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Cited by 333Folate and B Vitamins ResearchPorphyrin Metabolism and DisordersHematological disorders and diagnostics

Risk Factors of Vitamin B12 Deficiency in Patients Receiving Metformin

Ting, Rose Zhao-Wei·2006·Archives of Internal Medicine
DOI 10.1001/archinte.166.18.1975
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Abstract

BACKGROUND: Identification of risk factors for metformin-related vitamin B(12) deficiency has major potential implications regarding the management of diabetes mellitus. METHODS: We conducted a nested case-control study from a database in which the source population consisted of subjects who had levels of both serum vitamin B(12) and hemoglobin A(1c) checked in a central laboratory. We identified 155 cases of diabetes mellitus and vitamin B(12) deficiency secondary to metformin treatment. Another 310 controls were selected from the cohort who did not have vitamin B(12) deficiency while taking metformin. RESULTS: A total of 155 patients with metformin-related vitamin B(12) deficiency (mean +/- SD serum vitamin B(12) concentration, 148.6 +/- 40.4 pg/mL [110 +/- 30 pmol/L]) were compared with 310 matched controls (466.1 +/- 330.4 pg/mL [344 +/- 244 pmol/L]). After adjusting for confounders, we found clinically important and statistically significant association of vitamin B(12) deficiency with dose and duration of metformin use. Each 1-g/d metformin dose increment conferred an odds ratio of 2.88 (95% confidence interval, 2.15-3.87) for developing vitamin B(12) deficiency (P<.001). Among those using metformin for 3 years or more, the adjusted odds ratio was 2.39 (95% confidence interval, 1.46-3.91) (P = .001) compared with those receiving metformin for less than 3 years. After exclusion of 113 subjects with borderline vitamin B(12) concentration, dose of metformin remained the strongest independent predictor of vitamin B(12) deficiency. CONCLUSIONS: Our results indicate an increased risk of vitamin B(12) deficiency associated with current dose and duration of metformin use despite adjustment for many potential confounders. The risk factors identified have implications for planning screening or prevention strategies in metformin-treated patients.

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  • Vitamin B12 deficiency is related to dose and duration of metformin use and occurs more frequently among patients who use it for more than 3 years and in higher doses.

    “Vitamin B12 deficiency has been related with dose and duration of metformin use and occurs more frequently among patients that use it for more than 3 years and in higher doses [169].”

    From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [169]

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Authors
Ting, R. Z.-W.
Affiliations
Chinese University of Hong Kong (HK)
Corresponding author
Ting, Rose Zhao-Wei
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2006-10-09
Volume
166
Issue
18
Pages
1975
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.166.18.1975
OpenAlex
W2146883482
Cited by
333
References
19
Citations by year
2026: 4 · 2025: 12 · 2024: 13 · 2023: 24 · 2022: 18 · 2021: 24 · 2020: 20 · 2019: 17 · 2018: 19 · 2017: 16 · 2016: 27 · 2015: 14 · 2014: 15 · 2013: 14 · 2012: 15
FWCI
8.53
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Porphyrin Metabolism and Disorders
  • Health Sciences › Medicine › Emergency Medicine › Hematological disorders and diagnostics
Keywords
vitamin B12 deficiency, metformin, metformin dose, diabetes mellitus, risk factors, drug-induced vitamin deficiency, screening
MeSH terms
Age Factors, Aged, Diabetes Mellitus, Dose-Response Relationship, Drug, Female, Hong Kong, Humans, Hypoglycemic Agents, Male, Metformin, Risk Factors, Vitamin B 12 Deficiency, Odds Ratio, Case-Control Studies, Databases as Topic

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