4 人维生素 B12 水平<240pg/ml（17.4%）（P=0.014）。
T2DM 是发生缺血性中风的重要危险因素。我们发现，在服用二甲双胍的 T2DM 患者中，二甲双胍的使用与维生素 B12 缺乏之间存在关联，维生素 B12 缺乏与中风风险之间也存在关联。服用二甲双胍的糖尿病患者应监测其维生素 B12 水平。
