PMID- 34540601
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210921
IS  - 0253-8253 (Print)
IS  - 2227-0426 (Electronic)
IS  - 0253-8253 (Linking)
VI  - 2021
IP  - 2
DP  - 2021
TI  - Association of vitamin B12 deficiency with metformin use in patients with type 2 
      diabetes treated in the largest tertiary care hospital in Qatar.
PG  - 39
LID - 10.5339/qmj.2021.39 [doi]
LID - 39
AB  - BACKGROUND: Data on the effect of metformin on serum vitamin B12 (VitB12) level 
      in patients with type 2 diabetes mellitus (T2DM) in Qatar are limited; therefore, 
      we aimed to assess the prevalence of VitB12 deficiency and its related factors 
      among patients with tbl2DM treated with metformin at Hamad General Hospital in 
      Doha, Qatar, from January 1, 2017, to December 31, 2017. METHODS: This 
      cross-sectional analytical study involved patients with tbl2DM aged >/= 18 years 
      who used metformin for at least 3 months. The serum VitB12 was quantified on a 
      chemiluminescent enzyme immunoassay analyzer using Cobas e 801 module, Roche, and 
      VitB12 deficiency was defined as serum VitB12 level of </= 145 pmol/L. All data 
      were obtained from the patients' electronic medical records. RESULTS: The study 
      recruited 3124 eligible patients with tbl2DM. The overall prevalence of 
      metformin-associated VitB12 deficiency was 30.7% [95% confidence of interval, 
      0.290-0.323]. A significant difference exists in the median VitB12 levels between 
      the VitB12-normal and VitB12-deficient groups [129 vs. 286; p < 0.001]. Compared 
      with the VitB12-normal group, the VitB12-deficient group had higher mean body 
      mass index (BMI) (p < 0.001) and consumed higher doses of metformin (p = 0.001). 
      They also more often used sulfonylurea (p = 0.004), dipeptidyl peptidase-4 
      inhibitor (p < 0.001), thiazolidinediones (p < 0.001), glucagon-like peptide 1 
      [GLP-1] receptor agonists (p < 0.001), alpha-glucosidase inhibitor (p < 0.001), 
      and H2 blocker/proton pump inhibitors [PPI] (p < 0.001) than the VitB12-normal 
      group. Moreover, the VitB12-normal group consumed more calcium supplements 
      (p < 0.001) than the VitB12-deficient group. In the multivariate analysis, 
      independent risk factors for metformin-associated VitB12 deficiency in patients 
      with tbl2DM include high daily dose of metformin >2000 mg, male gender, high BMI, 
      smoking, sulfonylurea, dipeptidyl peptidase-4 inhibitor, H2 blockers/PPI, low 
      fasting blood glucose, and low hemoglobin. CONCLUSION: This study showed a high 
      prevalence of VitB12 deficiency in patients with tbl2DM taking metformin and a 
      significant negative correlation between the daily dose of metformin and serum 
      VitB12 level. Therefore, regular screening for serum VitB12 is necessary in 
      patients with tbl2DM on metformin treatment, especially those who have the 
      abovementioned risk factors.
CI  - (c) 2021 Khan, Yousif, Suliman, Saleh, Magdi, Alshurafa, Hassan, Ghazy, Salameh, 
      Abdallah, licensee HBKU Press.
FAU - Yousef Khan, Fahmi
AU  - Yousef Khan F
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Yousif, Abdelmonem B
AU  - Yousif AB
AD  - Department of Pharmacy, Hamad General Hospital, Doha, Qatar.
FAU - Suliman, Aasir
AU  - Suliman A
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Saleh, Ahmed Osman
AU  - Saleh AO
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Magdi, Mohamed
AU  - Magdi M
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Alshurafa, Awni
AU  - Alshurafa A
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Abdelmoneim Hassan, Ebtihal
AU  - Abdelmoneim Hassan E
AD  - Department of Accident & Emergency, Hamad General Hospital, Doha, Qatar.
FAU - Ghazy, Ahmed
AU  - Ghazy A
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Salameh, Omar K
AU  - Salameh OK
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
FAU - Abdallah, Ahmed
AU  - Abdallah A
AD  - Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail: 
      fakhanqal@yahoo.co.uk.
LA  - eng
PT  - Journal Article
DEP - 20210909
PL  - Qatar
TA  - Qatar Med J
JT  - Qatar medical journal
JID - 8101648
PMC - PMC8428509
OTO - NOTNLM
OT  - Vitamin B12 deficiency
OT  - metformin
OT  - sulfonylurea compounds
OT  - type 2 diabetes mellitus
EDAT- 2021/09/21 06:00
MHDA- 2021/09/21 06:01
PMCR- 2021/09/09
CRDT- 2021/09/20 06:12
PHST- 2021/03/10 00:00 [received]
PHST- 2021/05/24 00:00 [accepted]
PHST- 2021/09/20 06:12 [entrez]
PHST- 2021/09/21 06:00 [pubmed]
PHST- 2021/09/21 06:01 [medline]
PHST- 2021/09/09 00:00 [pmc-release]
AID - qmj.2021.39 [pii]
AID - 10.5339/qmj.2021.39 [doi]
PST - epublish
SO  - Qatar Med J. 2021 Sep 9;2021(2):39. doi: 10.5339/qmj.2021.39. eCollection 2021.