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- Title
Vitamin B12 and Folate Concentrations in Recent-onset Type 2 Diabetes and the Effect of Metformin Treatment.
- Authors
Kanti, Georgia; Anadol-Schmitz, Evrim; Bobrov, Pavel; Strassburger, Klaus; Kahl, Sabine; Zaharia, Oana P; Sarabhai, Theresia; Karusheva, Yanislava; Burkart, Volker; Markgraf, Daniel F; Trenkamp, Sandra; Ziegler, Dan; Szendroedi, Julia; Roden, Michael; GDS Group
- Abstract
<bold>Context: </bold>Vitamin B12 and folate deficiency are not only linked to hematological, neurological, and cardiovascular diseases, but are also associated with insulin resistance. Metformin can decrease vitamin B12 and folate concentrations.<bold>Objective: </bold>To examine (1) effects of short-term metformin treatment on serum holotranscobalamin (holoTC) and folate and (2) their association with insulin sensitivity in recent-onset type 2 diabetes.<bold>Design: </bold>This cross-sectional analysis comprised patients (known disease duration <12 months) on metformin monotherapy (MET, n = 123, 81 males, 53 ± 12 years) or nonpharmacological treatment (NPT, n = 126, 77 males, 54 ± 11 years) of the German Diabetes Study.<bold>Main Outcome Measures: </bold>HoloTC (enzyme-linked immunosorbent assay), cobalamin, and folate (electrochemiluminescence); beta-cell function and whole-body insulin sensitivity, measured during fasting (HOMA-B, HOMA-IR) and intravenous glucose tolerance tests combined with hyperinsulinemic-euglycemic clamp tests.<bold>Results: </bold>HoloTC (105.4 [82.4, 128.3] vs 97 [79.7, 121.9] pmol/L) and folate concentrations (13.4 [9.3, 19.3] vs 12.7 [9.3, 22.0] nmol/L) were similar in both groups. Overall, holoTC was not associated with fasting or glucose-stimulated beta-cell function and insulin-stimulated glucose disposal. Cobalamin measurements yielded similar results in representative subgroups. In NPT but not MET, folate levels were inversely correlated with HOMA-IR (r = -0.239, P = .007). Folate levels did not relate to insulin sensitivity or insulin secretion in the whole cohort and in each group separately after adjustment for age, body mass index, and sex.<bold>Conclusions: </bold>Metformin does not affect circulating holoTC and folate concentrations in recent-onset type 2 diabetes, rendering monitoring of vitamin B12 and folate dispensable, at least during the first 6 months after diagnosis or initiation of metformin.
- Subjects
VITAMIN B12; TYPE 2 diabetes; TREATMENT effectiveness; FOLIC acid; GLUCOSE tolerance tests; INSULIN resistance
- Publication
Journal of Clinical Endocrinology & Metabolism, 2020, pN.PAG
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa150